Blood Products Flashcards
Blood Administration: Typing
Blood is grouped according to the presence or absence of specific antigen
Blood Administration: Typing
•Type A: A antigen only on RBC’s
(B antibody in plasma)
•Type B: B antigen only on RBC’s
(A antibody in plasma)
•Type AB: Both A and B antigens on RBC’s
(neither A or B antibody in plasma)
•Type O: Neither A or B antigens on RBC’s
(Both A and B antibody in plasma)
- O negative is the Universal Donor
- AB+ is the Universal Recipient
Rh (Rhesus) Factor
- The presence or absence of the Rh antigen, “D” on the surface of the RBC’s determine the classification of Rh-positive (85%) or negative
- If a person is Rh negative they can only receive negative blood
- If a person is Rh positive they can receive Rh positive or negative blood
Rh Immune Globulin
- For Rh neg. women delivering Rh pos. infant
- Rh partial “D” positive women who deliver Rh pos. infant
- RH neg. women never sensitized at 28-32 weeks gestation, abortion, amniocentesis or other indicated procedures
- Vial (300 mcg)/15 mL per Rh pos. cell exposure
Blood Crossmatching
- Done to decrease the potential for reaction
* Mixing the recipient’s serum with the donor’s RBC followed by the addition of a Direct Coomb’s Test
Blood Administration
•Five types of transfusable blood products:
–Whole blood –Red Blood Cells (RBC’s) –Platelets (PLT’s) –Plasma (FFP) –Cryoprecipitate (CRYO)
Blood Administration
•Use of donated blood products post-collection:
–RBC’s – within 42 days
–PLT’s – within five (5) days
–FFP & Cryo – stored frozen and may be used up to one year
Blood Administration
•Whole blood
- Replenishes both volume and oxygen carrying capacity
- Emergency and acute trauma
- 500mL of volume per unit
Blood Administration
•PRBC’s
- Prevents circulatory overload
- 80% of the plasma has been removed
- Hemoglobin <10g/dl (<7%) (parameter)
- Hematocrit <10 g/dl (<21%) (parameter)
- Each unit should increase the hematocrit about 3%
- Each unit 250-300 mL/unit
- One unit over 2-4 hours [NO longer than 4 hours max]
•Post-Op common
Blood Administration
•Platelets
Given when platelets are less the 20,000 or with active bleeding
30-50mL ~60 units
rotated/agitated to prevent clumping
Irradiated platelets removes WBC that may cause reactions
Blood Administration
•FFP
[fresh frozen plasma]
Contains a lot of clotting factors & provides volume (220mL/unit) for INR > 1.7 and any coagulation deficiencies
often given with blood
Blood Administration
•Albumin
100 mL acts like 500 mL of plasma in providing volume into intravascular space
hypertonic
volume expander
(shock, burns)
Blood Administration
•Cryoprecipitate
Given when Fibrinogen level < 100 milligrams/dl
can increase fibrinogen by 50mg
Bacterial Contamination of Platelets
•Becoming one of the greatest transfusion infectious risk:
–Transfusion transmitted sepsis
•Confirmed in 1/100,000 recipients
•Actual risk higher due to under-reporting
•Immediate fatal outcomes are 1/500,000
- Critical to investigate febrile transfusion reactions, especially when transfusing platelets
- Sepsis risk
Special Attributes
- Leuko-reduced – Cytomegalovirus (CMV) reduced risk (transplant patients)
- Washed – removal of plasma proteins that may cause reactions
- Pathogen Reduced Platelet Product – reduces risk of bacterial contamination and emerging pathogens
Blood Administration
•Autologous Blood
- Safest way to receive a transfusion
- Pre-operative donation
- Donation at least 3 days prior to surgery (7-3 days before sx)
- Can not donate if hemoglobin is <11g/dl
Blood Administration
•Type & Crossmatch
–Time-out verification form must be completed for every blood bank crossmatch
–Completed at bedside
–Two licensed personnel verification signature
–Band completed by both individuals
–Includes:
•Patients full name
•MR #
•Date/time of collection
•Blood band ID #
•Signature of both individuals
