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Haematology (MOD) > Transfusion medicine > Flashcards

Transfusion medicine Flashcards

1
Q

What clinical signs may be suggestive of reduced oxygen perfusion to tissues and that a blood transfusion may be needed?

A

Tachycardia
Tachypnoea
Lethargy
Weakness

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2
Q

What should you ensure before deciding whether do do a blood transfusion?

A

Patients volume concentration

If normovolaemic do not transfuse

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3
Q

What blood product should be transfused after blood loss?

A 
Whole blood (gold standard)
Packed red cells
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4
Q

What blood product should be transfused after haemolysis?

A

Packed red cells

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5
Q

What blood product should be transfused for a coagulopathy?

A

Fresh frozen plasma
Regular plasma
Or cryoprecipitate

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6
Q

Some practices have their own blood donor programme. How long do they store whole blood for?

A

Up to 21 days

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7
Q

Most practices use the UK pet blood bank. Which species has no blood/platelet products available?

A

Feline blood or platelets

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8
Q

Do dogs and cats need to receive type-specific blood/blood products?

A

Ideally for dogs (not essential if first transfusion)

Cats = imperative for blood, not strictly necessary for plasma

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9
Q

Which RBC antigen should be tested for before giving blood? Why?

A

DEA-1

Most animals naive, but causes strongest immune reaction

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10
Q

The aim of blood transfusion is to supply blood until animal can develop their own RBCs - how long until the donor blood is gone?

A

1 week

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11
Q

What is a naive dog in terms of blood transfusion?

A

Never received a blood transfusion

most donors naive

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12
Q

What happens if a donor and recipient have different blood types but a transfusion still takes place?

A

Initially saves life

3-4 days later = haemolysis

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13
Q

What symptoms would you expect to see from a dog that has received a transfusion from a different blood type?

A

Lowered PCV

Jaundice (from haemolysis)

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14
Q

What happens if a donor gives blood to a sensitised recipient?

A 
Acute haemolysis (fast) 
Recipient already has antibodies to that blood type
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15
Q

What system is used for canine blood types?

A

Dog erythrocyte antigen system

DEA

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16
Q

What proportion of dogs are DEA negative?

A 
50% = DEA negative
50% = DEA positive
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17
Q

There are many different types of DEA (dog RBC antigens). Which one is most important?

A

DEA-1

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18
Q

What is sensitisation in terms of blood transfusion?

A

When a DEA -ve dog receives blood transfusion from +ve dog

Has mild reaction to blood and becomes SENSITISED

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19
Q

Why is it not essential to match dog blood types if the dog has not had blood before?

A

Dog cannot be sensitised if not had previous transfusion

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20
Q

What happens if a DEA-1 negative dog receives blood from a positive dog?

A

Mild reaction

Becomes SENSITISED

21
Q

What happens if a DEA-1 positive dog receives blood from a negative dog?

A

No reaction

22
Q

What blood system is used in cats?

A

A/B system

23
Q

What blood types can a cat have?

A

A
B
AB

24
Q

Why is it essential for cats to be blood typed before receiving a transfusion?

A

Cats have naturally occurring auto-antibodies

1ml of blood can cause haemolysis and be fatal

25
Q

What is worse, giving B cats A blood, or giving A cats B blood?

A

Giving B cats A blood = BAD

Giving A cats B blood = not as bad

26
Q

What happens if you give a B cat type A blood?

A

Severe acute haemolytic reaction

Can be fatal

27
Q

What happens if you give A cats type B blood?

A

Mild delayed haemolytic reaction

28
Q

What is the gold standard for blood typing?

A

Sending off to lab - rarely time to do so

29
Q

What in house methods can be used for blood typing?

A

Card method

Cassette based method (preferred - don’t rule out auto agglutination)

30
Q

The casette/card based methods for blood typing only test for what blood types?

A

DEA 1

A/B

31
Q

It is imperative to rule out auto-agglutination for which blood typing method?

A

Card based

If present, need to wash patients RBCs, hence cassette method is preferred

32
Q

What is crossmatching in terms of blood transfusions?

A

Checking for haematological incompatibility

33
Q

Do you need to cross match?

A

Yes if go has had previous blood transfusions

Possibly if received plasma products

34
Q

What is the gold standard for crossmatching?

A

Sending to lab (IDEXX)

In house = inaccurate

35
Q

For crossmatching, blood needs to be sent to a lab. Do they tend to find 100% compatible donors?

A

No - choose least risky

36
Q

How can blood transfusions be administered (what routes)?

A

IV or IO

37
Q

Transfusion reactions are usually dose dependent. How can they be reduced?

A

Start administering blood at slow rate

Then build up

38
Q

It is essential to keep blood sterile during a transfusion. Why?

A

Blood = good growth medium for bacteria due to sugar

39
Q

Is it better to administer blood transfusions by drips or syringe drivers?

A 
Dogs = drip 
Cats = syringe
40
Q

Blood transfusions must be given with what equipment?

A

Transfusion set with an in-line filter

41
Q

What should you flush with after a blood transfusion?

A

0.9% NaCl

42
Q

Why shouldn’t you give calcium fluids after a blood transfusion?

A

Causes clotting

43
Q

Should you give medication in the same line as a blood transfusion?

A

No - use different lines

44
Q

Should you warm donor blood prior to transfusion?

A

No - give at room temperature

45
Q

Should you allow a patient access to food and water during a transfusion?

A

Allow water access

No food

46
Q

What should you monitor a patient for after a blood transfusion?

A

Heart rate, RR, rectal temperature

Signs of anaphylaxis - swelling, urticaria, nausea, vomiting

47
Q

Severe haemolytic reactions to blood transfusions are obvious, but mild reactions are not. What should you do if you suspect a mild reaction?

A

Treat symptomatically
Have 15-30 min break, restart at slower rate
Do NOT disconnect patient

48
Q

What is the rough guidelines for how much blood to administer during a transfusion?

A

10-20ml/kg

Haematology (MOD) (7 decks)

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