Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Perf tech III > test 2 > Flashcards

test 2 Flashcards

1
Q

Autotransfusion

A
  • person receives their own blood for a transfusion, instead of banked allogenic (separate-donor) blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

two main kinds of autotransfusion:

A
  • Blood can be autologously “pre-donated”

* Alternatively, it can be collected during and after the surgery using an intraoperative blood salvage device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute Normovolemic Hemodilution (ANH)

A
  • Whole blood drained via gravity into a blood collection bag containing anticoagulant
    * Central line
    * Venous line
  • Room temperature with agitation
  • Good for 8 hours
  • Properly labeled: name, MRN, date, time withdrawn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cell saver

A
  • intraoperative cell salvage machine that suctions, washes, and filters blood so it can be given back to the patient instead of being thrown away
  • Because the blood is recirculated, there is no limit to the amount of blood that can be given back to the patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Haemonetics

A

• Cell Saver 5
- have different bowl sizes
• Elite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Medtronic

A

• Autolog

- use less saline solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sorin

A

• Xtra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cobe (Sorin)

A

• BRAT2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dideco

A

• Compact Advanced Cell Saver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fresenius (Terumo)

A

• C.A.T.S

- Continuous Autotransfusion System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Discontinuous cell salvage

A
  • happen in 3 different phases
    1) fill
    2) wash
    3) empty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Continuous cell salvage

A
  • 3 phases happen all at once
    1) fill
    2) wash
    3) empty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aspiration Set

A
  • Disposable
  • Usually packaged separately from washing set
  • Double line tube
    * Anticoagulant line with drip chamber and roller clamp control
    * Suction line for salvaged blood mixed with anticoagulant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anticoagulant

A
  • Disposable
  • Heparinized saline (30,000 units Heparin/1 L saline)
  • CPD (citrate-phosphate-dextrose)
  • ACD-A (anticoagulant citrate dextrose solution- solution A)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Collection Reservoir

A
  • Disposable
  • ~3000 to 4000 mL capacity
  • Gross filter or 30-100 micron filter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bowl

A

• Disposable
• Varying sizes from 50 mL to 250 mL
-based on blood loss expected and size of patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Wash Solution

A
  • Disposable

* Normal saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Disk

A
  • used in continuous cell salvage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Latham bowl

A
  • angled sides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Baylor bowl

A
  • straight sides
21
Q

C.A.T.S. process

A

1) first separation phase
- initial separation stage
- most of the unwanted constituents are separated out
- complete removal of non-emulsified fat
2) washing phase
- RBC resuspended with saline
- further removal of blood plasma
3) second separation phase
- final separation stage
- RBC packed to a hematocrit of 60-65%
- used saline removed
- monitors PRC filling level

22
Q

Wash Phase

A

• When the bowl is filled:
- The pump starts (clamps adjust)
- wash solution -> wash bowl
• Washing continues until the re-infuse/empty button is depressed (or the program ends and the predetermined amount of wash solution has been used)
• Effluent moves:
- wash bowl  waste bag
- Manual mode note : watch for clear effluent

23
Q

Empty Phase

A

• The centrifuge stops, then transfers
- wash bowl -> reinfusion bag
• The cycle ends and a new cycle can begin
• The reinfusion bag should not be used for direct pressure infusion -> patient
• The reinfusion bag may contain air
- Therefore, a separate blood bag attached to the reinfusion bag is used.
- disconnect -> purge air -> tie off

24
Q

blood reinfusion must begin within how many hours from

collection

A

6 hrs

25
Q

Ways of using Partially Filled Bowl

A

• “Concentrate”
• Send washed PRBC from reinfusion bag back to bowl
• Allows for a full bowl of RBC when no more blood is expected
from patient reservoir
• “Return”
• Sends contents of bowl back to patient reservoir

26
Q

Labeling Specimens

anesthesia and transport

A
  • Patients Registration sticker
  • Type: i.e. WPRBC’s
  • Time collected
  • Time of expiration
  • Volume
  • Initials
27
Q

Record Keeping

A
  • A signed autologous cell salvage record must be kept for every case
  • All the input and output data is recorded
28
Q

Indications

A
  • Intended for use in situations to control blood loss
  • Recovery of blood lost during surgery
  • Rare blood groups without blood available
  • Risk of infectious disease transmission
  • Autotransfusion is common intraoperatively/postoperatively
  • Recovery of blood in the extracorporeal circuit at the end of surgery or from aspirated drainage
29
Q

Advantages

A
  • High levels of 2,3-DPG
  • Normothermic
  • pH relatively normal
  • Lower risk of infectious diseases
  • Functionally superior cells
  • Lower potassium (compared to stored blood)
  • Quickly available
  • Eliminates need for compatibility testing
  • Reduces risk of TRALI (transfusion related acute lung injury)
  • Acceptable for most religious groups
  • Cost-effective
30
Q

