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20 Cards in this Set
- Front
- Back
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Pretransfusion compatibility testing begins with
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Pretransfusion compatibility testing begins with typing (ABO/Rh determination) and screening (detection of non-ABO antibodies).
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If an erythrocyte transfusion is needed what todo
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If an erythrocyte transfusion is needed, the crossmatch can be done quickly by using the patient’s serum or plasma and a representative sample from an ABO/Rh-compatible donor unit. Verification of patient identity at the bedside prior to administration is a critical final step in safe transfusion.
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what is critical final step in safe transfusion
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Verification of patient identity at the bedside prior to administration is a critical final step in safe transfusion.
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If a patient needs an emergency transfusion,
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If a patient needs an emergency transfusion, group O erythrocyte units and group AB plasma units are used until the ABO/Rh type can be determined. Group O erythrocytes can be transfused to anyone, because there are no A or B antigens on these cells to react with anti-A or anti-B hemagglutinins. Similarly, group AB plasma can be transfused to anyone because it contains no hemagglutinins to react with A or B antigens
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Rh-positive patients
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Rh-positive patients can safely receive either Rh(D)-positive or Rh(D)-negative blood, but Rh-negative patients must receive Rh(D)-negative blood to avoid alloimmunization. This is especially a concern for women of childbearing potential in order to prevent formation of anti-D antibodies, leading to severe hemolytic disease of the newborn.
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Rh-negative platelets
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Platelets are generally transfused without regard to ABO compatibility, but, rarely, hemagglutinins in platelet-rich plasma may cause self-limited hemolysis. Because Rh-negative platelets are in short supply, Rh immunoprophylaxis should be considered in Rh-negative women of childbearing age who are transfused with Rh-positive platelets if the platelets contain more than 2 mL of donor erythrocytes. Certain patients have a higher risk for alloimmunization.
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Patients with sickle cell disease and transfusion
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Patients with sickle cell disease can form multiple alloantibodies. Providing donor units that are matched for the patient’s Rh and other blood group antigens helps to prevent alloimmunization.
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Patients with warm autoimmune hemolytic anemia and transfusion
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Patients with warm autoimmune hemolytic anemia often have positive crossmatches because the autoantibody reacts with both the donor’s and the patient’s erythrocytes. “Incompatible” transfusion for these patients can provide critically needed oxygen-carrying capacity until medical therapy becomes effective or splenectomy is performed.
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why most donor erythrocytes will be incompatible on cross-match. in P with warm auto imm hemol anemia.. waht t do
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In the absence of pregnancy and previous blood transfusions, the likelihood of alloimmunization to erythrocyte antigens is extremely low. Because of the broad specificity of autoantibodies in patients with autoimmune hemolytic anemia, most donor erythrocytes will be incompatible on cross-match. In this situation, transfusion of ABO-/Rh-specific, but otherwise incompatible, blood is necessary and can be life-saving. The transfused donor erythrocytes will survive as long as the patient’s own erythrocytes and will provide oxygen-carrying capacity until definitive therapy, such as corticosteroids, becomes effective.
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What is the definition of febrile nonhemolytic transfusion reaction?
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What is the definition of febrile nonhemolytic transfusion reaction?
A rise in temperature of 1ºC or greater sometimes accompanied by chills or rigors. Hemolytic transfusion reaction and bacterial contamination must be excluded. |
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What are the features of febrile nonhemolytic transfusion reaction
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What are the features of febrile nonhemolytic transfusion reaction?
Typically occurs during transfusion but can be delayed up to an hour after transfusion. The fever is usually self-limited and resolves within 2-3 hours, but acetaminophen can be given. |
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How are febrile nonhemolytic transfusion reactions treated?
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How are febrile nonhemolytic transfusion reactions treated?
Some people will choose to pretreat with antipyretics. Some people believe that transfusion should be restarted once the transfusion reaction testing is done so that the patient is exposed to as little donors as possible. What has decreased the incidence of febrile transfusion reactions? Universal leukocyte reduction What has been attributed to the formation of febrile nonhemolytic transfusion reactions? The accumulation of pyrogenic cytokines in units during storage. Leukocyte reduction at the time of donation has been found to reduce the generation of these cytokines by leukocytes. Accumulated cytokines can be removed by plasma reduction or washing of the component. What clinical sequelae are associated with allergic transfusion reactions? Pruritus, urticaria, erythema, and cutaneous flushing. GI involvement includes nausea, vomiting, pain, and diarrhea. How are allergic transfusion reactions treated? Should intubate if there is upper airway involvement or give oxygen if there is dyspnea. Responds to administration of 50-100 mg diphenhydramine. Can premedicate with 25-50 mg of diphenhydramine before the transfusion. Transfusion can usually be restarted after treatment without a recurrence. What clinical sequelae are associated with severe allergic (anaphylactic) transfusion reactions? Cardiovascular instability (hypotension, tachycardia, cardiac arrhythmia, shock, cardiac arrest) and respiratory involvement (dyspnea, stridor). How are severe allergic (anaphylactic) transfusion reactions treated? transfusion should be stopped and the IV access maintained. Epinephrine should be available. Subcutaneous epinephrine (0.3-0.5 mL of a 1:1000 solution every 20-30 minutes or 5 mL of a 1:10000 solution IV every 5-10 minutes) should be given for significant bronchospasm or unresponsive hypotension. Which patients are more prone to allergic (anaphylactic) transfusion reactions? Patients with IgA deficiency can develop anti-IgA and have anaphylactic reactions. Patients with haptoglobin deficiency can have anaphylactic reactions due to IgG or IgE antihaptoglobin (common in Japanese patients with anaphylactic reactions). |
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What has decreased the incidence of febrile transfusion reactions?
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What has decreased the incidence of febrile transfusion reactions?
