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1) Blood Bank 2 Exam 1 > The Red Cell > Flashcards

The Red Cell Flashcards

1
Q

What does Leukoreduction mean?

A

Leuko is reduced (WBC is reduced)

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2
Q

What are the risks of Transfusion therapy?

A
  • Rejection
  • Exposure to pathogens
  • Clinical repercussions
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3
Q

What are the benefits of Transfusion therapy?

A
  • Blood oxygen content
  • iron
  • hemostasis
  • cardiac output
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4
Q

What is transfusion therapy?

A

A broad term that encompasses all aspects of the transfusion of patients.

  • Each blood component has specified indications for use and expected outcomes, and other considerations . In addition, patients with special considerations required strategies and decisions to optimize therapy.

-Each patient required individual transfusion plans that meet their specific circumstances. Considerations: volume tolerated, immune response, clinical state

  • Indications for use are continuously studied to give practitioners a guideline of what to measure in their patients that demonstrate the transfusion was an appropriate decision. Outcomes: Hgb, pulse, blood pressure, oxygen content, INR, platelet count.
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5
Q

What things are made from whole blood?

A
  • RBCs
  • Granulocytes ( Neutro, Eso, Baso)
  • Platelets
  • Plasma
  • Cryoprecipitate
  • Clotting factor derivatives
  • Rhogam
  • Immune Globulin
  • Anti-sera
  • Albumin
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6
Q

1 blood donation can help save the lives of up to _____ people

A

3

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7
Q

What is the average volume of Whole Blood?

A

450-500 mL

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8
Q

At what temperature is Whole Blood stored?

A

2-6 C (Refrigerated)

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9
Q

What is the shelf life of Whole Blood?

A

CPD (Citrate-Phosphate-Dextrose): 21 days

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10
Q

What is the Hct and Fibrinogen of Whole Blood?

A
  • ~38%
    -1000 mg
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11
Q

What is the platelet count of whole blood?

A
  • 150-400K
  • 100% coag factors
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12
Q

What is Whole Blood used for?

A
  • volume expansion + oxygen carrying capacity
  • most often “autologous units”
  • However new research is promoting it for Emergency situations
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13
Q

What are somethings to consider for Whole Blood?

A
  • platelets, white cells, clotting factors don’t last as long during storage
  • The major risk for whole blood is circulatory overload
  • Must match forward and reverse ABO
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14
Q

What are some key points to know for the use of whole blood in Trauma?

A
  • Damage Control Resuscitation (DCR) in pre-hospital setting suggests balanced transfusion of products is best practice 1:1
  • Low Titer O Whole blood (LTOWB)
    – Titer <1:256 anti-A and anti-B Ig<
  • Pros - all in one bag means less clerical error check and fewer Ivs
  • Cons - maintaining donor candidates, non transferrable product
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15
Q

True or False: Any blood bank can prepare blood components

A

False. Not just any blood bank can do it.

  • In order to collect and process blood a facility must submit to FDA inspection.

–
This includes packaging, labeling, repacking, or otherwise changing the container, wrapper, or labeling of any blood product package in furtherance of the distribution of the blood product from the original place of manufacture to the person who makes final delivery or false to the ultimate consumer.

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16
Q

List the steps of component preparation from Whole Blood Donation

A
  1. Collect
  2. Decide
  3. Centrifuge
  4. Separate
  5. Test
  6. Label
  7. Release to inventory for distribution

–
1. Collect in sterile closed system
2. Decide what product is used for within 8 hours: (may Leukoreduce components overnight or before fractionation)
3. Centrifuge to pack the RBCs and separate
- Platelets: Light spin at 20-24C
-Plasma: Hard spin at 1-10C (FP24 if prepared within 8-24 hours)
4. Separate components:
- For cryoprecipitate control thaw re-freeze FFP
- For platelets let sit 1 hour unagitated
5. Test donor blood for blood type & virus
6. Label products with ISBT label
7. Release to inventory for distribution

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17
Q

List the steps for Blood Component collection from Apheresis

A
  1. Decide
  2. Collect
  3. Return
  4. Test
  5. Label
  6. distribution

–
1. Decide what product is to be collect.
2. Collect in aphaeresis system
- Intermittent flow centrifugation
- Continuous flow centrifugation
3. Return uncollected components
- Red cells may also collect plasma in a separate bag.
4. Test donor blood for blood type & virus
5. Label products with ISBT label
6. Release to inventory for distribution

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18
Q

What are some risks to Blood component collection from apheresis?

A
  • Citrate toxicity (tingly of the lips or finger tip - calcium)
  • Vascular access
  • Vasovagal reactions
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19
Q

What does ISBT stand for?

What things are on the ISBT label?

A
  • International Society of Blood Transfusion

The ISBT label has:
- a unique donor identification number
- collection facility registration number
- and license number
- descriptive product code
- blood bar code
- expiration date,
- special testing information
- name of facility that modifies original product.

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20
Q

What is the WBC count reduced to in Leukocyte Reduced Packed Red Blood Cells (LRBC) or (PRBC)?

A

less than 5x10^6

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21
Q

What is the volume of LRBC?

A

Volume is 250-300 mL (If collected by aphaeresis, exact volume is listed

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22
Q

What is the Hct percentage of LRBC?

A

~ 60-80%
(desirable <80%)

23
Q

What is the shelf life of LRBC?

A

21-42 days

–
(up to 42 days)

24
Q

What is the storage temperature for LRBC?

