Flashcards in Blood Products and IV fluids Deck (32)
What is the formula for O2 delivery?
-Oxygen delivery (DO2) is determined by the formula
-DO2 = cardiac output X arterial oxygen content
2. Allergic and immune transfusion reaction
3. Volume overload
5. Iron Overload
1. Who is volume overload a common risk in? 3
2. Hyperkalemia is a risk in which populations specifically? 3
3. Iron overload more common in what?
1. Volume overload
3. Iron overload
-Large number of transfusions ex: chronic anemia
1. What is a massive transfusion defined as?
2. Complications? (PATCH) 5
1. Defined as replacement of blood volume in a 24 hour period or >50% of blood volume in 4 hours
2. Complications (PATCH)
-Platelets decrease, Potassium increase
Don’t forget about coagulation factors if replacing blood with PRBCs … may need a unit of what?
Type and Screen
1. Determines what?
2. Adverse rxn chance?
3. Takes how long?
Type and Crossmatch
1. Determines what?
2. Adverse rxn risk?
3. Takes how long?
Type and screen
1. Determines ABO and Rh status and the presnce of most commonly encountered antibodies
2. Risk of adverse reaction is 1:1000
3. Takes about 5 minutes
Type and crossmatch
1. Determines ABO and Rh status as well as adverse reaction to even low incidence antigens
2. Risk of adverse reaction is 1:10,000
3. Takes about 45 minutes
Depending on the clinical situation and the which society’s guidelines the range for transfusion is anywhere from Hgb of what?
1. Target Hgb values of ______ g/dL are associated with equivalent or better outcomes in many patient populations
Compared with a target Hgb of ___ g/dL
1. 7 to 8
Why not transfuse before Hgb gets so low?
1. The rate of normal O2 delivery exceeds consumption by a factor of what?
2. Theoretically (if fluid volume and cardiovascular status is maintained) O2 delivery will be adequate until the Hct reaches what?
3. Compensatory mechanism?
2. below 10!
-increased cardiac output,
-rightward shift of the oxygen-hemoglobin dissociation curve
-increased oxygen extraction
1. Blood Transfusion: Decision to transfuse depends on? 4
2. Can check what 15 min post infusion to assess status (if not actively bleeding)?
3. If stable, consider transfusing what instead of what?
3. one unit of packed red cells at a time (instead of multiple units in the initial order)
What makes up whole blood? 4
1. Red cells
What makes up plasma? 2
1. Fresh Frozen Plasma
2. Fractionated products
What makes up fractionated products? 5
1. F VII
2. F VIII
3. F IX
5. Immune Globin
FFP is made of? 2
2. Cryo supernatant plasma
1. When do you use FFP? 3
2. When do you transfuse platelets? 1
-To replace clotting factors
-Also when you infuse a lot of packed RBC
2. low platelet count that is symptomatic
1. Which blood type is the universal donor?
2. Which blood type is the rarest?
3. Which blood type(s) is/are the most common?
Which blood type is the universal donor?
1. O negative
Which blood type is the rarest?
2. AB negative (1% of the population)
Which blood type(s) is/are the most common?
1. What are they?
2. Isotonic solutions: Given when?
3. Hypotonic solutions
Given to do what?
4. Hypertonic solutions
Given to do what?
1. Solutions that contain small molecules and are able to pass through semipermeable membranes
2. Given to expand the ECF volume
3. reverse dehydration
4. increase the ECF volume and decrease cellular swelling
1. Solutions that contain what? 2
2. Describe their movement?
3. Pulling fluid out of the what for several days? 2
-high molecular weight proteins or
2. Do not cross the capillary semipermeable membrane and remain in the intravascular space
Remember which is a colloid vs. crystalloid:
1. D5W, D10W, D50W?
5. Combo: D5 ½ NS, D5NS, D10NS?
7. Ringer’s lactate?
1. Intracellular space
-Where is it and how much of the body does it make up?
2. Extracellular fluid includes
-Which spaces? 2
-Total body fluid?
1. Inside the body cells
2/3 of total body water
Signs and symptoms of intravascular depletion? 4
Signs and symptoms of interstitial fluid depletion? 4
Signs and symptoms of intravascular depletion
1. Decreased BP,
2. flat jugular veins
3. Increased HR
4. Cool extremities
Signs and symptoms of interstitial fluid depletion
1. Decreased skin turgor,
2. sunken eyeballs,
4. Can also have hemodynamic effects
Intravascular fluid makes up what portion of the ECF?
1/4 of ECF ~75 ml
1 Liter 0.9% saline: isotonic…distributed in ECF. Why?
since cell membrane not permeable to sodium)
1 liter 5% Albumin and PRBCs: remains where?
Dont give this if what?
remains in intravascular space
How is ½ normal saline handled?
½ as free water
½ as saline
1. Which electrolytes are lost in sweat and exhaled water vapor?
2. Which electrolytes are lost in the urine?
3. Renal failure patients do not need maintenance what? 2
2. All of them
3. Na or K
1. Serum sodium = what? 2
2. Sodium is regulated by what? 3
3. A disruption in water balance is manifested as an abnormality in what?
4. Sodium is a functionally impermeable solute so it contributes to what? How?
1. osmolality = water
-renal water handling
3. serum sodium
-and induces water movement across the membranes
Which ways would we get fluid loss?
Fluid gain? 4
1. Fluid loss
2. Fluid gain
A 25 year old pt presents with massive hematemesis X 1 hour. He has a hx of peptic ulcer disease.
Exam: Diaphoretic, normal skin turgor
Supine BP 120/70 HR 100
Sitting BP 90/50 HR 140
Serum sodium 140
1. What kind of loss?
2. What fluid?
-Intravascular mostly though because he hasnt vomited enough stomach contents to shit the sodium
of lactated ringer