5. Transfusion Flashcards
(162 cards)
1
Q
antigen is found on
A
RBC
2
Q
antibody is found
A
in plasma for the antigen that they do not have
3
Q
A: antibody
A
anti-B
4
Q
A: antigen
A
A antigen
5
Q
B: antibody
A
anti-A
6
Q
B: antigen
A
B antigen
7
Q
AB: antibody
A
none
8
Q
AB: antigen
A
A antigen
B antigen
9
Q
O: antibody
A
anti-A
anti-B
10
Q
O: antigen
A
none
11
Q
immunogemic
A
most likely to cause reaction due to incompatibility
12
Q
which blood system is most important
A
ABO
13
Q
which blood system is 2nd important
A
Rh system
14
Q
Rh antigens are
A
highly immunogenic
15
Q
Rh+ can receive
A
Rh+
Rh-
16
Q
Rh- can receive
A
Rh- only
17
Q
when do Rh antibodies develop
A
after exposure
- transfusion
- pregnancy
18
Q
main cause of hemolytic disease in newborn
A
Rh
19
Q
which blood type is universal recipient
A
AB+
20
Q
which blood type is universal donor
A
O-
21
Q
AB+ can receive
A
ALL blood
22
Q
AB- can receive
A
O-
A-
B-
AB-
23
Q
A+ can receive
A
O+
O-
A+
A-
24
Q
A- can receive
A
O-
A-
25
B+ can receive
O+
O-
B+
B-
26
B- can receive
O-
B-
27
O+ can receive
O+
O-
28
O- can receive
O-
29
universal FFP recipient
O
30
universal FFP donor
AB
31
O can receive FFP
O
A
B
AB
32
A can receive FFP
A
AB
33
B can receive FFP
B
AB
34
AB can receive FFP
AB
35
does the Rh matter for FFP
no
36
agglutination
occurs if antigen is mixed with its corresponding antibody
37
type and screen purpose
to detect antibodies commonly associated w/non-ABO hemolytic reactions
38
type and screen time
45-90 mins
39
incidence of reaction after T+S
<1%
40
type and cross purpose
1. confirm ABO/Rh typing
2. detects antibodies to other systems
3. detects antibodies in low titers
41
type and cross time
15 - 60 mins
42
which blood test is mixing pt blood with donor blood
type and cross
43
incidence of reaction after T+C
~ 0%
44
what are donor bloods tested for
Hep B
Hep C
HIV
syphilis
45
blood donation preservative
CPDA-1
46
CPDA -1
Citrate
Phosphate
Dextrose
Adenosine
47
CPDA shelf life
35d
48
Citrate function
anti-coag
binds Ca2+
49
Phosphate function
buffer
50
Dextrose function
red cell energy source
51
adenosine function
precursor for ATP synthesis
52
best blood to give if you have it
whole blood
53
PRBC shelf life
35 days
54
PRBC effect
1 unit will raise :
Hg 1g/dL
Hct 3%
55
PRBC SE
citrate toxicity
hypothermia
hyperkalemia
decr 2,3-DPG
56
when is transfusion considered
Hg 6-10 g/dL
57
which pts need higher Hg
CAD
cardiopulm
cerebrovascular
elderly
58
how many donors are needed for 1 bag of plts
6-8
59
plt storage
20-24C
60
Plt effect
1 unit will raise plts by 5k-10k
61
plt indication
thrombocytopenia
plt dysfunction
62
is ABO compatibility req for plts
no
63
only prophyaltic indication for plts
TBI
64
FFP contains
plasma proteins
most clotting factors
65
difference between FFP and albumi
FFP contains clotting factors
66
FFP effect
1 unit will raise clotting factor by 2-3%
67
is ABO compatibility needed for FFP?
yes
68
is Rh compatibility needed for FFP?
no
69
FFP indications
Tx of isolated factor deficiencies
warfarin reversal
coagulopathy (liver dz)
massive transfusio n
70
FFP warfarin reversal dose
5-8 mL/kg
71
cryo
prepicipitate remaining after FFP is thawed slowly
72
cryo contains
F VIII
FXII
vWF
fibrinogen
73
cryo effect
1 unit incr fibrinogen by 5-7 mg/dL
74
cryo indications
F VIII deficiency
hemophilia A
fibrinogen deficiency (< 80-100 mg/dL)
75
min required filter size for blood admin
170 micron
76
fluids for blood admin
NS only
77
why cant you give LR with blood?
