CCP 107 - Transfusion Medicine Flashcards
List the components of blood
- Erythrocytes (red blood cells)
- Leukocytes (white blood cells)
- Thrombocytes (platelets)
- Plasma
Describe the makeup, origin and function of “Erythrocytes”
- Red Blood Cells
- Developed in the bone marrow
- 4 hemoglobin/erythrocyte
- Oxygen (O2) and carbon dioxide CO2 transport
Describe the function and type of “Leukocytes”
- White Blood Cells
“Never Let Monkeys Eat Bananas”
- Neutrophils - 60% - respond to tissue damage, phagocytize bacteria, live 4 days
- Lymphocytes - 30% - immune response, T cells and B cells
- Monocytes - 6% - become macrophages, clean up tissue damage
- Eosinophils - 3% - responds to histamine/allergic reactions and parasites
- Basophils - 1% - become mast cells, produce histamine and heparin
Describe function of “Thrombocytes”
- Platelets
- A factor in clot formation
- Activated by collagen, thromboxane A2, ADP or thrombin
- Will become “sticky” and attach to other platelets to grow the plug - stabilized by fibrin
Describe the makeup and function of “Plasma”
- Plasma
- Liquid Component of blood
- Carries clotting factors
- 92-95% water, 5-8% proteins (globulin/albumin/fibrinogen), clotting factors, glucose, electrolytes, hormones, CO@ and O2
Describe the functions of blood
- Ph regulator
- Temperature Regulator
- Supplies O2
- Supplies Nutrients - Glucose, amino acids, fatty acids
- Removal of waste - CO2, Urea Lactic Acid
- Immunological Functions - Carries WBC, contains antibodies
- Coagulation
- Messenger - Transport of hormones, singling tissue damage
Explain the ABO/Rh system for red blood cells
Blood typing system (ABO):
- A system that defines the antigen (flag/marker that defines the cell) on a cell body and its compatibility with other blood types
- Cells with the same antigens can be transfused with like antigen cells
Explain the ABO/Rh system for plasma
Plasma typing system (ABO):
- A system that defines the antibody (Ig immunoglobulin) within the plasma
- Will activate when it senses “non-self” antigens causing agglutination
- No Rh factor designation
Define RhD
- Rh blood group, D antigen
- Originally discovered in Rhesus monkeys
- Can create transfusion reactions with mother/child during pregnancy
Discuss HLA in the setting of blood administration
- Proteins present on White Blood Cells (WBC)
- When blood cells are transfused without adequate leukoreduction into someone who is immunocompromised the donor cells recognize the recipients cells as “non-self” and attack the recipient cells - Graft vs Host Disease
- leads to end organ failure, DIC, death
List available Blood Products
- Packed Red Blood Cells (PRBC)
- Platelets
- Fresh Frozen Plasma (FFP)
- Cryoprecipitate
- Albumin
- Fractionated Blood Products
Describe Packed Red Blood Cells (PRBC)
Packed Red Blood Cells
- Average volume 300ml
- Hematocrit Hct 50-65%
- Residual plasma <20 %
- Stored 1 - 6*c
- Shelf life of 42 days
- Can be outside of refrigeration for 24 hours
- Must be transfused within 4 hours of being hung
- Citrate added for anti-coagulation
Describe Platelets
a
Describe Fresh Frozen Plasma (FFP)
a
Describe Cryoprecipitate
a
Describe Albumin
a
Describe Fractionated Blood Products
a
What are the Indications for Blood Transfusion
- Shock
- Coagulopathies
- Anemia/Hemorrhage: Hemoglobin >70 g/L -or- hemoglobin >90 g/L in ACS
One unit of RBC will increase hemoglobin by?
10 g/L
What is the ideal transfusion ratio?
1:1:1 (PRBC/Plasma/Platelets)
Describe Acute Hemolytic Transfusion Reactions (AHTR) and associated symptoms
a
Describe Febrile Non-Hemolytic Transfusion Reactions (FNHTR)
a
Describe Allergic reactions in Blood transfusion
a
Draw the Red Blood cell ABO/RH system chart
Insert Chart
Draw the Plasma ABO/RH system chart
Insert Chart
Which RED BLOOD CELL is considered the “Universal Donor”?
ABO/Rh O negative
Which RED BLOOD CELL group is considered the “Universal Recipient”?
ABO/Rh AB positive
Which PLASMA group is considered the “Universal Donor”?
ABO type AB
Which PLASMA group is considered the “Universal Recipient”?
ABO type O
What does antibodies do to red blood cells when they aren’t compatible?
Agglutination - Red cells get stuck together and are flagged for lysing
At what rate do you start the transfusion of Blood Products?
50 mL/hr for 15 minutes
What is the maximum time frame or number of blood units that a blood administration set can be used for?
- 4 hours
- 4 units of blood products
- Cannot mix blood units (ie RBC and Plasma cannot use the same administration set)
If giving Type O blood which demographics would receive O negative and which would receive O positive?
- O negative: Females of child bearing age
- O positive: Males and females older than child bearing age
According to new research, how many units of type A plasma can you provide to an unmatched individual and not receive negative side effects?
4-6 units
What blood product would you provide for a patient who was anemic?
- Packed Red Blood Cells (PRBC)
What blood product would you provide to replace clotting factors?
a
What blood product would you provide to assist with clot formation?
a
Are Red Blood Cells compatible with fluids other than normal saline?
No
What sized filter must be used with Red Blood cells?
170 - 260 microns
What does “Apheresis” mean?
- Single Donor
What is the recommended prophylaxis to prevent Citrate toxicity?
1g Calcium Chloride every 4-6 units of PRBC
Who are Irradiated PRBC’s used for and what changes will occur to the blood product?
- Patients at risk of developing Transfusion Associated Graft vs Host Disease (TA-GvHD)
- Higher Potassium (K+) and free Hemoglobin (Hgb)
