Blood Products & IV Fluids Flashcards Preview

Emergency Medicine > Blood Products & IV Fluids > Flashcards

Flashcards in Blood Products & IV Fluids Deck (45):
1

Role of Blood in Oxygen Delivery

Blood delivers oxygen to tissues
Anemia impairs oxygen delivery
Oxygen delivery = cardiac output x arterial oxygen content

2

Risks of Transfusing Blood Products

Infection
Allergic and immune transfusion reaction
Volume overload
Hyperkalemia
Iron overload
Surgical patients

3

Patients who are More Sensitive to Volume Overload

Elderly
Children
CHF

4

Patients who are More Sensitive to Hyperkalemia

Newborns
Renal failure
Massive transfusions

5

Patients who Develop Iron Overload

Large number of transfusions
Chronic Anemia

6

Define Massive Transfusion

Replacement of blood volume in a 24 hour period OR 50%+ of blood volume in 4 hours

7

Pneumonic for the Complications of a Massive Transfusion

PATCH

8

What does the pneumonic PATCH stand for in massive transfusions?

P: platelets decrease, potassium increases
A: ARDS, acidosis
T: temp decrease
C: citrate intoxication
H: hemolytic reaction

9

What does a type and screen determine?

ABO and Rh status and the presence of most commonly encountered antibodies

10

What does a type and crossmatch determine?

ABO and Rh status as well as adverse reaction to even low incidence antigens

11

Transfusion Thresholds

Not be based on Hgb/Hct levels alone
Generally symptomatic and Hgb of 6-10 g/dL

12

What hemoglobin level do studies indicate to target when providing blood products?

7-8 g/dL

13

By what factor does oxygen delivery exceed oxygen consumption?

Factor of 4

14

Compensatory Mechanisms for Delivery of Oxygen

Increased cardiac output
Rightward shift of the oxygen-hemoglobin dissociation curve
Increased oxygen extraction

15

Factors in the Decision to Transfuse Blood Products

Hub level
Clinical status
Co-morbidities
Patient preference

16

How long after an infusion can you check the Hgb/Hct levels?

15 minutes

17

When would you use FFP?

Clotting factors
Reverse warfarin
Massive transfusions
Liver disease

18

When do you transfuse platelets?

Low platelet counts that are symptomatic

19

Which blood type is the universal donor?

O negative

20

Which blood type is the rarest?

AB negative

21

Which blood types are the most common?

O positive
A positive

22

Define Crystalloids

Solutions that contain small molecules and are able to pass through semipermeable membranes

23

Why are isotonic solutions given?

Expand the ECF

24

Why are hypotonic solutions given?

Reverse dehydration

25

Why are hypertonic solutions given?

Increase ECF volume
Decrease cellular swelling

26

Define Colloids

Solutions that contain high molecular weight proteins or starch

27

Where is the final location of colloids?

Intravascular space
Too large to pass through the capillary walls

28

What type of fluid are D5W, D10W, and D50W?

Crystalloid

29

What type of fluid is albumin?

Colloid

30

What type of fluid is dextran?

Colloid

31

What type of fluid is saline?

Crystalloid

32

What type of fluid are D5 1/2, D5NS, and D10NS)?

Crystalloid

33

What type of fluid is hexastarch?

Colloid

34

What type of fluid is ringer's lactate (LR)?

Crystalloid

35

Signs and Symptoms of Intravascular Depletion

Decreased BP
Flat jugular veins
Increased HR
Cool extremities

36

Signs and Symptoms of Interstitial Fluid Depletion

Decreased skin turgor
Sunken eyeballs
Weight
+/- hemodynamic effects

37

Final Location of 0.9% Saline

Intravascular space
Interstitial space

38

Final Location of 5% Albumin and PRBCs

Intravascular space

39

Which electrolytes are lost in sweat and exhaled water vapor?

None

40

Which electrolytes are lost in the urine?

All of them

41

Which patients do not need maintenance sodium or potassium?

Renal failure patients

42

How is sodium regulated?

Thirst
ADH
Renal water handling

43

Conditions that Cause Fluid Loss

GI
Renal
Vascular
Skin

44

Conditions that Cause Fluid Gain

Iatrogenic
Heart failure
Liver failure
Kidney failure

45

Why does liver failure cause fluid gain?

Decreased albumin which leads to decreased oncotic pressure