Universal leukocyte reduction |
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What has been attributed to the formation of febrile nonhemolytic transfusion reactions?
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What has been attributed to the formation of febrile nonhemolytic transfusion reactions?
The accumulation of pyrogenic cytokines in units during storage. Leukocyte reduction at the time of donation has been found to reduce the generation of these cytokines by leukocytes. Accumulated cytokines can be removed by plasma reduction or washing of the component. What clinical sequelae are associated with allergic transfusion reactions? Pruritus, urticaria, erythema, and cutaneous flushing. GI involvement includes nausea, vomiting, pain, and diarrhea. How are allergic transfusion reactions treated? Should intubate if there is upper airway involvement or give oxygen if there is dyspnea. Responds to administration of 50-100 mg diphenhydramine. Can premedicate with 25-50 mg of diphenhydramine before the transfusion. Transfusion can usually be restarted after treatment without a recurrence. What clinical sequelae are associated with severe allergic (anaphylactic) transfusion reactions? Cardiovascular instability (hypotension, tachycardia, cardiac arrhythmia, shock, cardiac arrest) and respiratory involvement (dyspnea, stridor). How are severe allergic (anaphylactic) transfusion reactions treated? transfusion should be stopped and the IV access maintained. Epinephrine should be available. Subcutaneous epinephrine (0.3-0.5 mL of a 1:1000 solution every 20-30 minutes or 5 mL of a 1:10000 solution IV every 5-10 minutes) should be given for significant bronchospasm or unresponsive hypotension. Which patients are more prone to allergic (anaphylactic) transfusion reactions? Patients with IgA deficiency can develop anti-IgA and have anaphylactic reactions. Patients with haptoglobin deficiency can have anaphylactic reactions due to IgG or IgE antihaptoglobin (common in Japanese patients with anaphylactic reactions). |
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What clinical sequelae are associated with allergic transfusion reactions
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What clinical sequelae are associated with allergic transfusion reactions?
Pruritus, urticaria, erythema, and cutaneous flushing. GI involvement includes nausea, vomiting, pain, and diarrhea. |
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How are allergic transfusion reactions treated?
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How are allergic transfusion reactions treated?
Should intubate if there is upper airway involvement or give oxygen if there is dyspnea. Responds to administration of 50-100 mg diphenhydramine. Can premedicate with 25-50 mg of diphenhydramine before the transfusion. Transfusion can usually be restarted after treatment without a recurrence. |
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What clinical sequelae are associated with severe allergic (anaphylactic) transfusion reactions?
Cardiovascular instability (hypotension, tachycardia, cardiac arrhythmia, shock, cardiac arrest) and respiratory involvement (dyspnea, stridor). How are severe allergic (anaphylactic) transfusion reactions treated? transfusion should be stopped and the IV access maintained. Epinephrine should be available. Subcutaneous epinephrine (0.3-0.5 mL of a 1:1000 solution every 20-30 minutes or 5 mL of a 1:10000 solution IV every 5-10 minutes) should be given for significant bronchospasm or unresponsive hypotension. Which patients are more prone to allergic (anaphylactic) transfusion reactions? Patients with IgA deficiency can develop anti-IgA and have anaphylactic reactions. Patients with haptoglobin deficiency can have anaphylactic reactions due to IgG or IgE antihaptoglobin (common in Japanese patients with anaphylactic reactions). |
What clinical sequelae are associated with severe allergic (anaphylactic) transfusion reactions?
Cardiovascular instability (hypotension, tachycardia, cardiac arrhythmia, shock, cardiac arrest) and respiratory involvement (dyspnea, stridor). How are severe allergic (anaphylactic) transfusion reactions treated? transfusion should be stopped and the IV access maintained. Epinephrine should be available. Subcutaneous epinephrine (0.3-0.5 mL of a 1:1000 solution every 20-30 minutes or 5 mL of a 1:10000 solution IV every 5-10 minutes) should be given for significant bronchospasm or unresponsive hypotension. Which patients are more prone to allergic (anaphylactic) transfusion reactions? Patients with IgA deficiency can develop anti-IgA and have anaphylactic reactions. Patients with haptoglobin deficiency can have anaphylactic reactions due to IgG or IgE antihaptoglobin (common in Japanese patients with anaphylactic reactions). |
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How are severe allergic (anaphylactic) transfusion reactions treated?
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How are severe allergic (anaphylactic) transfusion reactions treated?
transfusion should be stopped and the IV access maintained. Epinephrine should be available. Subcutaneous epinephrine (0.3-0.5 mL of a 1:1000 solution every 20-30 minutes or 5 mL of a 1:10000 solution IV every 5-10 minutes) should be given for significant bronchospasm or unresponsive hypotension. Which patients are more prone to allergic (anaphylactic) transfusion reactions? Patients with IgA deficiency can develop anti-IgA and have anaphylactic reactions. Patients with haptoglobin deficiency can have anaphylactic reactions due to IgG or IgE antihaptoglobin (common in Japanese patients with anaphylactic reactions). |
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Which patients are more prone to allergic (anaphylactic) transfusion reactions?
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Which patients are more prone to allergic (anaphylactic) transfusion reactions?
Patients with IgA deficiency can develop anti-IgA and have anaphylactic reactions. Patients with haptoglobin deficiency can have anaphylactic reactions due to IgG or IgE antihaptoglobin (common in Japanese patients with anaphylactic reactions). |
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Indications for Red cell transfusion {7 main}
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Indications for Red cell transfusion {7 main}
1. Haemorrhage 2. Anaemia a. dilutional b. Iron-deficiency c. Megaloblastic d. Chronic disorders 3. Chronic renal failure 4. Erythropoiesis Failure 5. Sickle cell disease 6. Septic shock 7. DIC |
