Transfusion Flashcards
Universal plasma DONOR type:
AB Positive
Universal Blood DONOR
O negative
Universal Plasma RECIPIENT:
O Negative
Universal Blood Recipient:
AB positive
What is the difference between typing and screening?
Type is ABO and RH -/+ only (5 minutes)
Screening checks the most significant antibodies (45 minutes)
What is the chance of blood reaction with typing alone?
0.2%
What is the chance of blood reaction with crossmatching
0.05%
Which blood product contains the highest amount of fibrinogen?
Cryoprecipitate
Which blood product carries the highest risk of bacterial contamination?
Platelets, because they are kept at room temperature
You should not use _____ when administering platelets
Blood warmer or filter
What does FFP contain?
All coagulation factors
Fibrinogen
Plasma proteins
What is FFP indicated for?
Reversal of warfarin
Coagulopathy
Massive Transfusion
DIC
Hereditary Angioedema
What does cryoprecipitate contain?
The four Fs:
Fibrinogen
Factor 13
Factor 8
vWF
What is cryo indicated for?
Fibrinogen Deficiency
vWD
Hemophilia
What is the calculation for MABL?
When should patients with significant CAD be transfused?
Hct < 28-30%
What is the normal transfusion threshold?
Hgb 6
If 6-10 and symptomatic
What is the EBV for a premature neonate?
90-100 ml/kg
What is the EBV for a full term neonate?
80-90 ml/kg
What is the EBV for an infant?
80 ml/kg
What is the EBV for an adult?
70 ml/kg
What is the hematocrit in a PRBC?
70%
Consequences of RBC storage include:
Decreased 2,3-DPG
Decreased pH
Increased K
Hemolysis
Proinflammatory mediator production
What does leukoradiation remove?
WBCs
What does washing remove?
any remaining plasma
Leukoradiation reduces the risk of:
HLA sensitization
Febrile non-hemolytic
CMV transmission
Washing prevents:
Anaphylaxis in IgA deficient patients
Irradiation destroys:
Donor leukocytes, reducing the risk of GVHD in transplant patients
What are the most common infections transmitted through PRBCs ranked?
- CMV
- Hep B
- Hep C
- HIV
What should you do if you suspect a transfusion reaction?
Give a fluid bolus to prevent renal occlusion
Give bicarb to alkalize the urine, which decreases Hgb precipitation
An acute hemolytic reaction causes three processess:
- Acute Tubular Necrosis
- DIC from massive clotting activation
- Hemodynamic instability from bradykinin release
TRALI results from _____ in donor blood
HLA and neutrophil antibodies
Which DONORS have a high risk of causing TRALI?
Multiparous Women
Those who’ve gotten a lot of transfusions
Organ transplant
Is massive transfusion associated with acidosis or alkalosis?
ALKALOSIS
Citrate is metabolized to bicarb in the liver
Is massive transfusion associated with hyper or hypo glycemia?
HYPER
Glucose in the blood to facilitate glycolysis
What are contraindications to blood salvaging?
Sickle Cell
Thalassemia
Oncologic Procedures
Infected Surg Site
What is the lethal triad?
Hypothermia
Coagulopathy
Acidosis
What
