Autotransfusion- Exam 3 Flashcards Preview

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Flashcards in Autotransfusion- Exam 3 Deck (71)
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31

Wash phase

when the bowl is filled: the pump starts (clamps adjust)
wash solution --> wash bowl

32

In the wash phase, washing continues until when?

Until the reinfuse/empty button is depressed (or the program ends and the predetermined amount of wash solution has been used)

33

What way does effluent move in the wash phase?

Wash bowl --> waste bag

34

What way does effluent move in the wash phase?

Wash bowl --> waste bag

35

In manual mode (wash phase), what do you need to watch for?

Watch for clear effluent

36

What happens in the empty phase?

The centrifuge stops, then transfers wash bowl --> reinfusion bag
The cycle ends and a new cycle can begin
The reinfusion bag should not be used for direct pressure infusion --> patient
The reinfusion bag may contain air
Therefore, a separate blood bag attached to the reinfusion bag is used
Disconnect --> air purge--> tied off

37

Blood should be reinfused within how many hours of washing?

AABB- 4 hours
Manual of Clinical Perfusion- 6 hours

38

Blood should be reinfused within how many hours of washing?

AABB- 4 hours
Manual of Clinical Perfusion- 6 hours

39

Labeling Specimens (Anesthesia and transport)

Patients Registration Sticker
Type: WPRBCs
Time collected
time of expiration
Volume
initials

40

Labeling Specimens (Anesthesia and transport)

Patients Registration Sticker
Type: WPRBCs
Time collected
time of expiration
Volume
initials

41

Record Keeping

A signed autologous cell saver record must be kept for every case
All the input and output data is recorded
Usually single sheet that may contain:
-Volume collected for reinfusion
-Hct for reinfusion volume (WPRBC's -QC)
-Type and volume of wash solution used
-Heparinized saline/CPD concentration & amount used
-Date/time/patient information

42

Record Keeping

A signed autologous cell saver record must be kept for every case
All the input and output data is recorded
Usually single sheet that may contain:
-Volume collected for reinfusion
-Hct for reinfusion volume (WPRBC's -QC)
-Type and volume of wash solution used
-Heparinized saline/CPD concentration & amount used
-Date/time/patient information

43

Indications

Control blood loss
Recovery of blood lost during surgery
Rare blood groups w/o blood available
Risk of infectious disease transmission
Autotransfusion is common intraoperatively/postop
recovery of blood in ECC at end of surgery from aspirated damage

44

When can autotransfusion be done?

Post protamine
CPB circuit salvage
ICU pre-washing
pRBCS for pediatrics

45

What are some advantages of autotransfusion?

High levels of 2,3-DPG
Normothermic (bank blood is cold)
pH relatively normal
lower risk of infectious disease
functionally superior cells
lower potassium (compared to stored blood)
quickly available

46

What does 2,3-DPG do?

Helps with oxygen transfer

47

What substances are washed out?

plasma
platelets
WBCs
anticoagulation solution
plasma free hemoglobin
cellular stroma
activated clotting factors
intracellular enzymes
potassium
plasma bound antibiotics

48

What are some contraindications?

presence of bacterial contaminations at surgical site
malignancy of surgical area
C-section (obstetrics)
topical hemostatic agents

49

Any ________ procedure poses risk of contamination.

Abdominal

50

If there is a question of possible contamination, what should happen?

Blood may be held until the surgeon determines whether or not bowel contents are in the surgical field (standby w/ reservoir)

51

If blood is contaminated what should happen?

Entire contents should be discarded
*If patient's life depends on this, it may be reinfused with the surgeon's consent

52

What will reduce the bacterial contamination of blood, but will not be totally eliminated?

Large amounts of 0.9% NS

53

What will reduce the bacterial contamination of blood, but will not be totally eliminated?

Large amounts of 0.9% NS

54

Malignancy

The possibility exists of reinfusion cancer cells form the surgical site

55

What are some possible exceptions to the malignancy contraindication?

Removal of an encapsulated tumor possible; blood may be aspirated from the surgical site, processed and reinfused with the surgeon's consent
-If an inadequate supply of blood exists (wprbcs may be used to support the patient with the surgeon's consent

56

What is recommended if using autotransfusion with malignancy?

Leukocyte reduction filters

57

Why is autotransfusion not usually used in C-sections?

Possibility of amniotic fluid embolism exists, but emerging literature surggests that amniotic fluid is being cleared during the wash cycle

58

Can a cell saver be used in a Jehovah's witness patient?

Cell saver can be used with strict guidelines of irrigating profusely to remove amniotic fluid and then suctioning the blood that is being lost

59

What are some topical hemostatic agents?

Avitene
Helistat
Hemopad
instat
collagen type products

60

Topical Hemostatic Agents

Avitene
Helistat
Hemopad
instat
collagen type products

Waste or wall suction must be used
Autotransfused can be resumed once these products are flushed form the surgical site
If gelfoam, surgicel, thrombogen, thrombostat are used, autotranfusion possibly can continue (direct suctioning of these products should be avoided)