transfusion medicine Flashcards
what is Canadian Blood Services responsible for?
- donor screening
- collecting blood from volunteers
- blood typing
- performing testing to ensure blood is safe
- producing blood components
- matching bone marrow donors and recipients
what is primary donation for CBS
whole blood- most of it is separated into components to meet needs of different patients
what is pheresis
specialized collection procedure - used to only collect platelets. plasma/ or granulocytes– plasmapheresis, plateletpheresis, leukopheresis. whole blood removed from donor, centrifuged and filtered to separate desired components the remainder is returned to donor. -takes longer
autologous donation
patient donates whole blood to themselves. -patient scheduled for surgery donate their own blood just in case. f
what are CBS testing blood for 9
-ABO grouping
-RH typing
-antibody screening
-Hep b surface antigen and hepa B core antibody
-anti HCv
-anti-HIV
anti-HTLV(detect antibodies against human T-lymphotropic virus)
-syphilis screening
-west nile virus
packed red blood cells
prepared from whole blood-removing plasma
- patients have decreased oxygen carrying capacity-symptomatic anemia.
storage: 42 days in fridge
plasma
harvest from whole blood- obtained by plasmapheresis. -fresh frozen plasma if refigerated within 8 hours
- patients with deficiencies of all coagulation factors
- if at -18 it is stored for a year
platelets
prepared from whole blood by plateletphereis
- patients whose platelet function impaired - thrombocytopenia
- store at room temp for 5 days
blood components vs blood products
blood products have lot numbers, blood components do not
blood products 5
coagulation factor concentrates intravenous immune globuline hyper immune globulin Rh immune globulin Albumin
coag factor concentrates blood product
proteins in blood that control bleeding
- from pooled donor plasma or recombinant DNA
- hemophilia, factor VIII as part of therapy
intravenous immune globulin blood product
prepared from pooled.
immunoglobulins and passive immunity. - immediate protection. expensive
*hypogammaglobulinemia
hyper immune globulins blood product
passive immunization preparations. exposed to Hep b, Respiratroy syncytial virus, measles, tetanus, chicken pox, rabies and cytomegalovirus
Rh immune globulin blood product
contains antibodies to Rh D antigen.
-given to women who are Rh D negative to prevent them from making into-D after birth of an Rh positive child. -*protect future fetuses
known as Rhogam shot
Albumin blood product
separated from pooled plasma by fractionation procedure. used to treat patients whose blood volume depleted- common with severe burns. helps retain fluids
transfusion medicine
storage, immunohematological testing and issuing of blood components for transfusion
-antigen antibody testing
what does trans med do
- determine ABO and Rh blood type
- screen donors and recipients for unexpected blood group antibodies
- compatibility testing of donor and recipient blood
- investigate transfusion reactions
- investigate maternal-fetal incompatibilities that may lead to hemolytic disease of newborn
strict trans med blood collection protocols
- two people independently verifying identity of patient -usually you and patient
- patient ristband
- COLLECT 2 6ML EDTA
what is done during type and screen
- Also known as compatibility testing
- the ABO group and Rh type of patient determined
- antibody screen is performed on patient for unexpected antibodies in patients plasma that might lead to incompatible transfusion
- crossmatch is performed with donors red blood cells that are mixed with patients plasma. a suitable donor unit of blood is selected on the basis of the patients ABO/Rh type and will usually be the same ABO/Rh type.
blood types , antigen and plasma antibodies
type A: antigen A: plasma antibodies is anti-b
type B: antigen B: plasma antibodies is anti-A
type AB: antigen A and B no plasma antibodies
type O, no antigens, plasma antibodies are anti-A and anti-B
blood group for Rh, red cell antigen and serum antibody
Rh pos, has Rh or D antigen and it does not have any serum antibodies
Rh neg, has no D antigen and ** only has anti-D in plasma AFTER exposure, so it does not naturally occur in body but if exposed it will build this antibody
the Rh blood group
Rh pos has D antigen on cells.
A pos means their ABO is a and their Rh or D type is positive
**anti D is not a naturally occurring antibody, Rh neg not born with anti D it is acquired after exposure.
-this exposure could be from mom Rh neg having baby Rh pos -antibodies produced so second baby in trouble. - or transition of Rh pos blood
how to determine ABO and Rh type
-3 tubes with reagent containing anti-a anti-b and anti-D -patients blood added to each tube- if agglutination occurs this means that patients blood cells have that antibody the antigen binds to.
anitbody screen
detect unexpected antibodies in patients plasma -uses prepared red cell reagents called antibody screening cells
cross match
check to see if patients plasma and donors red cells compatible- mixed and checked for agglutination or hemolysis- no adverse rx= match
-once marched, blood issued.
most common error in transfusion med
clerical errors, collecting blood from wrong patient, poor labeling and transfusing to wrong patient
transfusion reactions
- can be life threatening-adverse reactions
- fever, chills, shortness of breath, back pain, chest pain, allergic response, rash blood in urine, shock.
- transfusion reaction lab procedures performed immediately to rule out hemolytic transfusion reaction (destroying RBC)
hemolytic disease of newborn
- occurs when mother has an antibody that reacts with fetus blood cells.
- appear jaundiced due to high levels of bilirubin -mild=uv lights
- bilirubin toxic- exchange transfusion may be required
pre natal screening
ABO/ Rh type done on mother. if Rh neg Rh HDN may occur. mother closely monitored, if anti-d produced, she is given Rh immune globulin
post-natal screening
done on baby cord blood. ABO/Rh type and DAT direct anti globulin testing is done
