Blood typing and transfusions Flashcards

Question

Answer 1

Anemic patients Many causes Hemolysis Hemorrhage Trauma victims Hypovolemic shock resulting from Internal haemorrhage Spelic or liver lacerations These highly vascular organs beel rapidly and excessively Difficult to manage as they are non-compressible External hemorrhage Easier to recognize and treat Catastrophic blood vessel injury May pr may not be compressible External: apply tourniquet or compress the area Internal: often require surgical correction Stabilise patient

Answer 2

Hypothermia Pale mm CRT >2s Tachycardia Tachypnea Hypotension depressed/unresponsive

Answer 3

Blood is filtered before administration or while it is being given Use in line filters– retains blood clots, platelet microaggregates, WBCs and fat Warm blood products to 37*C in a water bath Concurrent fluid therapy in 0.9% saline Avoid calcium containing solutions (LRS) – clot formation Avoid hypotonic solutions (5% dextrose in water or hypotonic NaCl) – RBC lysis Maximum rate of administration is 10ml/kg/hr, except in those suffering from hypovolemic shock Recipient may be pretreated Diphenhydramine 1-3mg/kg IM or SQ Administer IV using strict aseptic technique Complete the transfusion within 4 hours to prevent contamination of the blood supply Volume to be administered us based in body weight, estimated blood volume, hematocrit and the goal of therapy

Answer 4

1 unit = 450ml (dogs) 1 unit = 50-60ml (cats) Volume guidelines 10ml/kg of packed RBCs 20ml/kg of whole blood

Answer 5

Blood type and crossmatch Use 0.5-1ml/kg/hr of whole blood for the first 15-30min as a test dose Watch for signs of reaction If none, proceed with the transfusions

Answer 6

Recommended for acute haemorrhage, anemia, coagulation disorders, and thrombocytopenia Provides RBC Plasma proteins Viable platelets All clotting factors

Answer 7

Recommended for anaemic patients Provides RBC Plasma protein Stable coagulation factors including fibrinogen NO platelets NO FACTORS V AND VIII

Answer 8

Blood often stored after having been split into its various components Packed RBC For patients that are anaemic but not hypovolemic Plasma Used to increased blood volume Provides immunoglobulins Provide coagulation factors

Answer 9

Decreased pH Decreased calcium Decreased 2,3-DPG Decreased ATP Increased ammonia levels Increased potassium ions in some japanese breeds of dogs Bacterial proliferation/contamination

Answer 10

Due to the problems of finding compatible donors and disease transmission, a substitute for blood has been sought Oxyglobin Blood is collected aseptically from cattle and filtered to remove the Hgb from the rest of the RBC The Hgb structure is similar between species, it is minimally antigenic There is no need for typing or crossmatching Labelled for use in dogs but has also been used off label in cats, horses, llamas, birds and humans

Answer 11

Hemolysis Hemoglobinemia Hemoglobinuria DIC Acute renal failure Death Allergic reactions that are non-hemolytic Volume overload/overly rapid delivery Pulmonary edema Bacterial contamination of blood Hypocalcemia Disease transmission Decreased PCV If a transfusion reaction occurs, it means that the transfusion is not doing the intended job There are added complications for an already compromised patient

Answer 12

Immunologic–due to donor and recipient incompatibility Acute or delayed hemolysis Non-immunologic–due to mishandling of RBCs

Answer 13

Hyperthermia Tachycardia Tachypnea Agitation/restlessness Muscle tremors Urticaria,pruritis–leading to anaphylaxis Nausea, salivation, vomiting Hypotension SHOCK

Answer 14

STOP the transfusion and alert the veterinarian Administer intravenous crystalloids Dexamethasone 0.25mg/kg given IV slowly Diphenhydramine 2 mg/kg given IM Q8H Epinephrine (1:10,000) 0.1mg/kg IM The protocol should be determined by the veterinarian before the transfusion begins IF the allergic reaction is mild, you can try to restart the transfusion at a slower administration rate WHILE MONITORING THE PATIENT CLOSELY

Answer 15

The tube method Gold standard Only used in reference labs Described on Pages 118-119 of your textbook Card agglutination tests Immunochromatography assay

Answer 16

Brand–Rapid Vet-H Fast and accurate Samples must be free of autoagglutination Cards are available for Typing dogs as DEA 1, 4, 5 and DAL positive or negative Typing cats as A, B or AB Uses monoclonal antibodies specific to the erythrocyte antigens that are being tested for Requires whole blood in an EDTA tube

Answer 17

A rapid and accurate test method Very similar to the canine heartworm test Lines indicate the patient’s blood type Uses a positive control for each test

Answer 18

Major Crossmatch: 2 drops of recipient plasma are mixed with 2 drops of washed donor cells Minor Crossmatch: 2 drops of donor plasma are mixed with 2 drops of washed recipient cells Controls: 2 drops of donor plasma is mixed with 2 drops of washed donor cells AND 2 drops of recipient plasma is mixed with 2 drops of washed recipient cells Incubate for 15-30 minutes Centrifuge for 5 minutes and examine the tubes for evidence of hemolysis or agglutination Procedure is described if further detail on Page 120 in your textbook Commercial cross matching kits are also available

Answer 19

Used to detect whether agglutination or hemolysis are likely to occur when the donor and recipient blood samples are mixed→ serological incompatibility Reduces the likelihood of a transfusion reaction

Answer 20

Should be done prior to any transfusion, but especially when: The animal had a blood transfusion at least 3-4 days earlier Unknown donor history Donor blood type unknown Breeding female

Answer 21

Cross matching does NOT prevent sensitization of the patient to future transfusions Even though a specific blood donor is crossmatch compatible with the patient today, if 5 or more days have passed since the first transfusion and additional transfusions are needed, another crossmatch MUST be performed