Exam 3 Blood products Flashcards
1 unit PRBC will raise the Hgb by?
1 g/dL
What 2 Hgb will cause issues?
Hgb Bart’s & Hgb H (beta & alpha thalassemia)
What is the most common RH factor?
Rh+
What will cause a right shift in the Oxyhemoglobin dissociation curve?
- Low pH
- Increased CO2
- increased temp
- increased 2,3DPG
What serum antibody is present in type O blood?
- Anti-A & B. ]
- No antigen on erythrocyte
Type A donor blood will cause a reaction in someone with what blood type?
B & O
What is added to store blood?
Citrate phosphate dextrose adenine (CDPA-1)
Storing blood for longer time does what?
Shifts oxyhemoglobin curve to the left, which impairs oxygen delivery
What’s the dose of FFP?
10-15 mL/kg
What works well for angioedema?
FFP & TXA
What are some uses for FFP?
- If PT or aPTT are >1.5 times mean.
- DIC.
- Liver dysfunction.
- Warfarin reversal.
- Angioedema
Cryoprecipitate contains?
Factors VIII, XIII, Fibrinogen
1 unit of Platelets increases someone’s Plt count by?
5-10k
What is the pH of normal saline?
5.5
What are the signs of hemolytic transfusion reaction?
- hemoglubinuria
- Fever
- chills
- hemoglobinemia
- hypotension
- dyspnea
How is a hemolytic transfusion reaction treated?
Treat ARF & DIC
What are the S/S of nonhemolytic transfusion reactions & how is it treated?
- S/S= fever & chills.
- Treatment= antipyretics, leukocyte reduced products
How are noncardiogenic pulmonary transfusion reactions treated?
Respiratory support with high PEEP & steroids
When do TRALI’s present?
Within first 6hrs of transfusion
TRALI’s usually occur with what type of product?
Plasma components like platelets & FFP
What are the S/S of TRALI’s?
- Acute hypoxemia
- PaO2/FiO2 ratio <300
- bilateral infiltrates
- absent Left Atrium hypertension
- cyanosis
- hypotension
- fever
What labs are taken with a TRALI?
- CBC
- edema aspirate fluid
- CXR
What are the S/S of TACO?
- Coughing
- HTN
- rales
- cyanosis
- orthopnea
- severe HA
- peripheral edema
- difficulty breathing
What product contains the most fibrinogen?
Cryoprecipitate
What needs to be done before transfusing whole blood to a trauma Pt?
Determine blood type
Calcium is important for which clotting factors?
Factors II, VII, IX & X
How does hypothermia affect calcium?
Leads to decreased ionized calcium
Which calcium product is usually preferred & why?
Calcium gluconate d/t less likely to cause tissue necrosis if extravasated
Which calcium product is preferred in Pt’s with abnormal liver function & why?
Calcium chloride because decreased citrate metabolism results in slower release of ionized calcium
10% calcium gluconate contains___ of calcium & 10% calcium chloride contains___ of calcium?
90mg & 270mg
What is the LY30?
What happens to the clot over 30mins
What is the MA on a TEG?
How strong the clot gets
What can be given for a low MA on a TEG?
FFP, Cryo or Plt
What can be given if the LY30 is >3%?
TXA
What is the R on a TEG?
The time it takes for the clot to form
What can be given if the R is long (>10)?
FFP, Plt, PCC
- R= Reaction time (to initial fibrin formation)
What is the K on a TEG?
The time from when it starts to be a clot until it is a firm clot
What is the normal LY30?
0-3%
What can be given for a >3 K time on a TEG?
Cryoprecipitate
What product can be given for an ACT >140?
FFP