PRBC vs cell salvaged blood

A 
Packed red cells have a higher:
1) total volume
2) HCT
3) RBC volume
4) potassium
5) plasma free Hgb
Cell salvage blood have a higher
1) remaining volume
2) pH
3) 2,3 DPG
31
Q

Substances washed out

A
  • Plasma
  • Platelets
  • WBC’s
  • Fat
  • Anticoagulant solution
  • Plasma free hemoglobin
  • Cellular stroma
  • Activated clotting factors
  • Intracellular enzymes
  • Potassium
  • Plasma bound antibiotics
32
Q

Relative Contraindications

A
  • Presence of bacterial contamination of the surgical site
  • Malignancy of the surgical area
  • Obstetrics
  • Topical hemostatic agents
33
Q

Contamination of the surgical site

A

• Any abdominal procedure poses the risk of contamination
• If there is a question of possible contamination the blood may be held until the surgeon determines whether or not bowel contents are in the surgical field
• Standby w/ reservoir
• If the blood is contaminated the entire contents should be discarded
- If the patient’s life depends upon this – it may be re-infused with the surgeon’s consent
- Large amounts of a 0.9% NS will reduce the bacterial contamination of the blood, it will not be totally eliminated

34
Q

Malignancy

A

• The possibility exists of reinfusion of cancer cells from the surgical site

35
Q

Possible exceptions to this malignancy

A

• Removal of an encapsulated tumor is possible
• If an inadequate supply of blood exists
**The use of leukocyte reduction filters is recommended

36
Q

Obstetrics

A

• do not want to suck up Amniotic fluid because it can cause inflammatory rxns that can cause an embolism
- washing cycle clears the amniotic fluid
• Can be used In a Jehovah’s witness patient to remove amniotic fluid and then suctioning the blood that is being lost

37
Q

Topical Hemostatic Agents

A
  • Do not get into cell saver because of clot formation
    • Waste or wall suction source must be used
    • Autotransfusion can be resumed once these products are flushed from the surgical site
    • If Gelfoam, Surgicel, Thrombogen or Thrombostat are used, autotransfusion possibly can continue
38
Q

Special Considerations- Sickle Cell Anemia

A
  • Debated issue
  • Blood may sickle and further reduce oxygen-carrying capacity
  • No trials, only case reports
39
Q

Special Considerations Pheochromocytoma

A
  • Adrenalectomy
  • Blood may contain catecholamines that may cause severe hypertension when re-infused
  • Cell salvage does not wash out catecholamines
40
Q

Special Considerations - Orthopedic

A

• Antibiotics which are plasma bound can be removed, topical antibiotics which are not plasma bound may not be washed out
- may actually become concentrated to the point of being nephrotoxic
• Cement is often used or encountered during primary or revision total joint replacement surgery. Cement in the liquid or soft state should not be introduced into the autotransfusion system
- use small bowl and 1.5x wash

41
Q

Special Considerations - Emergency

A

• In life saving situations with the consent of the surgeon, autotransfusion can be utilized in the presence of the previous stated contraindications i.e. sepsis, bowel contamination and malignancy
- NOT YOUR CALL

42
Q

Contraindications a Perfusionist is most likely to encounter

A
  • Wound infections
  • Pleural effusion (fluid behind lungs)
  • Betadine
  • Warm solutions
  • Sterile water and other irrigation solutions
  • Malignancy
  • Topical hemostatic agents
  • Thrombin
43
Q

Jehovah’s Witness Patients

A 
• Refuse transfusion of whole blood and it’s products
        • Red cells
        • Platelets
        • White cells
        • Plasma
• Many will accept
        • Albumin
        • Cryoprecipitate
        • Clotting factor concentrates
        • Immunoglobulins
- circuit needs to be one continuous circuit
44
Q

Disadvantages

A

• Depletion of plasma and platelets

  • Removes plasma/platelets to eliminate activated clotting factors and activated platelets (causes coagulopathy if re-infused)
    - This disadvantage is evident when very large blood losses occur
45
Q

Typically, patient may require FFP/platelets when:

A
  • estimated blood loss > half of the patient’s blood volume

• Must test to determine the need for blood products

46
Q

IBBM-CPBMT Certification

A

• Currently, the International Board of Blood Management is the governing body for certification in autotransfusion (CPBMT)

47
Q

IBBM’s mission

A

• The IBBM’s mission is to promote education and sound scientific principles to advance the safe and competent practice of perioperative blood management

48
Q

In order to become a Certified Perioperative Blood Management Technologist (CPBMT)

A
  • Have a minimum of a high school diploma/ equivalent
  • Be practicing in the field of blood management for a minimum of one (1) year
  • Complete fifty (50) autotransfusion procedures/y

Perf tech III (55 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions