SA Med Transfusion CSV Flashcards
1
Q
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~Why do we transfuse patients?
A
Replace blood components
2
Q
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~When transfusing what are the main components of blood we use?
A
RBC’s
3
Q
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~What major Dz’s can be managed with transfusion therapy?
A
IMHA
4
Q
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~What is the minimum PCV that most anesthesiologist want for Sx?
A
22% for non-elective Sx
5
Q
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~What percent loss of blood volume can a healthy animal tolerate with out CS?
A
20%
6
Q
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~What is the blood volume of a dog?
A
90ml/kg
7
Q
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~With Peracute blood loss (with in minutes up to an hour) what change will you see in HCT?
A
No change in HCT
8
Q
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~After fluid shifts (ICF/ECF) in a blood loss event what happens to HCT?
A
Decrease
9
Q
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~What Dz conditions may result in a need for transfusion?
A
Anemia
10
Q
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~What test can be done to determine if there is a thrombocytopathia?
A
BMBT
11
Q
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~What is the #1 rule of transfusion therapy?
A
Give only what they need when they need it
12
Q
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~What is in whole blood?
A
All cellular & plasma components of blood
13
Q
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~What are they components therapy products available?
A
PRBC’s
14
Q
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~When you give whole blood to a pt what do they get?
A
RBC’s
15
Q
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~What are the indications for transfusing whole blood?
A
Combined RBC & Plasma deficiency
16
Q
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~What two Dz conditions occurring together call for transfusion of whole blood?
A
Anemia &
17
Q
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~When is whole blood considered fresh?
A
Used with in 8hrs of collection
18
Q
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~How long can whole blood be stored?
A
21-28days
19
Q
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~When is whole blood considered “stored”?
A
Used >8 after collection
20
Q
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~How is Packed Red Blood Cells processed?
A
450ml fresh whole blood stored in CPDA +/- optisol spun down to make 1unit = 250ml of PRBC’s
21
Q
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~When is transfusion with PRBC’s indicated?
A
Anemia!
22
Q
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~What are the 3 big clinical signs of Anemia?
A
Tachypnea
23
Q
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~When transfusing with PRBC’s why are you choosing this product?
A
Restore O2 carrying capacity
24
Q
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~How long can PRBC’s be stored?
A
about 42 days in refrigerator
25
# ~
~What are the three types of plasma available for transfusion?
Fresh
26
# ~
~When is Plasma considered Fresh?
Processed from 450mL of fresh whole blood and used within 6hrs of collection
27
# ~
~When is plasma considered FFP?
when used within 1yr of collection
28
# ~
~When is plasma considered just “frozen”?
When used \> 1yr after collection
29
# ~
~How long can Plasma be frozen for after that first year?
4 additional years
30
# ~
~What is the max dose of plasma?
20ml/kg/day
31
# ~
~What does FFP have in it?
All coagulation factors & other proteins
32
# ~
~What can you NOT treat with a plasma transfusion (any kind)?
Hypoalbunemia - cant give enough to raise albumin levels adequately with out going over max dose
33
# ~
~Other than how long it has been frozen what is the difference between FFP & Frozen Plasma?
Frozen Plasma lacks coagulation factor 8
34
# ~
~What is the life span of refrigerated Platelets?
1 week
35
# ~
~What are the indications of giving platelets?
Thrombocytopenia —\> Hemorrhage
36
# ~
~What is the best way to get funcitonal platelets to a pt?
Fresh Whole Blood
37
# ~
~What are the other options when giving platelets?
Cryopreserved platelets
38
# ~
~What is the issue with the “other” options to give platelets?
In Vitro function is either impaired or very short (hrs)
39
# ~
~What does Cryoprecipitate contain?
Fibrinogen
40
# ~
~What is one example of when you would give cryoprecipitate?
vWF/Hemophillic dog needing Sx
41
# ~
~What are the general indications for giving Cryoprecipitate?
Bleeding dogs w/ specific plasma protein defeciencies
42
# ~
~What does cryoprecipitate come from?
1 unit of Fresh Plasma spun again then frozen
43
# ~
~What is Cryo-poor plasma?
What is left after cryoprecipitate is made
44
# ~
~What is the indication for using Cryo-poor plasma?
