Transfusion in practice

Question 1

What are indications for red cell transfusion?

Answer 1

Anaemia

Question 2

What are indications for platelet transfusion?

Answer 2

Thrombocytponenia

Question 3

What are indications for fresh frozen plasma transfusion?

Answer 3

Low coagulation factors

Question 4

What are indications for cryoprecipitate?

Answer 4

Low fibrinogen

Question 5

What are the most useful things to know for anaemia?

Answer 5

Blood pressure

Pulse

Question 6

Can group A receive group O plasma safely?

Answer 6

Not completely - plasma will have small amount of anti A

Question 7

What is the emergency line number for major haemorrhage?

Answer 7

2222 - state “major haemorrhage protocol activation” and location of patient

Question 8

What is the shelf life of platelets?

Answer 8

7 days

Question 9

What temperature are platelets stored at?

Answer 9

22C

Question 10

What is rationale for red cell transfusion?

Answer 10

Prevent or correct severe anaemia that might otherwise cause organ damage
Improve QoL
Prepare patient for surgery or speed up recovery
Reverse damage caused by patient’s own cells

Question 11

What are indications for platelet transfusion?

Answer 11

Prophylactically or therapeutically to stop bleeding
Dilutional thrombocytopenia
Cardiopulmonary bypass surgery
Disseminated intravascular coagulation if bleeding
Abnormalities of platelet function

Question 12

What temperature is fresh frozen plasma stored at?

Answer 12

-25C

Question 13

How long does it take to get FFP to a patient?

Answer 13

Half an hour - has to defrost

Question 14

What kind of FFP is given to people who are born in 1996 on?

Answer 14

Treated for mad cow disease

Question 15

What are indications for FFP use?

Answer 15

Replacement of coagulation factors due to major haemorrhage
DIC in presence of bleeding
Thrombotic thrombocytopenic purpura
Replacement of coagulation factor deficiencies where factor concentrate unavailable

Question 16

Would you transfuse ffp to a bleeding patient on a DOAC?

Answer 16

No

Question 17

What temp is cryoprecipitate stored at?

Answer 17

-25C

Question 18

What is contained in cryoprecipitate?

Answer 18

FVIII, vWF, Fibrinogen, FXIII

Question 19

What are indications for cryoprecipitate transfusion?

Answer 19

Hypofirbinogenaemia secondary to massive transfusion
DIC with bleeding and fibrinogen<1g/L
Bleeding associated with thrombolytic therapy causing hypofibrinogenaemia
Renal or liver failure and abnormal bleeding
Inherited hypofibrinogenaemia if fibrinogen concentrate unavailable

Question 20

What are principles for taking blood?

Answer 20

Group and screen/save
Cross match
Group specific blood
Two sample policy
72 hour (10 day) validity
Communication with blood bank is key

Question 21

What unit is blood prescribed in for adults?

Answer 21

Units

Question 22

What is 1 unit of blood?

Answer 22

What you get from one donation - around 450 mls of blood

Question 23

What happens if blood is given to quickly?

Answer 23

Circulatory overload

Question 24

What are risks in transfusion?

Answer 24

Transfusion ABO incompatible
Never events - death or near harm
Transfusion associated circulatory overload
HIV
Hep C
HBV