Haem/Transfusions Flashcards
Which blood type is the universal donor?
O-
Which blood type is the universal receiver?
AB
How is major haemorrhage defined?
- Loss of one blood volume in 24 hours
- 50% total blood volume lost in less than 3 hours
- More than 150ml/minute
What bloods should you order in a bleed before transfusing blood?
FBC
Group and save
Clotting screen
U&E
When should you think about transfusing blood?
< 30% loss (1500ml) fluids
30-40% red cell transfusion
> 40% (2L) major haemorrhage protocol
What is group and save?
Identifies patients ABO and rhesus blood group and screens blood for antibodies.
What is cross-match?
Mixing the patients blood with the blood they are going to receive to check for a reaction.
How long does group and save and cross-match take?
40 mins each
How long should one unit of blood be given over?
2 hours
How can you safely give blood to a patient who is at risk of overload?
Prescribe diuretic at same time
When might you need to give platelets?
Haemorrhagic shock
Severe thrombocytopenia <20
Low pre-op platelets < 50
What does fresh frozen plasma (FFP) contain?
Clotting factors and plasma proteins.
When is FFP given?
Major haemorrhage (every 2 packs of red cells)
DIC
Liver disease haemorrhage
TTP
What does cryoprecipitate contain?
Fibrinogen, vWF, factor VIII, fibronectin.
When is cryoprecipitate given?
LOW FIBRINOGEN:
Massive haemorrhage
VW disease
DIC with low fibrinogen
List 6 complications of blood transfusion.
Infection transmission
Overload
Transfusion related acute lung injury (TRALI)
Haemolytic reaction
Allergic reaction
Febrile non-haemolytic transfusion reactions
What blood tests can confirm haemolytic reaction to blood products?
Coombs test positive
Hyperbilirubinaemia
What are signs of haemolytic transfusion reaction?
Pyrexia Dyspnoea and wheezing Loin pain Hypotension DIC with bruising Acute oliguric renal failure
What are causes of macrocytic anaemia?
Vitamin B12 deficiency Folate deficiency Myelodysplasia Liver disease Hypothyroidism Alcohol
What are causes of normocytic anaemia?
Primary bone marrow failure - rare: aplastic anaemia Secondary bone marrow failure: • Anaemia of chronic disease • Combined haematinic deficiencies • Uraemia
What blood tests can you do if you suspect haemolysis?
FBC (reticulocytes) Blood film - spherocytes, schistocytes Bilirubin LDH Haptoglobin Direct coombs test
What might you suspect if you see macrocytosis with hyperhsegmented neutrophils?
B12 or folate deficiency
Myelodysplasia