A

2-6 C

25
Q

What are LRBC used for?

A
  • most common red cell component
  • Reduced HLA exposure and fever
  • Expected outcome: increase Hgb 1g/dL or Hct by 3% - 24 hours after transfusion is completed
  • Risks: Graft vs Host, pathogen exposure
26
Q

What are DRBC?

A

(Previously frozen) Deglycerolized RBCs

27
Q

What is the volume, storage temperature, and shelf life, and Hct for DRBC?

A
  • 180 mL
  • -65 C
  • Shelf life of 10 years (once washed/thaw, 24 hrs)
  • Hct ~70-80%
28
Q

What is DRBC used for?

A
  • Expected outcome: increase Hgb 1g/dL or Hct by 3%, 24 hours after transfusion is completed
  • Good for rare antigens and patients with allergic reactions
29
Q

What are the considerations for DRBC?

A
  • Obtained from whole blood through centrifugation, glycerolization, freezing, thawing, washing.

The washing process removes plasma proteins, platelets and WBC’s

30
Q

True or False: After degycerolization, QC is performed by osmolarity (420mOsm - 500mOsm) of the component demonstrating less than 1% glycerol residual.

A

True

31
Q

What is LIRBC?

A

Leukoreduced Irradiated Packed Red Cells

32
Q

What is the volume, storage temperature, and shelf life, and Hct for LIRBC?

A
  • volume: ~300mL
  • Storage: ~ 2-6 C
  • Shelf life: 28 days post irradiation even or expiration date, which ever comes first
  • Hct: ~60-85% (desirable <80%)
33
Q

What is LIRBC used for?

A
  • Immunocompromised
34
Q

What are the considerations and risk for LIRBC?

A
  • Obtained from packed RBCs that are irradiated with 25 Gy, Cesium-137 or Cobalt-60.
  • Risks: red cells have higher degradation after irradiation, HLA immunization.

–
mitogenic capacity of T cells is eliminated

35
Q

True or False: A radiochromic film label is placed on the unit before irradiation. Darkening of the film confirms irradiation is complete.

A

True

36
Q

Storage and and Visual inspection: At what temperature should red cell blood component products be stored at in transfusion service?

A

2-6 C

37
Q

What temperature should red cell components be kept at during transfer between sites in or outside of the hospital?

A

1-10 C

–
The temperature outside of the range will change the expiration date to 4 hours non-refrigerated, 24 hours refrigerated

38
Q

What is the 30 minute rule?

A
  • some hospitals have a 30 minute limit for blood being outside of the blood bank on the floor

(must be started within 30 minutes of issue)

39
Q

Inspect this Red Cell Component unit. Can we use this? If not, why not?

A

We can’t use this product because we can visually see it is hemolyzed.

40
Q

Inspect these Red Cell Component units. Can we use these? If not, why not?

A

We can’t use this product because we can visually see lipemia.

41
Q

Inspect these Red Cell Component units. Can we use these? If not, why not?

A

We can’t use this product because we can visually see bacterial contamination.

42
Q

Inspect this Red Cell Component unit. Can we use this? If not, why not?

A

We can’t use this product because we can visually see particulate matter (clot in RBC unit).

43
Q

Inspect these Red Cell Component units. Can we use these? If not, why not?

A

We can’t use this product because we can visually see discoloration.

44
Q

When visually inspecting red cell components units, what are 5 things that you need to look for?

A
  • Hemolysis
  • Lipemia
  • Bacterial Contamination
  • Particulate Matter
  • Discoloration
45
Q

True or False: Red cell components can be returned to the blood bank if temperature is greater than 10 C.

A

False. Blood component that leave the blood bank for transfusion, can only be returned if it’s unspiked and temp is 1-10 C.

46
Q

True or False: Red cell components are not to be kept if they fail visual inspection: bubbles, blots, discoloration, temp indicator out.

A

True

47
Q

True or False: Red cell components can be kept if RBC aliquot seal failure <24 hours

A

True.

If the open system is greater than 24 hours, it should be thrown away.

48
Q

Can we return to autologous units to blood bank after patient has been discharge?

A

No. Autologous units will be thrown away after that patient has been discharge.

49
Q

True or False: Blood components are to kept if they have be stored in validated coolers or refrigeration units outside of blood bank @ 2-6 C.

A

True

50
Q

True or False: Blood components can be kept if transported from vendor, by taxi, helicopter or police @1-10C.

A

True

51
Q

True or False: Blood components need to be thrown away when unit retype doesn’t match the label.

A

True

52
Q

What are two Red Blood Cell Substitutes that are still under investigation by FDA?

A
  • Hemoglobin Based Oxygen carriers (HBOC)
  • Universal Red Cel Engineering
53
Q

What is the use of Hemoglobin Based Oxygen carriers ?

State the benefits and cons.

A
  • Uses: Trauma, Sickle Cell Anemia
  • Benefits: Deliver oxygen quickly to smaller tissues, chemically altered to change oxygen affinity.
  • Cons: vasoconstriction, renal failure, short half-life, increased chance of MI and coagulalopathy.
54
Q

What is the use of Universal Red Cell Engineering?

State the benefits and cons.

A
  • Uses: Creation of universal donor from any blood. (Gut bacteria that remove or sequester A or B or H sugars.)
  • Benefits: same RBC function, no incompatibility
  • Cons: dependent on volume blood donors, extra processing step, sepsis

1) Blood Bank 2 Exam 1 (6 decks)

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