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74 Cards in this Set
- Front
- Back
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family/friend donate blood for an individual
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directed donation
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from donor supply
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standard donation
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preplanned transfusion for possible need
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autologous donation
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collect blood loss during surgical procedure and give it back to them
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intraoperative blood salvage
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which type of blood donation is not considered as safe
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directed donation
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what are blood products screened for (7)
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- antibodies HIV 1&2
- hep B core antibody - Hep C virus - Human Tcell lymphotropic virus type 1 - Hep B surface antigen - syphillis - CMV |
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# of antigens ID'd on surface of RBC
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>200
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why is FFP frozen immediately
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to preserve clotting factors
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length of time that FFP is good for
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1 year if remains frozen
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FFP be pooled and processed into derivatives such as (3)
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- albumin
- immuneglobulin - factors VIII & IX |
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what is done to plt to prevent clumping
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gentle agitation
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how are plts stored
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- room temp
- 5 days then discarded |
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what happens to plts in cold temps
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clumps
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used for anemia
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PRBC
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prevents fluid overload
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removing of plasma in PRBC
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how are PRBCs stored
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- 42 days then discarded
- refrigerated |
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sugars present on erythrocyte membrane
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ABO
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% of population that is Rh positive
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85
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No D antigen
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Rh negative
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what are most transfusion reactions due to
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donor leukocytes
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what forms antibodies to antigens on leukocytes
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recipient
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what are the processes to reduce leukocyte exposure (3)
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- leukocyte filtering @ time of collection
- leukocyte filter on administration tubing - irradiation |
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removes all leukocytes, used w/ immunocompromised
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irradiation
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better results but its expensive
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leukocyte filtering at time of collection
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S&S of reaction with PRBC (9)
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- itching
- hives - swelling - SOB - fever -chills - low back pain - nausea - pain at IV site |
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how soon should infusion start with PRBC
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30 min
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indicator of bacterial contamination
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gas bubbles
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IV size used with PRBC
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20 ga or larger
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gauge for plt
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22 or larger
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infusion time for FFP
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30-60 min
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should occur after administration of 2 units
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change out tubing
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caused by antibodies to donor leukocytes in unit
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febrile nonhemolytic reaction
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potentially life-threatening. donor blood incompatible with recipients blood
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acute hemolytic reaction
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hypervolemia related to too much blood too quickly
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circulatory overload
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thought to be sensitivity reaction to plasma protein in component being transfused
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allergic reaction
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low incidence, but great risk to pt if present
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bacterial contamination
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S&S of febrile nonhemolytic reaction (2)
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- chills
- fever (within 2 hrs) |
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what is the most common type of blood reaction
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FNR
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how can FNR be reduced
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by using leukocyte reduction filter
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can occur with as little as 10mls
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ABO reaction
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what is the most common cause of AHR (2)
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- specimen mislabled
- check process not done correctly |
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S&S of AHR (7)
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- fever
- chills - low back pain - nausea - chest tightness - dyspnea - anxiety |
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what does hemoglobinuria result in (3)
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- hypotension
- bronchospasm - vascular collapse |
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what is the cause of hemoglobinuria
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- erythrocyte destruction releasing hgb
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how should start of transfusion be
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5ml/min then go increase it to finish in 4 hours if no adverse effects occurred in the beginning
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Ga for FFP and plt
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22 or larger
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should be done at end of FPP and plt infusion
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Vs to compare to baseline
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how is dx of FNR made
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by excluding other causes
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S&S of severe allergic reaction (5)
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- bronchospasm
- laryngeal edema - shock treated with epi -corticosteroids - vasopressor |
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tx for mild allergic reaction
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stop transfusion
give antihistamine cont if look better |
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how to prevent circulatory overload
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adjust rate of infusion to pt condition
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tx for circulatory overload
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- diuretics during and/or after transfusion
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S&S of C overload (7)
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- dyspnea
- orthopnea - tachycardia - sudden anxiety - JVD - crackles at bases - increased BP |
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cont'd C overload can result in what
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pulmonary edema
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tx for severe overload (4)
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- stop transfusion
- placed in upright position - feet dependent - maintain IV |
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what is often the cause of bacterial contamination
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contaminants on donors skin
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greater risk for bacterial contaminiation
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plts due to room temp storage
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appearance of contaminated unit
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normal or cloudy
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S&S of bacterial contamination (3)
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- fever
-chills - hypotension |
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what can bacterial contamination result in that has a high mortality rate
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septic shock
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tx for bacterial contamination (5)
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stop transfusion
fluids broad spectrum abx corticosteroids vasopressors |
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what is the most common transfusion related cause of death
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TRALI
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onset of TRALI
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within 2-6 hrs
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S&S of TRALI (5)
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- SOB
- hypoxia - hypotension - fever - pulm edema |
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Dx criteria for TRALI (3)
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- hypoxemia
- bilateral pulm infiltrates - no cardiac explanation for pulm edema |
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tx for TRALI (3)
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- oxygen
- intubation - fluid support |
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gradual hemolysis of erythrocytes, extravascular via RES
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delayed hemolytic reaction
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when can DHR occur
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within 14 days of transfusion
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S&S of DHR (5)
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- fever
-anemia -increased bili level - decreased/absent heptaglobin -jaundice |
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what can DHR result in with future transfusion
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sever reaction
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risk low with testin of donor blood, but still possible
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disease acquisition
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stimulates proliferation and differentiation of myeloid stem cells
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G-CSF
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stimulates myelopoiesis
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GM-CSF
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stimulates erythropoiesis
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erythropoitin
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