Quiz 11 Flashcards
What is the minimum weight requirement for a blood donor?
10.5 mL/kg or 110 lbs.
What is the pulse (beat/min) requirement?
50-100 beats per minute
What is the BP range for blood donors?
less than 180/100
What should not be on the:
1. arms
2. antecubital region (inner elbow)
- track marks (from IV drug use)
- lesions
What is the hemoglobin range for:
1. males
2. females
- 13.0 g/dl or greater
- 12.5 g/dl or greater
What is Autologous Blood Collection?
Donating blood for yourself in preparation for a future surgery
Why would someone decide to donate blood autologously?
rare blood type/difficult blood type compatiblity
What is the max amount for Autologous blood collection?
11.0 g/dL
Does Autologous Blood Collection have any age restrictions?
no
What is the percentage of discarded Autologous Blood?
50%
Does Autologous Blood cross over to the general blood supply if unused?
no
When is viral markers NOT performed for Autologous Blood?
if the blood is given in the same place it’s been collected
What is Acute Normovolemic Hemodilution?
Collection of whole blood from a patient who is about to have surgery and replacement with crystalloids or colloids
What is the max amount of blood collected for Acute Normovolemic Hemodilution?
12 g/dL
What is the expiration of blood for Acute Normovolemic Hemodilution? Why?
- less than 8 hrs
- to retain the platelet and coagulation factor functioning
Multiple units are collected for Acute Normovolemic Hemodilution. What unit has the highest hematocrit?
the first unit
When should the first unit of Acute Normovolemic Hemodilution blood be transfused?
it should be the last pack transfused… AFTER BLEEDING HAS STOPPED
What is Intraoperative Blood Salvage?
- Blood, that is lost during surgery, is collected
- Collected blood is washed/filtered
- Filtered blood is returned (put back) to the patient
When is Intraoperative Blood Salvage used?
surgeries with large amounts of blood loss
Why do some Jehovah’s Witness patients accept Intraoperative Blood Salvage transfusions?
the blood collected is also transfused back; continuous circuit and so the blood is considered not to have left the body
What is directed donation?
donation for someone you know
Is directed donation blood units crossed over to the general inventory?
yes, it also must meet blood restrictions/criteria
What types of transfusion therapy can a single whole blood donation provide?
- packed RBCs
- platelets
- fresh frozen plasma (FFP)
- cryoprecipitate (CRYO)
Why is whole blood not usually transfused?
TL;DR it’s useless if it’s not fresh
it would have to be very fresh in order to provide functioning platelets and coagulation factors and is difficult to obtain; also ABH antibodies can be introduced (hemolytic reaction)
How can RBCs be obtained from whole blood?
- centrifugation
- apheresis
What temperature is packed RBCs stored?
1-6°C
***What is the shelf-life of blood in Citrate phosphate dextrose (CPD)?
21 days
***What is the shelf-life of blood in Citrate phosphate dextrose- adenine (CPDA-1)?
35 days
***What is the shelf-life of blood in Additive solutions?
42 days
What is the percentage of the hematocrit (of RBCs) collected in CPD or CPDA-1?
65-85%
What is the percentage of the hematocrit (of RBCs) collected in additive solutions?
55-65%
How can babies have repeated transfusions with the same pack of donor blood?
STERILE DOCKING! take repeated aliquots from a RBC unit
When is packed RBCs used?
- treatment of symptomatic anemia
- bleeds during surgery
What is Leukoreduced RBCs?
no WBC in the blood unit (filtered out)
[less than 5 x 10^6 white cells in the unit with about 85% of the original amount of RBCs]
Is Leukoreduced RBCs CMV safe?
yes, it is an equivalent of a CMV seronegative product
Why is Leukoreduced RBCs used?
helps prevent febrile-nonhemolytic reactions
How is blood leukoreduced?
obtained by filtration at the time of collection or within about 72 hours of collection
Why is Irradiated Red Blood Cells used?
For prevention of transfusion-associated GVHD in susceptible patients-inhibits T cells
How is Irradiated Red Blood Cells made?
Gamma irradiation of 2500 rads to center of the unit; causes single strand breaks in DNA
What is the shelf-life of Irradiated Red Blood Cells?
