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Immunohematology 480 > Components, Preparation, Donors > Flashcards

Components, Preparation, Donors Flashcards

1
Q

450 mL size donor bag maximum/minimum amount

A

450 mL +/- 45mL

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2
Q

500 mL size donor bag maximum/minimum amount

A

500 mL +/- 50 mL

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3
Q

How many hours after collection must the plasma be frozen if making fresh frozen plasma from units that have CPD, CD2D, or CPDA-1 as the anticoagulant?

A

8 hours

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4
Q

How many hours after collection must the plasma be frozen if making fresh frozen plasma from units that have ACD as the anticoagulant?

A

6 hours

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5
Q

Single donor plasma has lost the viability of what labile coagulation factors

A

V and VIII

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6
Q

NSA (normal serum albumin):
Contains?
Expiration time/temp?
Purpose?

A

Contains: 80% albumin, 17% globulin
Expiration time/temp: 5 years at 2-10 degree C
Purpose: volume expander (rare) and used with apheresis donors

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7
Q

What are the two categories of synthetic volume expanders and what products are included in each group?

A

Crystalloids: ringer’s lactate and normal isotonic saline
Colloids: dextran and HES

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8
Q

How many RBC’s are expected to be in a unit of packed cells?

A

250 mL

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9
Q

Why are the colloid volume expanders used?

A

Hemorrhagic shock and burn patients

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10
Q

What is the hermetic seal?

A

Completely enclosed system-reducing exposure to microbes/contaminants. If broken, the unit must be used within 24 hours

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11
Q

Washed RBC indications for use

A

If patient has history of plasma protein antibodies, PNH diagnosis, severe allergies

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12
Q

Fresh frozen plasma indications for use

A

For multiple or unknown coagulation factor deficiency

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13
Q

Single donor plasma indication for use

A

For treatment of stable clotting factor deficiencies

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14
Q

Platelet concentrates indication for use

A

Thrombocytopenia

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15
Q

Cryoprecipitated Anti-hemophiliac Factor indications for use

A

Correct FVIII, FXIII deficiencies

Fibrinogen

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16
Q

Packed RBCs indication for use

A

Restore O2 carrying capacity

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17
Q

Whole blood indication for use

A

Used for massive blood loss

Treatment of cardiopulmonary bypass patients either intraoperatively or up to 6 hours post operatively

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18
Q

Leukocyte reduced RBC indication for use

A

History of febrile transfusion reactions, reduced exposure to MHC antigens

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19
Q

Irradiated RBC indication for use

A

Graft vs. host disease

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20
Q

Component to use for hypovolemia

A

Crystalloid products (saline or electrolyte) solutions

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21
Q

Component to use for open heart surgery

A

Preoperative hemodilution and then reinfusion of the collected blood. Any additional units should be as fresh as possible to aid in the overall 2,3 DPG depletion recovery

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22
Q

Component to use for patients with repeated febrile transfusion reactions

A

Leukocyte-reduced red blood cells

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23
Q

Component to use for leukemia/ repeated transfusions of platelets necessary

A

Single-donor platelets prepared by pheresis

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24
Q

Component to use for hemophilia A

A

Factor VIII concentrate or cryoprecipitate antihemophilic factors

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25
Component to use for hemophilia B
Factor IX concentrate
26
Component to use for disseminated intravascular coagulation
Fresh frozen plasma
27
Component to use for anemia
Packed RBC's
28
Component to use for hypofibrinogenemia
Cryoprecipitate anti hemophilic factor
29
Component to use for acute blood loss
Packed RBCs
30
Component to use for severe burns with dehydration
NSA | 5-25% (normal serum albumin)
31
Component to use for massive transfusion from trauma (more than 10 units needed)
Whole blood
32
What is the cryoprotective agent for frozen red blood cells and recommended storage temp?
``` High glycerol (40% w/v) - 80 degrees C Low glycerol (20% w/v) - 120 degrees C ```
33
How are frozen RBC prepared for transfusion?
1) equilibrate with 12% NaCl 2) wash 1.6% NaCl 3) final washing 0.9% NaCl and 0.2% dextrose
34
What are the advantages of frozen RBC over banked blood?
1) No plasma for people with PNH or anti-IgA | 2) Extended shelf life for rare units
35
What is the optimum temp for shipping of blood?
1-10 degrees C
36
2,3 DPG is the most important factor in what RBC function
Hemoglobin affinity for oxygen
37
ATP is important for what RBC parameters?
RBC viability | Membrane integrity
38
How is refrigerator temp monitored?
Continuous recorder with alarm system
39
When inspecting blood each day, what do we look for?
Clot, discolorization | Bacterial contamination
40
Changes that occur in stored, anticoagulated blood
Decrease in 2,3 DPG Increased plasma hemoglobin Increased plasma K Decrease in ATP
41
What type of cooling system needs to be included with fresh frozen plasma?
Dry ice
42
What type of cooling system needs to be included with frozen RBC's?
Dry ice
43
What type of cooling system needs to be included with whole/packed cells?
Ice to maintain 2-10 degree C window
44
What type of cooling system needs to be included with platelets?
Maintain 20-24 degree C window
45
How old of blood is allowed if a fresh whole blood transfusion is indicated?
<5 days
46
What is the temp for units of blood during transport?
1-10 degree C
47
As units of packed cells are stored, what happens to the pH and 2,3 DPG?
Both decrease
48
What extra qualifications must a donor for platelet pheresis meet?
Apheresis platelet donor must not have taken aspirin-containing medication in last 3 days. Platelet count obtained on donor if donating more frequently than every 8 weeks
49
What is the expiration limit for apheresed platelets?
5 days in a closed system | 24 hours in open system
50
Factors removed by plasmapheresis
``` Immune complexes Auto or alloantibodies Inflammatory mediators Protein-bound toxins Lipoproteins Platelet-aggregating factor ```
51
What is the average number of platelets in each bag of random donor platelets?
5.5 x 10^10
52
What is the average number of platelets in a single donor unit?
3.0 x 10^11
53
What is the requirement for pH in a unit of platelets?
6.2 or greater
54
A random donor pack of platelets is expected to increase the recipients platelet count by how much?
5,000-10,000 microliter
55
What is the expected effect in the recipient after receiving 1 unit of packed cells?
Increased Hct by 3% | Increase Hgb 1 g/dL
56
What is the expected effect in the recipient after receiving 1 unit of random donor platelets?
Increase 5,000-10,000 per unit
57
What is the expected effect in the recipient after receiving 1 unit of platelets from a single donor by pheresis?
Increase 30,000-60,000 per unit
58
What is the expected effect in the recipient after receiving 1 unit of whole blood?
Increase Hct 155 | Increase Hgb 1 g/dL
59
What would be the acceptable white blood count if you used a leukoreduced, pooled, random donor platelet component?
<5.0 x 10^6
60
Why is the correct maintenance of the pH important for the storage of platelets?
Viability
61
What is the probability of syphilis transmission via blood products?
The syphilis microbe will not be viable after 3 days. Most likely transmission would be from platelets but has not been documented. Testing appears to continue as a general screen for at-risk sexual activity
62
What is the international coding system used for component labeling?
International Society for Blood Transfusion (ISBT) | Code 128
63
Why may we test a donor's ALT?
Elevated liver enzymes to screen for Hepatitis
64
How many units of FVIII should be in each bag of cyro?
80-150 IU (minimum of 80 IU per plasma collection)
65
What is Rh immune globulin?
Rh immune globulin is anti-D prepared from humans. It is given to an Rh-neg unsensitized mother of an Rh pos baby within 72 hours post-partum or about 28 weeks antenatal. Mini doses are given antenata
66
Is there a risk of disease transmission with this product?
Low risk of HIV, Hepatitis A & B, and Hepatitis C antibodies have been identified
67
How long do RBC's survive normally?
120 days
68
What percentage of RBCs in a unit of blood should be viable in the patient 24 hours after transfusion?
75% of donor blood should be viable in patient after 24 hours
69
What is HBIG and when is it used?
Hepatitis B immunoglobulin. It is used when there is exposure to hepatitis B with no immunity
70
How can RBCs be rejuvenated after expiration date and for how long?
Within 3 days after expiration, add PIPA - shelf life then becomes 24 hours
71
Why are units irradiated?
To make T cells nonviable to eliminate GVHD caused by transfused WBCs
72
What is the range of radiated in Gy's for inactivation of WBC's in prevention of GVHD?
25-35 gy's
73
How long are records maintained for both the donor and recipient?
10 years
74
Describe what bacterial contamination may look like in a packed unit of cells
Purplish, white flecks throughout when mixed
75
What is the expiration time and storage temp for PPF and NSA?
5 years at 2-10 degrees C
76
How long can fresh frozen plasma be thawed before the labile coagulation factors are nonviable?
24 hours
77
How many mL of plasma is in a unit of fresh frozen plasma?
150-250 mL
78
What is the difference between FFP and single donor plasma (SDP)?
FFP still has labile coagulation factors that are viable (< 1 yr) and SDP does not (1-5 yrs)
79
What are the labile coagulation factors that are non-viable in single donor plasma?
Factors V and VIII
80
How fast should RBCs be infused?
Within 4 hours
81
When should blood be warmed?
Rapid or exchange transfusion | Patients with PCH or cold agglutinins reactive at 37 degree C
82
What is a transfusion reaction?
Adverse response to a transfusion
83
Advantages of autologous transfusion
Reduced risk of transfusion reaction | Reduced risk of transmission of infectious disease
84
What diseases are routinely tested by molecular methods on donor units?
West Nile, HIV, HBV, St. Louis Encephalitis, Zika
85
Purpose of solutions infused
Only 0.9% saline or 5% albumin should be used to dilute blood components
86
Purpose of warmers
Blood warmer with automatic temp control set for 37 degree C with an alarm if temp is exceeded
87
Speed of transfusion
Within 4 hours
88
How long must blood samples be kept for both the donor unit and recipient past transfusion?
At least 7 days
89
Symptoms of mild donor reactions
Pallor, sweating, hyperventilation, decreased blood pressure, nausea. Treatment: stop donation, loosen tight clothing and elevate feet. Apply cold towel to forehead, neck
90
Symptoms of moderate donor reactions
Periods of unconsciousness, decreased pulse, decreased blood pressure, hyperventilation. Treatment: check blood pressure, pulse and temp until normal again. Administer O2
91
Symptoms of sever donor reactions
Convolutions or seizure, hyperventilation, tetany | Treatment: summon help immediately, ensure adequate airway, give 95% O2
92
What is intraoperative blood salvage?
Blood is collected by drainage tubes at surgical site. Used most frequently in cardiopulmonary bypass surgery and total knee replacements
93
How long before intraoperative blood salvage must be re-infused or discarded?
Must be used within 6 hours
94
What is preoperative hemodilution?
Usually used in cardiopulmonary bypass surgery where 1-3 units of blood are removed from the patient before surgery and re-infused back post surgery. The blood can be store at 1-6 degrees C for 24 hours or at room temp for four hours
95
What are the coagulation factors in cryoprecipitate?
FVIII VWF FXIII Fibrinogen
96
When preparing cryoprecipitate, how long do you have before the plasma needs to be frozen?
8 hours
97
When preparing cryoprecipitate for freezing, what is the maximum amount of time allowed between the initiation of the freeing to being frozen solid?
1 hour
98
If cryoprecipitate is being pooled, how many hours is the maximum allowed between pooling and transfusion?
4 hours

Immunohematology 480 (8 decks)

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