She doesnt think there is one just use FFP if not needing specific Cryoprecipitate
45
# ~
~What types of Albumin are available in Vet Med?
Lyophilized canine albumin (5% & 16%)
46
# ~
~What are the clinical signs of low Albumin?
Edema
47
# ~
~What is the big risk with giving Human serum albumin to animals?
High risk of Anaphalaxis
48
# ~
~What are the indications for transfusing Albumin?
Raise Albumin levels in critically ill
49
# ~
~What other products do we have to give pt’s oncotic support?
Colloids
50
# ~
~What is a really good indication for transfusing Albumin?
Chronically Low BP that nothing else has helped
51
# ~
~What is the main risk of giving any biological transfusion product?
Hypersensitivity Reactions
52
# ~
~What options are available for transfusing Leukocytes?
Only Fresh Whole Blood due to their very short 1/2 life - generally not preformed
53
# ~
~What is the signalment of animals can be used for blood donors?
Healthy
54
# ~
~What specific tests results do you need for a blood donor?
PCV\>35%
55
# ~
~What is the most common component of anticoagulant solutions used in blood products?
Sodium Citrate
56
# ~
~Why is Citrate so important in anticoagulant solutions?
Citrate chelates calcium —\> inhibiting calcium dependent coagulaiton
57
# ~
~What coagulation factor is Calcium?
Factor IV
58
# ~
~What are the two main anticoagulant solutions for blood products?
ACD - Acid-citrate- dextrose
59
# ~
~What does the Dextrose do in ACD/CPD?
Nutrition for RBC’s
60
# ~
~What does Acid/Phosphate do in ACD/CPD?
Optimizes pH for RBC survival
61
# ~
~What is the ratio to use for anticoagulant:blood when making blood products?
1:9
62
# ~
~Should you sedate your blood donors?
No just keep calm
63
# ~
~How should blood donors be positioned when giving blood?
Sternal or lateral recumbancy
64
# ~
~What type of prep is used and what vein?
Sterile prep of Jugular Vein
65
# ~
~What type of bag, where should the needle be & what type of procedure?
Anticoagulation Bag
66
# ~
~How can you make sure you are getting exactly 450ml of whole blood in the bag?
Use a gram scale
67
# ~
~How many blood types of dogs are there?
More than a dozen
68
# ~
~Do dogs have natural alloantibodies to blood types?
NO!
69
# ~
~How can you identify a dog’s antigen group?
Serological testing
70
# ~
~With Dog kennel side blood typing tests what are we testing for?
(+ or -) for DEA type 1 antigens
71
# ~
~What is the most common blood antigen in dogs?
1.1 62% have it
72
# ~
~What are the other types of DEA that you would want to test for in donors?
3
73
# ~
~Which dogs most commonly have DEA types 3 & 5?
Greyhounds & Japanese breeds
74
# ~
~What is interesting about DEA type 7?
It is a circulating antigen and attaches to RBC instead of being integrated into cell membrane
75
# ~
~What is DAL?
DAL system is prevalent in Dalmations & Antibodies to DAL produce acute reactions in dogs with out it
76
# ~
~How do you test for DEA types other than 1?
Send out serology cannot do in house
77
# ~
~What are the three feline blood types?
A
78
# ~
~Do cats have naturally occurring alloantibodies what does this mean?
YES! This means you must always test donors & recipients even on their 1st transfusion
79
# ~
~What type of alloantibodies do cats with Type A blood have?
Weak “anti-B” antibodies - they will have a reaction if given type B blood
80
# ~
~What type of alloantibodies do cats with Type B blood have?
Strong “anti-A” antibodies - they can die if given type A blood
81
# ~
~What type of alloantibodies do cats with Type AB blood have?
None! They are universal recipients of PRBC’s (not whole blood)
82
# ~
~What antibody type is primarily responsible for hemagglutination reactions?
IgM
83
# ~
~What antibody type is primarily responsible for hemolytic reactions?
IgA or IgM
84
# ~
~What cat breeds all have type A blood?
Siamese
85
# ~
~What cat breeds have the less common type B blood?
British breeds (but not all of them)
86
# ~
~What is Neonatal isoerythrolysis?
Kittens w/ type A or AB born to queen w/ type B —\> get alloantibodies against there blood from milk —\> Anti-A antibodies cause hemolysis & possibly death
87
# ~
~What can be done to prevent Neonatal isoerythrolysis?
