Advanced Surgery-Lecture 8 (Blood Transfusions)

Front 1

Why would you want to give a blood transfusion?

Back 1

Anemia (regenrative or non-regenerative) or acute blood loss, anticoagulant rodenticide toxicity, thrombocytopenia, DIC, Coagulopathy, Von Willebrand's sisease, Hypoalbuminemia

Front 2

What are the 3 types of red blood cell products that are available?

Back 2

Fresh whole blood (less than 8 hrs old)

Stored whole blood (more than 8 hours old)

Packed red cells (harvested from 1 unit of whole blood)

Front 3

Name at least 2 plasma products that are available

Back 3

Platelet rich plasma, fresh plasma, fresh frozen plasma, stored plasma, albumin.

Front 4

1. Fresh whole blood

2. Stored whole blood

3. Packed red cells

A. Typically given for rodenticide toxicities, and acute bleeds. Usually collected and given right away.

B. Typical PCV is 80%

C. Only good for 28-35 days typically

Back 4

1. A

2. C

3. B

Front 5

This blood product is used in Von Willebrand's disease, and hemophillia A.

Back 5

Cryoprecipitate

Front 6

This is a synthetic blood product that is made from cows, and is a hemoglobin based oxygen carrier. (Doesn't contain proteins or clotting factors)

Back 6

Oxyglobin (no longer on the market, some places have it stock piled though)

Front 7

What are the qualifications for an appropriate donor?

Back 7

1-6 y/o

50+ lbs

UTD on vax

On HWP and flea Preventative

Healthy/no medications

no hx of pregnancy

never had blood transfusion

never had serious dz

friendly and good tempered

Front 8

How many mls of blood are collected from donors?

Back 8

450 ml

Front 9

What should the PCV be in the donors blood when collected?

Back 9

40% (normal is 37-55%) PCV is checked prior to every donation

Front 10

True or False

Before a donor dog donates blood, they must have negative tick panels and negative von willebrand's, also should be more than 10 days post vax.

Back 10

True

Front 11

How often can a dog donate blood?

Back 11

every 4-5 weeks (typically 1-4 times/year is average)

Front 12

If a cat wants to donate blood, what are some criteria?

Back 12

1-8 y/o, 10+ lb, UTD on vax, on flea preventative, FeLV/FIV neg, on no other meds, no hx of preg, no hx of blood transfusion, no hx of serious dz.

Front 13

what should a cat's PCV be for transfusion?

Back 13

35%

Front 14

How many mls of blood are taken from a donor cat?

Back 14

60ml at once

Front 15

How many canine blood groups have been identified?

Back 15

12

Front 16

What is DEA?

Back 16

Dog Erythrocyte Antigen (most common are DEA 1.1 neg and pos, and the universal donor is DEA 1.1 neg).

Front 17

What is the universal dog blood type?

Back 17

DEA 1.1 negative

Front 18

What are the 3 main feline blood types?

Back 18

A, B, AB

Front 19

What is the main blood type in cats in general?

Back 19

Type A is most common, Type B in purebreeds

Front 20

True or False, the universal blood type in cats is type A.

Back 20

False, There is no universal donor in cats, although type AB cats can receive either blood type with little reaction.

Front 21

What should you do if you are unable to blood type a dog prior to transfusion?

Back 21

Use a universal donor, but next time they MUST be bloodtyped.

Front 22

What does cross matching help to predict?

Back 22

Reaction to blood transfusions

Front 23

How would you collect blood from a donor?

Back 23

Blood type, CBC/Chem, PCV/TS, aseptic collection, Place IV cath, induce anesthesia (if needed), Prep jug for blood draw (clip/sx prep), draw 450 ml, pressure on jug (5 min), SQ fluids (replaces fluids taken), Offer small high calorie meal

Front 24

What is ACD?

Back 24

Acid citrate dextrose (14 day storage life)

Front 25

What is CPD?

Back 25

Citrate phosphate dextrose (21 day storage life)

Front 26

True or False

When warming blood, you should throw it into a pot of boiling water, or put it into the microwave in order to heat it quickly.

Back 26

False

warm it slowly to room temp., and use strict asepsis (excessive warming will cause hemolysis)

Front 27

What are the 3 routes that blood can be transfused?

Back 27

IV, IO, IP

Front 28

What are 3 things that you should check prior to giving blood?

Back 28

TPR (temp, pulse, respiration)

Front 29

What should you premed a patient with prior to transfusion?

Back 29

Diphenhydramine

Front 30

True or False

When giving a transfusion, all products should be given with a new IV line with a blood filter.

Back 30

True

Front 31

Over how long of a period should you give whole blood?

Back 31

4-6 hours (never more than 6 because it can become contaminated)

Front 32

How often should you check TPR while giving a transfusion?

Back 32

Every 1/2 hour for the first hour, then every hour until transfusion complete (also take a PCV about 2 hours after transfusion).

Front 33

What can happen to a patient with normal Albumin that is given Albumin?

Back 33

They can have an anaphylactic reaction.

Front 34

How many times are you able to give an animal Albumin?

Back 34

Once in a lifetime thing

Front 35

What is Urticaria?

Back 35

Swelling around muzzle, eyes, and hives

Front 36

Give 3 common reactions to transfusions.

Back 36

Urticaria, fever, vomiting, diarrhea, hemoglobinemia, hemoglobinuria, hematuria, restlessness, pulmonary edema, hypotension.

Front 37

What are some things that you need to monitor after doing a blood transfusion?

Back 37

Pulse rate and quality, RR and pattern, mm color, CRT, BP, and PCV.

Front 38

If an animal shows that it is having a reaction during transfusion, what should you do?

Back 38

Stop or slow the transfusion, antihistamines prior to transfusion help, shock therapy (IV fluids), May be necessary to intubate to ensure adequate oxygenation

Front 39

What is the math for transfusion? (the easy math)

Back 39

20ml/kg (administration rateis typically 5-10 ml/kg/hr given over 4 hours

Front 40

If you give 20 ml/kg of whole blood, how much should the PCV increase?

Back 40

10%

Front 41

If giving 10ml/kg of packed red cells, how much should PCV increase?

Back 41

20%

Front 42

Give the steps of cross matching

Back 42

1. Draw 1ml of blood from the donor

2. put into purple top tube (label).

3. Draw a 2ml sample from recipient

4. put into purple top tube (label)

5. spin both purple top tubes in centrifuge (gives plasma and RBC)

6. Get 4 microscope slides

Front 43

Describe the slides process in cross matching

Back 43

Slide 1: 1 drop (donor) RBC, 1 drop plasma

Slide 2: 1 drop patient RBC, 1 drop plasma

(These are the control slides)

Slide 3: 1 drop patient plasma, 1 drop donor RBC

Slide 4: 1 drop donor plasma, 1 drop patient RBC

(These are the cross match slides)

Front 44

What should you look for in RBC's when interpreting cross matching?

Back 44

agglutination (clumping) if this occurs, it means that there are significant antibodies present to react to blood cells, and recipient isn't a candidate for the donor's blood.