CABB Transfusion Medicine Flashcards

1
Q

How do you prepare a canine blood donor

A

Take blood in EDTA tube to do PCV/TP
Clip an area 5cm x 5cm over the mid-jugular region over jugular area
Apply emla cream +apply bandage 20- 30 minutes before collection
GPE (Veterinarian to sign off)
Scan for microchip, ( if no microchip- fill out paperwork for microchip)

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2
Q

Equipment required for blood donation

A

Clippers
450ml blood collection bag with/CPD
Electronic weigh scales 1000g
Material for neck bandage
5 -6 swabs , kling and Vet Wrap +Scissors
Plastic or guarded hemostat ( what for ?)
Vacuum pump
Padded table and a rolled up towel to place under the dog’s neck

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3
Q

What is the role of the Phlebotomist assistant in blood donation before the needle is in the dog

A

Remove collection bag from its plastic storage bag.
Place the empty collection bag on the scales inside the vacuum container
zero the scale
Note the bags are hung such that the blood flows through the anticoagulant during the collection
guarded hemostat to clamp 5cm from needle on collection tubing

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4
Q

What is the role of the phlebotomist assistant in blood donation once the needle is in the dog

A

Once Phlebotomist has inserted the needle in the skin, the assistant removes the hemostat clamp
Once the needle is in the jugular, the assistant turns on the vacuum pump and observes the scale.
When the scale gets up to approx. 450 ml, Assistant turns off pump, clamps the tube,
Needle is withdrawn

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5
Q

What is the role of the TA/Student after blood is drawn

A
Apply pressure to neck area for 5 mins
Put on neck bandage
Remove donor dog from table
Give ½ can of gastrodiet
Check demeanour, heart rate, mucous membrane colour and pulse quality after eating and 15 minutes later
Check neck area for hematoma 
If all OK-  Donor can go home-
Check neck area 1 hour later.
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6
Q

What happens to the collection bag once the blood has been drawn

A

Blood in the collection tube is stripped into bag
Bag is rocked gently to fully mix the anticoagulant
The collection tube is allowed to fill with blood again.
A heat sealer is used to make the segments

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7
Q

Why do we make segments in the bag

A

to allow for crossmatching without contaminating the bag

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8
Q

What do we do with the bag once the segments have been made

A

Collection bag is clearly labeled with Donors ID number
Some blood is collected and sent to IDEXX for testing of specific canine blood born diseases.
Bag is put into fridge to chill blood
Blood is chipped to CABB for processing into its components

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9
Q

Why do we use a vacuum pump when doing canine blood donation

A

Because dogs do not donate as quickly as humans, a vacuum pump assists to ensure a quick donation. Most donations are complete within 5 to 10 minutes.

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10
Q

What happens once the blood bank receives our blood

A

they spin it and separate the plasma into a bag and the packed red blood cells

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11
Q

what happens to the plasma once it’s been seperated

A

they spin it again, and separate the platelets from the plasma.

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12
Q

What is the lifespan of the red blood cell concentrate

A

1 month

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13
Q

How long do the separated platelets last for

A

5-7 days

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14
Q

What is the red cell concentrate used for

A

To treat anemia

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15
Q

How long do you need to let the packed red blood cells to come to room temperature

A

30 minutes to come to room temperature.

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16
Q

How long can the packed red blood cells be left out

A

within 6 hours of being out of the fridge

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17
Q

Why do you need to filter the packed RBC

A

To prevent thromboembolic complications by trapping cells, cellular debris and coagulated protein.

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18
Q

What is frozen plasma or cryosupernatant used for

A
Rodenticide poisoning
Parvovirus
Replacing proteins
Pancreatitis
Christmas Disease (clotting)
Orphan puppies (antibodies)
19
Q

What is the cryoprecipitate used for

A

Treating Hemophilia A

Treating von Willebrand’s

20
Q

What is fresh frozen plasma used for

A

Treating Hemophilia A and von Willebrand’s. Use when cryoprecipitate is not available.

21
Q

How do you thaw and warm frozen plasma

A

Frozen products should be thawed in a 37 C warm bath inside plastic baggy
DO NOT OVERHEAT

22
Q

What would you write for blood bank record keeping

A
Date
Unit Number
Product type
Recipient
Disposition
Used?
Outdated and discarded?
23
Q

What is involved in patient monitoring

A

Vital signs pre-transfusion
Close supervision for first 30 minutes of a transfusion
Regular scheduled monitoring 15 minute interval

24
Q

When do acute blood transfusion reactions occur

A

within 24hrs of start of transfusion

25
Q

when do delayed blood transfusion reactions occur

A

after 24hrs of start of transfusion.

26
Q

A blood tranfsusion reaction has two levels of severity which are

A

mild and life threatening

27
Q

what are the two types of blood transfusion reactions

A

immune mediated or non immune mediated

28
Q

what does an immune mediated blood transfusion reaction involve

A

an antibody-antigen reaction

29
Q

What are the 4 types of immune mediated blood transfusion reactions

A

Acute hemolytic transfusion reaction (AHTR)
Delayed hemolytic transfusion reaction
Anaphylactic reaction
Febrile reaction

30
Q

what is a febrile reaction

A

antibody reaction to donor platelets or white blood cells

31
Q

what are the 6 types of non immune mediated reactions

A
Circulatory overload
Citrate toxicity
Hemolysis
Coagulopathy
Hypothermia
Pulmonary microembolism
32
Q

Describe an acute hemolytic reaction

A
Most feared reaction
Very rare
Usually avoided by performing crossmatch
Most common cause is clerical error
rapid onset, within 5 minutes
33
Q

What happens during an acute hemolytic reaction

A
Intravascular hemolysis
Uncontrolled bleeding
Shock
Acute renal failure
convulsions
34
Q

Describe a delayed hemolytic reaction

A
Occurs 3-21days after transfusion
Often sub-clinical to mild
Fever
Anorexia
Mild jaundice
35
Q

Describe an anaphylactic reaction

A
Onset rapid, 1-45 minutes 
Emesis
Hypertension
Severe shock
Edema
Dyspnea
Bronchoconstriction
36
Q

Describe a febrile reaction

A

Occurs within 30 minutes, can last up to 8 hours
Temperature increase of at least 1° C and no other cause of fever can be found
Vomiting
Tremors

37
Q

Describe a circulatory overload and what causes it

A

Prevented by calculating volume of blood products into total daily fluid intake
Patients with cardiac disease most at risk
Dyspnea, coughing, tachycardia, pulmonary edema, vomiting
Congestive heart failure

38
Q

Describe citrate toxicity

A

Dangerous in patients with liver disease
Chills
Humans feel tingling in extremities, chills, iron taste in mouth, scalp feeling too tight
Oral calcium supplement relieves symptoms
Keep patient warm

39
Q

What can hemolysis cause

A
Free hemoglobin in unit
Thermal
Mechanical
Hemoglobinuria
Renal failure
Shock
40
Q

Describe coagulopathy

A

Massive transfusion within 24 hours can cause Depletion of coagulation factors
Not a common problem in animal

May need correction with infusion of cryoprecipitate or FFP

41
Q

Describe hypothermia effects during blood transfusion

A

Infusion of cold blood products
Cardiac arrhythmia
Sudden death

Warm blood products to no higher than 37°C

42
Q

What is a pulmonary embolism

A

Microaggregates of platelets and fibrin during storage
May pass through standard blood filter
Danger to patients with tiny vasculature
Use pediatric filter for cats and small dogs

43
Q

What do you do if the animal is having a reaction

A

Stop the transfusion
determine the type of reaction
Initiate appropriate treatment