indications for a transfusion

Question 1

what is the main reason for RBC transfusion

Answer 1

anemia ( low RBC/hgb)
increase O2

Question 2

tests to asses need for transfusion or determine if transfusion has improved anything

Answer 2

CBC
- hgb
-hct
-plt count
coag screen
- pt
-ptt
- inr
- tt

Question 3

when do you transfuse a non bleeding patient

Answer 3

hgb <70 g/L

Question 4

how much does 1 unit increase hgb

Answer 4

10g/L

Question 5

transfusion time for an RBC unit

Answer 5

over 2hrs usually but always within 4

Question 6

when do you give plts

Answer 6

<10 x10^9/L

Question 7

expected results 1 hr post transfusion of plts

Answer 7

increased 15-25 ( ideally but often doesnt occur )

Question 8

what is considered refractory with plts

Answer 8

an increase of <7.5 x10^9/L

Question 9

recommended transfusion time for plts

Answer 9

60 mins
always within 4 hrs

Question 10

what do you do if patient is refractory after plts

Answer 10

give ABO identical plts
if that doesnt work- may have HLA
or HPA
- get HLA/HPA compatible donor

Question 11

when do you give a factor instead of frozen plasma

Answer 11

when patient has a specific deficiency of a factor
ex. vit K to reverse warfin

Question 12

when do you give frozen plasma

Answer 12

> /= 1.8 if patient is bleeding or have a high potential to bleed and have multiple factor deficiencies w/ no good conc. factor alternative available

Question 13

recommended transfsuion time for plasma

Answer 13

30 min-2hrs
always within 4 hrs

Question 14

volume of frozen plasma and apheresis frozen plasma

Answer 14

2 whole blood donations;FP( 290mL each)

= 1 AFP( 500mL )

Question 15

how much does frozen plasma improve patient

Answer 15

factor levels are increased by ~25% = shortened pt/inr or ptt

Question 16

when do you give cryoprecipitate

Answer 16

when fibrinogen is <1g/L

or for vWD or hemophilia A when factor conc. are unavailable and DDAVP is not available or ineffective

Question 17

adult dose of plasma

Answer 17

10-15 mL/kg

Question 18

adult dose of cryo

Answer 18

10 units - may be pooled with saline

Question 19

expected response per dose of cryo

Answer 19

increase in fibrinogen by 0.5g/L

Question 20

transfusion time of cryo

Answer 20

usually 10-30min always within 4 hrs

Question 21

autologous donations must be

Answer 21

labelled for autologous donation only ( cant be given to anyone else)

segregated during storage

discarded if not used

Question 22

what is the timeline for autologous donations leading up to a surgery

Answer 22

from 42 days to 72hrs before the procedure