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38 Cards in this Set

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what percent of americans donate blood?
5%
how many pints of blood do men have? women?
12 pints; 9 pints
What are the general guidelines for donating blood
- > 17 years old
- >110 lbs.
- haven't donated in last 56 days
- "healthy" (feel well and able to perform normal activities)
- if chronically ill need to be on treatment and the condition needs to be undercontrol
Temporarily Deferred from Donation
-heart attack or cardiac surgery in last 6-12 mon.
-malaria in last 3 yrs. or travel to an endemic area
-blood transfusion w/in year
-tattoo or piercing w/in year
-household contact with a person who has hepatitis
-not feeling well on the day of donation
-antibiotics in the last 72 hrs.
-low blood cell count
Permanently Deferred
-Chemo or radiation to treat some types of cancers
-hepatitis at age 11 yrs. or older
-high risk of having HIV due to IV drug use or sexual contact
What is the nucleic acid amplification testing (NAT) used for?
detects genetics material of viruses for HIV-1 and HCV, WNV
Autologous transfusions
blood donor and recipient are the same
Allogenic transfusions
blood transferred to someone other than the donor
preoperative donation
Patients can make autologous donations up to 72 hrs. prior to surgery
44% are unused by the donor and are discarded
Blood Type A
Antigens on RBC--> A
Antibodies in serum--> Anti-B
Able to Receive--> A, O
Blood Type B
Antigens on RBC--> B
Antibodies in serum--> Anti-A
Able to Receive--> B, O
Blood Type AB
Antigens on RBC--> A and B
Antibodies in serum--> none
Able to Receive--> A, B, AB, O
Blood Type O
Antigens on RBC--> none
Antibodies in serum--> Anti-A and Anti-B
Able to Receive--> O
Rh Typing
2 alleles, fully expressed on fetal RBCs by 30 days gestation
Rh standard of care
-Rh-Immune Globulin (RHIG, RhoGam)
-administered IM, should cover 15 mL of fetal RBCs
-should be given w/in 72 hrs. of delivery of Rh+ infant
-in case of abortion, assume Rh+
Kleinhauer-Betke Test
-quantitative measurement of fetal blood in maternal blood
-20 ug/RhoGam/1mL fetal RBCs
When is whole blood used
Used for Rh complications (limited to exchange transfusions of neonates)
what is the shelf life of blood?
-35 days
-after storing 72 hrs. no viable platelets and negligible Factor VIII acitivity
Disadvantages of Whole blood transfusions
-Volume overload
-Incr. K, NH3, H+
-Exposes patient to larger number of antigens and antibodies
-Provides low level of clotting factors
Components of whole blood
RBCs
Platelets
Plasma
Cryoprecipitated AHF (factor VIII)
Granulocytes (transfused w/in 24 hrs. of collection)
How are packed RBCs obtained
-obtained from centrifugation
What is the shelf life of Packed RBCs
storage up to 42 days, frozen up to 10 yrs.
How much do packed RBCs help a patient
one unit raises Hgb by 1 g/dL or HCT by 3%
Are packed RBCs good for getting leukocytes
no, they are poor; 70-85% removed by centrifugation, filters, or UV irradiation
How are frozen packed RBCs used?
cryoprotective agent is added, stored several years, thawed and washed prior to transfusion
Deglycerolized RBCs
-removes nearly all leukocytes and plasma
-most expensive
Washed RBCs
-isotonic saline (IgA deficient patient)
-must be transfused within 24 hrs.
-contamination risk during processing
Advantage of Washed RBCs
-removes leukocytes--> febrile reaction
-Removes plasma--> allergic reactions
-same increase in Hct as packed RBCs
Platelets
-stored up to 5 days
-raises platelets by 50-60,000/uL in avg. size adult
-transfused platelet survive 3-5 days
-Use ABO compatible and Rh- for Rh- women of childbearing age
How many platelets do you need before surgery to avoid bleeding
>50,000
What type of platelets do you give to an immunocompromised pt.? to a pt. refractory to multiple transfusions?
-Irradiated platelets
-HLA-matched platelets
Fresh Frozen Plasma
-frozen w/in 6 hrs. of collection
-stored for up to 1 yr.
-use ABO compatible
Isolated deficiencies of fibrinogen, factor 8, or factor 13 better treated by what?
cryoprecipitate
Cryoprecipitate
-each bag exposes recipient to 10 donors
-Use ABO compatible
Compatibility Testing
-review old blood bank records
-ABO, Rh of pt. and donor
-Antibody screen of pt. and donor serums (ABO, Rh, Kell, Duffy, Kidd)
-crossmatch
Crossmatch (2 types)
Major--donor RBCs/Pt. serum
Minor--pt. RBCs/donor serum (less important)
Adverse Transfusion Reactions
-Hemolytic-intravascular vs -extravascular
-Febrile
-Allergic
-Delayed
-Hypothermia
-Hypocalcemia
-Hypo/hyper kalemia
-Graft vs host
-Disease transmission
If a transfusion reaction occurs what do you do?
-discontinue transfusion
-determine type of reaction
-check for hemolysis
-CBC, creatinine, coag studies