Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

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  • Properly labeled: name, MRN, date, time withdrawn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

25
Ways of using Partially Filled Bowl
• “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
Labeling Specimens | anesthesia and transport
* Patients Registration sticker * Type: i.e. WPRBC’s * Time collected * Time of expiration * Volume * Initials
27
Record Keeping
* A signed autologous cell salvage record must be kept for every case * All the input and output data is recorded
28
Indications
* 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
Advantages
* 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
PRBC vs cell salvaged blood
``` 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
Substances washed out
* Plasma * Platelets * WBC’s * Fat * Anticoagulant solution * Plasma free hemoglobin * Cellular stroma * Activated clotting factors * Intracellular enzymes * Potassium * Plasma bound antibiotics
32
Relative Contraindications
* Presence of bacterial contamination of the surgical site * Malignancy of the surgical area * Obstetrics * Topical hemostatic agents
33
Contamination of the surgical site
• 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
Malignancy
• The possibility exists of reinfusion of cancer cells from the surgical site
35
Possible exceptions to this malignancy
• Removal of an encapsulated tumor is possible • If an inadequate supply of blood exists **The use of leukocyte reduction filters is recommended
36
Obstetrics
• 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
Topical Hemostatic Agents
- 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
Special Considerations- Sickle Cell Anemia
* Debated issue * Blood may sickle and further reduce oxygen-carrying capacity * No trials, only case reports
39
Special Considerations Pheochromocytoma
* Adrenalectomy * Blood may contain catecholamines that may cause severe hypertension when re-infused * Cell salvage does not wash out catecholamines
40
Special Considerations - Orthopedic
• 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
Special Considerations - Emergency
• 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
Contraindications a Perfusionist is most likely to encounter
* Wound infections * Pleural effusion (fluid behind lungs) * Betadine * Warm solutions * Sterile water and other irrigation solutions * Malignancy * Topical hemostatic agents * Thrombin
43
Jehovah’s Witness Patients
``` • 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
Disadvantages
• 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
Typically, patient may require FFP/platelets when:
- estimated blood loss > half of the patient's blood volume | • Must test to determine the need for blood products
46
IBBM-CPBMT Certification
• Currently, the International Board of Blood Management is the governing body for certification in autotransfusion (CPBMT)
47
IBBM's mission
• The IBBM's mission is to promote education and sound scientific principles to advance the safe and competent practice of perioperative blood management
48
In order to become a Certified Perioperative Blood Management Technologist (CPBMT)
* 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.
© 2025 Bold Learning Solutions. Terms and Conditions