CABB Transfusion Medicine Flashcards
How do you prepare a canine blood donor
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)
Equipment required for blood donation
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
What is the role of the Phlebotomist assistant in blood donation before the needle is in the dog
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
What is the role of the phlebotomist assistant in blood donation once the needle is in the dog
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Needle is withdrawn
What is the role of the TA/Student after blood is drawn
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.
What happens to the collection bag once the blood has been drawn
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
Why do we make segments in the bag
to allow for crossmatching without contaminating the bag
What do we do with the bag once the segments have been made
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
Why do we use a vacuum pump when doing canine blood donation
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.
What happens once the blood bank receives our blood
they spin it and separate the plasma into a bag and the packed red blood cells
what happens to the plasma once it’s been seperated
they spin it again, and separate the platelets from the plasma.
What is the lifespan of the red blood cell concentrate
1 month
How long do the separated platelets last for
5-7 days
What is the red cell concentrate used for
To treat anemia
How long do you need to let the packed red blood cells to come to room temperature
30 minutes to come to room temperature.
How long can the packed red blood cells be left out
within 6 hours of being out of the fridge
Why do you need to filter the packed RBC
To prevent thromboembolic complications by trapping cells, cellular debris and coagulated protein.
What is frozen plasma or cryosupernatant used for
Rodenticide poisoning Parvovirus Replacing proteins Pancreatitis Christmas Disease (clotting) Orphan puppies (antibodies)
What is the cryoprecipitate used for
Treating Hemophilia A
Treating von Willebrand’s
What is fresh frozen plasma used for
Treating Hemophilia A and von Willebrand’s. Use when cryoprecipitate is not available.
How do you thaw and warm frozen plasma
Frozen products should be thawed in a 37 C warm bath inside plastic baggy
DO NOT OVERHEAT
What would you write for blood bank record keeping
Date Unit Number Product type Recipient Disposition Used? Outdated and discarded?
What is involved in patient monitoring
Vital signs pre-transfusion
Close supervision for first 30 minutes of a transfusion
Regular scheduled monitoring 15 minute interval
When do acute blood transfusion reactions occur
within 24hrs of start of transfusion
when do delayed blood transfusion reactions occur
after 24hrs of start of transfusion.
A blood tranfsusion reaction has two levels of severity which are
mild and life threatening
what are the two types of blood transfusion reactions
immune mediated or non immune mediated
what does an immune mediated blood transfusion reaction involve
an antibody-antigen reaction
What are the 4 types of immune mediated blood transfusion reactions
Acute hemolytic transfusion reaction (AHTR)
Delayed hemolytic transfusion reaction
Anaphylactic reaction
Febrile reaction
what is a febrile reaction
antibody reaction to donor platelets or white blood cells
what are the 6 types of non immune mediated reactions
Circulatory overload Citrate toxicity Hemolysis Coagulopathy Hypothermia Pulmonary microembolism
Describe an acute hemolytic reaction
Most feared reaction Very rare Usually avoided by performing crossmatch Most common cause is clerical error rapid onset, within 5 minutes
What happens during an acute hemolytic reaction
Intravascular hemolysis Uncontrolled bleeding Shock Acute renal failure convulsions
Describe a delayed hemolytic reaction
Occurs 3-21days after transfusion Often sub-clinical to mild Fever Anorexia Mild jaundice
Describe an anaphylactic reaction
Onset rapid, 1-45 minutes Emesis Hypertension Severe shock Edema Dyspnea Bronchoconstriction
Describe a febrile reaction
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
Describe a circulatory overload and what causes it
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
Describe citrate toxicity
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
What can hemolysis cause
Free hemoglobin in unit Thermal Mechanical Hemoglobinuria Renal failure Shock
Describe coagulopathy
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
Describe hypothermia effects during blood transfusion
Infusion of cold blood products
Cardiac arrhythmia
Sudden death
Warm blood products to no higher than 37°C
What is a pulmonary embolism
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
What do you do if the animal is having a reaction
Stop the transfusion
determine the type of reaction
Initiate appropriate treatment
