Haematology Flashcards
4 things haematology needs to assess peri-op
O2 carrying capacity of blood
VTE risk assessment
Haemostatic competence
Immune competence
GROUP + ? for anaemia and no anaemia
Normal Hb: save or cross match in high bleeding risk
Low Hb: crossmatch
What are high bleeding risk procedures
Vascular Liver Spleen Cardiothoracic Polypectomy Urology
How to assess haemostatic competence
Platelet count
If low, get repeat count and blood film
If platelet clumping, get citrate sample
When are coagulation tests required
Bleeding disorder or FH Unexplained menorrhagia Hx of unusual bleeding Hx of postop bleeding Unexplained thrombocytopenia Emergency operation
What is included in a coagulation screen
PT
APTT
Fibrinogen
TT
How to assess immune competence
Neutrophil count
If <1 treat underlying cause before surgery or give prophylactic ABx if emergency
What are the blood transfusion products
RBCs
Platelets
Cryoprecipitate
Fresh frozen plasma
When are packed RBCs indicated
Bleeding
Hb below <70
Chronic anaemia e.g thalassaemia
When are platelets indicated
Platelets <10
<20 in sepsis
<50 in bleeding
<100 in intracranial haemorrhage
Indications for FFP
DIC
Massive haemorrhage
NOT WARFARIN REVERSAL
What does cryoprecipitate contain
Fibrinogen and factor VIII
How does acute haemolytic transfusion reaction occur
ABO incompatibility
Antigens on blood products bind to antibodies in patients plasma leading to massive haemolysis
Signs of acute haemolytic transfusion reaction
Hypotension Tachycardia Haemaglobinuria Flank pain Fever Chills
Examples of acute transfusion reaction
Acute haemolytic transfusion reaction Febrile non haemolytic transfusion reaction TRALI TACO Anaphylaxis Bacterial infection Graft vs host Blood borne virus transmission