28 days or the original shelf-life
Why does washed RBCs need to be used within 24 hrs?
an open system is obtained, so if used past 24 hrs, there is a risk of bacterial contamination
Why is washed RBCs used?
Helps prevent repeat allergic reactions and may also be used to transfuse IgA deficient patients
What is washed RBCs?
RBCs w/o plasma
How is washed RBCs made?
Washing RBCs with normal saline to remove plasma
What is Frozen Deglycerolized Red Blood Cells?
RBCs that are frozen with glycerol as a cryoprotective agent
What is the shelf-life of Frozen Deglycerolized Red Blood Cells?
10 years
What is the shelf-life of !THAWED! Frozen Deglycerolized Red Blood Cells? Why?
24 hours since an open system is created in the process
What type of blood utilizes the Frozen Deglycerolized Red Blood Cells technique?
Rare RBCs and some O negative
What are Platelet Concentrates also known as?
random donor platelets
Where are Platelet Concentrates derived from?
whole blood via centrifugation
Do Platelet Concentrates need to be pooled to be given a therapeutic dose?
yes
How many platelets are in one unit of Platelet Concentrate?
5.5 x 10^10 platelets
What temperature is Platelet Concentrate stored? For how long?
20-24°C with gentle agitation for 5 days
What MUST BE the pH of Platelet Concentrates be, after 5 days?
greater than 6.2
What are Platelet Concentrates replaced with?
apheresis platelets
Platelet concentrates may be:
- leukoreduced
- cultured with no growth prior to release for transfusion
- irradiated without change of shelf-life
- washed (and transfused w/in 4 hrs
What are Apheresis Platelets also known as?
single donor platelets
What are Apheresis Platelets?
Leukoreduced by the instrument at the time of collection
What temperature are Apheresis Platelets stored at? for how long?
- 20-24°C with continuous soft agitation
- for 5 days
How many (1. platelets 2. WBCs) are in Apheresis Platelets?
- at least 3x10^11 platelets
- less than 5x10^6 WBCs
When are Apheresis Platelets cultured? (expiration?)
within 48 hrs
What percentage of Apheresis Platelets are utilized?
90%
What MUST be done to Apheresis Platelets?
irradiated (no change in shelf life) or washed (4 hour shelf life)
Are Apheresis Platelets CMV safe?
yes
What temperature is plasma stored at?
-18°C
What is the shelf-life of plasma?
1 year
How do you make Fresh frozen plasma (FFP)?
1.separated from whole blood
2. placed in a freezer within 8 hours of collection
[possesses all coagulation factors at 100%]
How do you make plasma?
- be separated from whole blood
- placed in a freezer within 24 hours of collection; slight loss of factors V and VIII
What coagulation factors does fresh frozen plasma (FFP) have?
all of em
What coagulation factors does plasma have?
all, but less factor V (5) and VIII (8)
How do you make apheresis plasma?
must be placed in a freezer within 6 hours of collection
How is plasma thawed for transfusion?
37°C in a water bath
How do you store thawed plasma?
1-6°C for 24 hours
What is the shelf-life of thawed plasma?
extended for up to 5 days and the product is renamed as “thawed plasma”
What is plasma used for?
to replace coagulation factors in patients with elevated PT or aPTT from factor deficiencies from decreased production by the liver to increased utilization for example in DIC
How is Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO) prepared?
- thawing FFP at 1-6°C
- reconstituting the precipitate in approximately 10-15 mL of plasma
What does Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO) contain?
- fibrinogen ( > 150 mg)
- factor VIII ( > 80 IU)
- von Willebrand factor
- factor XIII
- fibronectin
How do you store Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO)?
stored at -18°C or colder for 1 year
What is the shelf-life of Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO)?
1 year
What temperature do you thaw Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO)?
37°C
What is the procedure for transfusing thawed Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO)?
- kept at room temperature
- transfused within 6 hours
Does Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO) need to be pooled to be given a therapeutic dose?
yes (keep upto 4 hrs at room temp)
Can Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO) be pre-pooled?
yes, if frozen (shelf-life 6 hrs)
What is Cryoprecipitate Antihemophilic Factor (CRYO AHF or CRYO) used for?
fibrinogen replacement