LR contains Ca2+ which binds the citrate causing clots
78
which blood products cannot be warmed
plts
cryo
79
min IV size for blood amin
20 ga
80
things you must check before blood admin (6)
Name
MRN
DOB
Unit #
Blood Type
Expiration Date
81
how many people must check before blood admin
2
82
what is the mandatory transfusion trigger
there is no mandatory transfusion trigger
83
ABL =
ABL = EBV x [ (Hct i - Hct f) / Hct i ]
can use Hct or Hgb
84
adult male Blood volume
75 mL/kg
85
adult female blood volume
65 mL/kg
86
infant blood volume
80 mL/kg
87
full term neonate blood volume
85 mL/kg
88
premie neonate blood volume
95 mL/kg
89
which blood do you give if you dont know blood type
O-
90
MTP
need to transfuse 1-2x the pt blood volume
91
MTP other definitions
loss of 50% BV in 3 hr
need >4 u PRBCs in 1 hr
blood loss > 150 mL/hr
92
Class 1 hemorrhage
loss of <15% BV
no change HR/BP
93
class 1 hemorrhage treatment
no fluids needed
94
class 2 hemorrhage
loss of 15-30% BV
sympathetic response
incr HR
incr DBP
95
class 2 hemorrhage treatment
need to give fluid
96
class 3 hemorrhage
loss of 30-40%
hypoperfusion
metabolic acidosis
97
class 3 treatment
crystalloids
not-long term solution
98
class 4 hemorrhage
loss of >40% BV
99
class 4 treatment
needs blood products ASAP
100
blood consumption score
+1 pt for:
- HR > 120bpm
- SBP < 90mmHg
- positive FAST
- penetrating injury
101
which blood consumption score indicates need for MTP
+2
102
belmont transfusion speed
1000 mL/min
103
belmont SE
citrate tox
hypothermia
hyperkalemia
acid-base disturbances
104
goal SBP
80-100 mmHg
105
goal Temp
> 35 C
106
goal Hb
> 7g/dL
107
goal pH
> 7.2
108
goal BE
> -6
109
goal lactate
< 4 mmols/L
110
goal Ca2+
> 1.1 mmol/L
111
goal Plts
> 50K
112
goal PT/PTT
< 1.5 x nL
113
goal INR
< 1.5
114
goal fibrinogen
> 1.0g/L
115
how long before surgery do you need autologous transfusion
4-5 wks
116
Hg for autologus
11
117
Hct for autologus
34%
118
how long between autologus donations
72 hrs
119
cell saver blood is mixed with
heparin
120
how much blood loss is needed for cell saver
> 1000 mL
121
cell saver Hct
50-60%
122
cell saver CI
cancer
sepsis
123
citrate tox S+S
paresthesia
hyptension
arrythmias
124
citrate tox treatment
CaCl
CaGlu
125
transfusion immune SE
hemolytic
febrile
anaphylaxis
TRALI
TACO
GvH disease
post transfusion purpura
126
transfusion infection SE
hepatitis
HIV
cytomegalovirus
epstein-barr
parasitic
bacterial
127
transfusion other SE
hypothermia
L shift Hg-O2 curve
hyperkalemia
human error
iron overload
128
hemolytic rxn
destruction of RBCs by recipients antibodies
129
acute hemolytic timeline
w/i 24 hrs of transfusion
sometimes immediate
130
acute hemolytic cause
ABO incompatibility
131
acute hemolytic S+S
incr temp
incr HR
decr BP
hemoglobinuria
oozing
132
acute hemolytic treatment
stop transfusion
labs
test urine for Hg
diuresis
133
delayed hemolytic rxn timeline
>24 hrs post-transfusion
134
delayed hemolytic cause
Rh incompatibility
135
delayed hemolytic S+S
malaise
jaundice
fever
decr Hg
136
febrile rxn cause
pts develop antibodies to leukocytes
137
febrile reaction S+S
temp incr >1 deg within 4hrs
138
febrile rxn treatment
stop transfusion
labd
antipyretics
benadryl
139
allergic rxn is common with which blood product
FFP
140
anaphylacitc rxn is common is what pts
IgA-deficient pts with anti-IgA antibodies
141
anaphylactic S+S
decr BP
incr HR
bronchospasm
hives
142
anaphylactic treatment
100 mcg epi
fluids
steroid
143
leading cause of death fron transfusions
TRALI
144
TRALI timeline
w/i 6 hrs of transfusion
145
TRALI is more common with which products
plt
FFP
146
TRALI S+S
dyspnea
cyanosis
chills
fever
decr BP
147
TRALI treatment
supp O2 (not 100%)
vent support
PEEP 5-7
148
TACO cause
blood products given faster than CO can keep up
149
TACO S+S
3 or more:
- resp distress
- pulm edema
- incr BNP
- incr CVP
150
TACO treatment
stop infusion
supp O2
vent support
diuresis
151
GvH diseasee common in what pts
immunocompromised
152
GvH S+S
rash
fever
diarrhea
liver dysfunction
153
GvH treatment
give irradiated products to avoid lymphocyte reactiojn
154
post-transfusion purpura
plt alloantibodies destroy pts plts
155
PTP plt levels
< 10,000
156
PTP treatment
IV IgG
plasmapheresis (plasma exchange)
157
which hepatitis are we most concerned with
Hep C
158
how long after covid to donate blood
10d post + test
159
how long after covid vax to donate blood
14 days post vax
160
second leading cause of transfusion mortality
bacterial infection
most often cuse by bacteremia or contamination
161
bacterial infection S+S
fever
chills
tachycardia
emesis
hypotension
shock
162
bacterial infection treatment
stop transfusion
get cultures
give abx
