blood transfusion

Question 1

where does the blood come from

Answer 1

Volunteer donors meeting the minimum criteria
o Hb 135g/L men
o Hb 125g/L women
o Weight 50kg
Blood safety
o donor selection questionnaire
o contact details if becomes unwell post donation

Question 2

how is blood processed and tested?

Answer 2

• Bag of whole blood centrifuged to separate into component parts
• Samples undergo microbiological testing – HIV, Hep B, C and E, HTLV, Syphillis
• Red cells stored at 4°C for 35 days
• FFP – stored -30°C for 3 years
• Platelets – stored 22°C for 7 days with agitation

Question 3

aims of pre-transfusion testing

Answer 3

identify ABO and RhD group of patient (test patients rbc with anti-A, anti-B and anti-D antisera)
Agglutination shows blood not suitable for transfusion

Question 4

indications for red cell transfusion

Answer 4

Symptomatic anaemia Hb<70g/L (80g/L if cardiac disease)
Major bleeding
Always consider cause before transfusion – is there another option
Transfuse a single unit of red cells and then reassess patient

Question 5

indications for platelet transfusion

Answer 5

Prophylaxis in patients with bone marrow failure and very low platelet counts
Treatment of bleeding in thrombocytopenic patient
Prophylaxis prior to surgery/ procedure in thrombocytopenic patient
Always consider the cause before transfusion

Question 6

indications for FFP transfusion

Answer 6

• Treatment of bleeding in patient with coagulopathy (PT ratio >1.5)
• Prophylaxis prior to surgery or procedure in patient with coagulopathy (PT ratio >1.5)
• Management of massive haemorrhage
• Transfuse early in trauma
• Not in absence of bleeding/planned procedure

Question 7

how patients should be monitored during transfusion

Answer 7

• Observations before blood is commenced
• Observations at 15 minutes
• Observations within 60 minutes of completion

Question 8

what is the most important thing in giving transfusions

Answer 8

needs patient identification at every single step