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Blood Banking > Transfusion > Flashcards

Transfusion Flashcards

1
Q

Types of transfusion reactions

A
  1. HTRs
  2. Chemically/physically induced TRs
  3. non-HTRs
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2
Q

Possible causes of HTRs

A

RACC

  1. Antibody binding to RBCs
  2. Release of Anaphylatoxins
  3. Activation of Cytokines
  4. Activation of Cimplement Cascades
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3
Q

2 types of HTRs

A
  1. Immediate HTRs
  2. Delayed HTRs
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4
Q

Immediate HTRs occurs ______________________________
________________ the transfusion

Reaction within __________hrs

Induce diuresis by:
__________________________
__________________________

Signs and symptoms:
- fever with back pain
- hemoglobinuria, hypotension, generalized bleeding

EFFECTS IN BLOOD
1. elevated free Hb
2. Elevated bilirubin
3. Decreased Haptoglobin
4. Variable DAT result

A

Immediate HTRs occurs very soon, during, or just after the transfusion

Reaction within 24 hrs

Induce diuresis by:
Mannitol
Potassium sparing diuretics

Signs and symptoms:
- fever with back pain
- hemoglobinuria, hypotension, generalized bleeding

EFFECTS IN BLOOD
1. elevated free Hb
2. Elevated bilirubin
3. Decreased Haptoglobin
4. Variable DAT result

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5
Q

Delayed HTRs

Anamnestic response from previous _____________________
_______________________________

Occur _______________________
___ days after transfusion

S/s:
1. Jaundice
2. Decreasing Hct levels

Common antibodies:
- Anti-Jk^a
- anti-E
- Anti-D
- anti-C
- anti-K
- Anti-Fy^a
- Anti-M

EFFECTS IN BLOOD
1. Decreased Hct and Hb
2. +DAT
3. + Post-transfusion Antibody

A

Delayed HTRs

Anamnestic response from previous transfusion, transplant or pregnancy

Occur 7-10 up to 140 days after transfusion

S/s:
1. Jaundice
2. Decreasing Hct levels

Common antibodies:
- Anti-Jk^a
- anti-E
- Anti-D
- anti-C
- anti-K
- Anti-Fy^a
- Anti-M

EFFECTS IN BLOOD
1. Decreased Hct and Hb
2. +DAT
3. + Post-transfusion Antibody

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6
Q

Most severe HTR

A

ABO incompatibility

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7
Q

Causes of chemically/physically induced TRs(non-immune TRs)

A

PaFaHappyMirtday

Physical damage - intravascular lysis
Freeze damage - blood warmers
Heat damage - absence of cryopreservatives
Mechanical damage - blood pumps, roller pumps…..

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8
Q

Non-HTRs

A
  1. IMMEDIATE non-HTRs
  2. DELALYED non-HTRs
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9
Q

IMMEDIATE NON-HTRs

A

FANANTAT

Febrile NHTRs
Aallergic/Urticarial TRs
NCPE/TRALI
Anaphylactic/toid TRs
TACO
Air embolism
TAS

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10
Q

DELAYED Non-HTRs

A

APTIC

Alol immunization
Post-transfution Purpura
TA GVHD
Iron Overload
Citrate overload

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11
Q

A.k.a. HDFN

A

Erythroblastosis Fetalis

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12
Q

Conditions for HDFN to occur

A

B+M+MIgG

  1. Baby + Rh/ABO
  2. Mother - Rh/ABO
  3. Mother spcfc Ab
  4. Spcfc Ab mus be IgG
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13
Q

Most common HDFN

A

ABO

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14
Q

Most severe HDFN

A

Rh

Rh > kell

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15
Q

Ref temp ——————–
Transport. Temp ———
- plt granulocyte ———

A

Ref temp ——————– 1-6°C
Transport. Temp ——— 1-10°C
- plt granulocyte ——— 20-24°C

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16
Q

Transfusion procedure is checked and monitored by 2 nurses

A

!!!!

17
Q

Main cause of transfision-related deaths and acute HTRs

A

CLERICAL ERRORS

18
Q

Spxmn must be collcected within ___ of scheduled transfusion
A. 14 days B. 7 days
C. 3 days D. 48 HOURS

A

C

19
Q

Central venous access is desirable for ___________

A

High volume administration or long term therapy

20
Q

Peripheral access with ____________ or catheter is typically sufficient for blood transfusion.

A. 23g needle B. 18g needle
C. 16g needle D. 21g needle

A

B

21
Q

These TWO should be the only solution used as IV solutions to dilute blood components

A

Isotonic Saline
5% Albumin

22
Q

Use of this is PROHIBITED since it is hypotonic and will cause RBC lysis

A

5% Dextrose in Water
(D5W)

23
Q

Use of this solution is PROHIBITED since it contains calcium(initiate coagulation)

A

RINGER’S LACTATE SOLUTION

24
Q

Why is Infusion slow for the first ______ minutes?

A

Reason: to observe for signs of transfusion reaction,

10-15 minutes

25
Q

How long is plasma and platelet units transfused?

A

30-60 minutes

26
Q

What is the desirable time to complete a transfusion?

A

within 2 hours

27
Q

1mL in transfusing blood is equal to?

A

15 drops

28
Q

What is the use of blood warmers?

A

**use for cold blood (causes hypothermia)

29
Q

Hypothermia in transfusion results to?

A

Cardiac arrhythmia and hemorrhage

30
Q

Blood warmer is used for:

A
  • patient receiving many units in a short period of time
  • for cold bloods
31
Q

Blood warmer temp.

Automatic temp. Control is set to alarm when blood is @?

A

@*37°C !!!NOT BE WARMED OVER 38°C!!!

42°C

32
Q

Special considerations in transfusion

For emergency transfusion, what is the appropriate blood type to be given?

A

Group O, Rh negative packed RBCs

33
Q

Special considerations in transfusion

Maximum bagunits for adults(massive transfusion)?

A

8-10 units

34
Q

Special considerations in transfusion

Maximum bag units for infants(massive transfusion)?

A

> half a unit

35
Q

Special considerations in transfusion

Adverse effects of massive transfusion

A

CH2DA (chada mahigugma)

Citrate toxicity and hypocalcemia
Hypothermia
2,3-DPG depletion
Ddepletion of Coag. Factors & plt
Accumulation of biochem and microaggregates

36
Q

Special considerations in transfusion

A

jIMENE BTS

Intrauterune tranafusion
Massive transfusion
Exchange transfusion
Neonatal RBC transfusion
Emergency transfusion

37
Q

Any transfusion should be done within:

A

4 hours

Blood Banking (7 decks)

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