Blood products and transfusions

Question 1

4 main constituents of blood?

Answer 1

Erythrocytes
Leukocytes
Plasma proteins
Platelets

Question 2

6 different types of plasma proteins found in the blood?

Answer 2

Ig
Albumin - allows transport of bilirubin etc
Hormones
Vitamins
Sugars, salts
Clotting factors

Question 3

If an immunocompromised patient is receiving blood transfusion what extra treatment is required for the blood?

Answer 3

CMV negative and irradiated blood therapy

Question 4

Red cells are stored at what temperature? for how long?

Answer 4

4 degrees

35 days

Question 5

What is fresh frozen plasma used for? stored at? for how long?

Answer 5

replaces all clotting factors - active bleeding very useful
frozen at -25 degrees
Can last 36 months

Question 6

What temperature are platelet transfusions stored at and how long do they last?

Answer 6

22 degrees

5 days

Question 7

What is cryoprecipitate, what temperature is it stored at, how long does it last?

Answer 7

Cryoprecipitate is fibrinogen
frozen at -25 degrees
Can last 36 months

Question 8

Name 2 types of patients that coagulation factors would be administered to?

Answer 8

Haemophilia

Warfarin reversal

Question 9

What is the transfusion threshold of Hb in patients under 65, over 65, with co-morbidities and with significant active bleeding?

Answer 9

Under 65 = below 70g/L
Over 65 = below 80 g/L
With comorbidities = below 90g/L
Significant active bleeding = below 100g/L

Question 10

What is classified as significant active bleeding when considering transfusion thresholds?

Answer 10

over 500ml/hr

Question 11

What factors need to be taken into account when considering a red cell transfusion?

Answer 11

Patient age - under or over 65
Any co-morbidities
Significant active bleeding

Question 12

When labelling a blood sample what do you need to rememeber?

Answer 12

To fill the label out by hand

Question 13

How many samples and at what time interval are needed for cross match samples of blood?

Answer 13

2 samples are needed for cross matching taken from the patient 5 minutes apart

Question 14

What does the Maximum Surgical Blood Ordering Schedule do?

Answer 14

Offers guidance on the number of units of blood needed for specific operations
Determine if you need group and screen or group and crossmatch

Question 15

How many hours do you have to transfuse patient after blood products have left storage?

Answer 15

4 hours

Question 16

If someone experiencing massive amounts of bleeding what is activated?

Answer 16

Massive transfusion protocol

Ring lab and say you are activating Red Alert

Question 17

Difference in requesting group and screen compared to group and crossmatch? What is performed for each one?

Answer 17

Group and screen = not expected to need blood, group, antibodies, held for 7 days
Group and cross match = expected to need blood, group, antibodies, check donor blood is compatible, held for 2 days

Question 18

What is the name of the proteins on RBC that act as an antigen to the recipients antibodies during transfusion?

Answer 18

Agglutinogens

Question 19

Which blood group is the universal donor?

Answer 19

O negative

Question 20

Which blood group is the universal acceptor?

Answer 20

AB positive

Question 21

How long does it take to fully cross match blood? to do a group-specific cross match?

Answer 21

40 minutes

15 minutes

Question 22

What are the symptoms of an acute haemolytic reaction?

Answer 22

Fever, pyrexia, rash, pain at infusion site, bleeding (infusion site), DIC, RDS, hypotension, tachycardia, anxiety

Question 23

What 4 methods can be used to avoid transfusions in the case of Jehovahs Witnesses for example?

Answer 23

Cell savage
tranexamic acid
Iron supplementation
Erythropoietin

Question 24

What is SHOT?

Answer 24

serious hazards of infusion - monitors all reactions from transfusions and produces recommendations to improve safety

Question 25

Name a few acute transfusion reactions that can happen?

Answer 25

``` Acute haemolytic anaemia Bacterial contamination Febrile non-haemolytic reaction Allergic transfusion related acute lung injury transfusion related circulatory overload ```

Question 26

3 potential delayed transfusion reactions?

Answer 26

Delayed haemolytic reaction Transfusion infections Iron overload

Question 27

What are some potential massive transfusion complications?

Answer 27

``` Hypothermia Hypocalcaemia Hyperkalaemia Coagulopathy Thrombocytopenia Acidosis ```

Question 28

What is the test for haemolytic anaemia?

Answer 28

Coombs test

Question 29

How many samples are needed for cross matching? when does the number of samples needed change?

Answer 29

2 samples 5 minutes apart | Do not need 2 samples when the patient has had a previous group and crossmatch

Question 30

When are CMV negative components specifically asked for?

Answer 30

Immunocompromised IU infusion to babies less than 20 weeks Pregnant mothers

Question 31

When do you need HLA matched red cells?

Answer 31

When the patient is waiting on a renal transplant or a transplant patient who doesnt take immunosuppressants

Question 32

When are HLA matched platelets advised?

Answer 32

CKD | On transplant list not taking immunosuppressants