Hematology II Flashcards
What is major reason for transfusion of PRBCs in the OR?
improve oxygen caring capacity
Hgb 7-8 do you tranfuse?
- If undergoing ortho or cardiac surgery
- if have stable cardiovascular disease, after doing clinical evaluation
When do we transfuse pt with Hgb 8-10?
symptomatic anemia
ongoign bleeding
ACS with ischemia
hematology/oncology pt with severe thrombocytopenia
What is type and screen?
test patients blood for Rh factor, and wha antibodies they have
What is type and cross?
type and screen and then you cross match it with blood > tag it and set aside for patient
O type blood has what antigens? and what antibodies?
No antigens
Anti-a & anti-b antibodies
What blood can someone with O type receive?
O blood
Type A blood has?
A antigen
anti-B antibody
What blood can someone with type A receive?
Type O
Type A
Type B blood has?
B antigen
anti-a antibody
What blood can someone with type B receive?
type b
type O
What blood can someone with type AB receive?
O
A
B
AB
T/F Rh+ can receive Rh- but not the other way around?
true
AB type blood has what antibodies?
none. no antibodies
Universal Donor?
O-
Universal recepient?
AB+
antigen
marks the blood cell
antibodies
attack and destroy other blood cells
sx of acute hemolytic transfusion reaction
fever, chills, flushing
chest/flank/back pain
hypotn
oliguria or anuria or hemoglobinuria
diffuse bleeding out of IVs and tubes
tx for acute hemolytic transfusion rxn
- stop transfusion
- keep uop 75-100 ml/hr
- assay urine and plasma for hgb [ ]
- return unused blood to the blood bank
- prevent hypotension
- recheck labelling
your patient is under anesthesia and you gave blood, what are some signs that your patient is having an acute hemolytic transfusion rxn
increased T
unexplained tachycardia
hypotension
hemoglobinuria
bronchospasm
diffuse oozing in surgical field
what are hemolytic transfusion rxns due to
ABO incompatability
_________ is a transfusion reaction with a mild reaction, typically with re-exposure d/t Ab to non-D antigens
hemolytic
sx of hemolytic transfusion reaction
- clinical low grade fever
- mild jaundice
- unexpected drop in hgb
how do you manage transfusion reaction?
supportive therapy:
1. monitor hgb
2.hydration
3. tranfuse if hgb too low
what causes febrile non hemolytic transfusion reaction?
typically due to multiple transfusions which leads to the development of alloantibodies on donated blood WBC
most common transfusion reaction?
febrile non hemolytic transfusion reaction
sx of febrile non-hemolytic transfusion reaction
- fever.chills
- respiratory depression
- anxiety
4.headache - myalgia
what is the treatment for a febrile non-hemolytic transfusion reaction?
tylenol
RALi within 6 hours of tranfusion you will have what sx?
dyspnea
chills/fever
bilateral pulmonary edema
significant pulmonary compromise > intubation
hypotension in cardiac patients
TRALI treatment?
stop transfusion
O2/ventilation > low Tidal Volume
indications to transfuse PRBC?
symptomatic anemai
Hbg<6 if healthy
massive hemorrhage
decreased O2 carrying capacity
how long to platlets last normally? if donated?
7-10 days
4-5 days
I unit of platelets should increase plt count by
30,000-60,000
home many plateletpheresis packs per 10kg of weight?
one
T/F plt have to be ABO compatible?
false, preferred but not required
contents in plts?
plts and clotting factors
plt transfusion triggers
- active bleeding with bleedign time 2x normal
- active bleeding with plt < 20,000
- active bleeding with bleeding time < 60,000 for surgical pts
- active bleeding after complete heparin neutralization (post ECC bypass)
For CNS procedure give plts if they are < ?
100,000
FFP must be ABO compatible?
True
contents in FFP?
all coagulation factors (especially II, VII, IX, and X)
protein C
protein S
antithrombin III
for every 3 UPRBC you should give how many FFP?
one
for every 3 UPRBC you should give how many FFP?
one
if massive tranfusion protocol, normally you give __ FFP for every ___ PRBC?
1:1
Indications to give FFP
bleeding from warfarin therapy
massive transfusion/coagulopathy
coagulation factor deficiency
Antithrombin III deficiency
correction of multiple coagulation deficits
correction of microvascular bleeding w/ abn coags
give if entire blood volume has been tx
10 - 15 ml/kg of FFP should increase clotting factors by ______________%
20-30
FFP in NOT indicated for
PT, INR, or aPTT that is normal
solely for augmentation of blood volume or albumin [ ]
1 “pool” of cryoprecipitate will increase fibrinogen ______________
45 mg/dL
____________________ is a concentrated version of FFP
cryoprecepitate
T/F: cryoprecipitate must be ABO compatible
false, preferred but not required
cryoprecipitate product content
fibrinogen
factors V, VIII, and XIII and vWF
when do you transfuse cryo
hypofibrinogenemia (<80-100)
massive hemorrhage
bleeding pts with vWD, unresponsive to DDAVP
tx of microvascular bleeding with fibrin deficicency