Test Queen & Tom if she is B & he is A/AB then do not let kittens nurse (hand rear them)
88
# ~
~What are the 2 steps to confirming compatibility of blood donor/recipeint?
1. Obtain blood type
89
# ~
~When obtaining blood type what do you do?
Test for type
90
# ~
~When determining if there are circulating antibody specific for blood types not expressed by recipient RBC’s what do you do?
Major & Minor cross match test
91
# ~
~What are the two types of blood typing tests available cage side that give instant results?
Card style agglutination test
92
# ~
~What is a major crossmatch TQ?
Assesses compatibility between DONOR RBC’s & patient/recipient PLASMA/SERUM
93
# ~
~What is a minor crossmatch TQ?
Assesses compatibility between DONOR PLASMA/SERUM & patient/recipient RBC’s
94
# ~
~Does compatible cross matching rule out the possibility of an adverse transfusion reaction?
NO!
95
# ~
~What does cross matching determine?
Serological compatibility
96
# ~
~What specifically is cross matching testing for?
Natural alloantibodies (cats)
97
# ~
~What are you looking for in a cross match test?
Hemolysis &/or Agglutination
98
# ~
~What is the difference between rouleaux formation and Agglutination?
Rouleaux - RBC’s stacked like coins
99
# ~
~Is there a magic PCV level that automatically indicates transfusion?
No based on CS & Judgement of pt/case
100
# ~
~When should you transfuse Plasma?
Severe bleeding due to a factor deficiency
101
# ~
~When should you transfuse component replacements?
Deficit causing clinical signs
102
# ~
~How do you transfuse blood products?
Wear Gloves!
103
# ~
~What is the Rate at which you should infuse blood products?
0.25-1ml/kg/hr for 1st 20 minutes
104
# ~
~How long can blood products sit at room temp before they must be discarded?
No more than 4 hrs
105
# ~
~When will acute reactions occur during transfusion?
With in the first 20 min!
106
# ~
~What should you monitor & what indicated a reaction during transfusion?
Mentation —\>dull/obtunded
107
# ~
~How often should you monitor during transfusion?
Every 5min for the first 30 then every 15 until done
108
# ~
~What are two types of Autologous transfusions?
Planned self transfusion
109
# ~
~When would you do a planned self transfusion?
When Sx in planed a few wks in advance and you anticipate possible large hemorrhage
110
# ~
~When would you do an Emergency Auto transfusion & how?
Blood salvaged intra-op or from body cavity
111
# ~
~When will you NEVER do an emergency Auto transfusion?`
NOT neoplastic effusions (like ruptured HSA)
112
# ~
~What are the most common types of immunologic transfusion reactions?
Acute Hemolytic
113
# ~
~What are the less common types of immunologic transfusion reactions?
Delayed
114
# ~
~What is an immunologic acute hemolytic transfusion reaction & CS?
T2 hypersensitivity
115
# ~
~What is an immunologic acute Non-hemolytic transfusion reaction & CS?
T1 hypersensitivity
116
# ~
~What is an immunologic delayed transfusion reaction & CS?
Extravascular hemolysis 2-21 days post
117
# ~
~What is an immunologic Purpura transfusion reaction & CS?
Thrombocytopenia 1 wk post
118
# ~
~What are non immunologic transfusion reaction?
Anaphylactoid
119
# ~
~What is an Anaphylactoid non-immunologic transfusion reaction & CS?
Too rapid infusion
120
# ~
~What is a TACO non-immunologic transfusion reaction & what is it from?
Transfusion
121
# ~
~When is Citrate Intoxication a big risk?
After massive transfusions
122
# ~
~What qualifies as a massive transfusion?
Replacing the entire blood volume in 24hrs or
123
# ~
~When is hyperammonemia or Acidosis transfusion reactions most common?
When using older blood products
124
# ~
~What is treatment for transfusion reactions?
Stop/slow down
125
# ~
~What is Oxyglobin?
Cell free bovine derived Hg
126
# ~
~What is Oxyglobin used for?
Increase O2 & CO2 transport ONLY
127
# ~
~What are some good things about it Oxyglobin?
Significant colloidal Effect
128
# ~
~What is bad about Oxyglobin?
Not readily available
