Hemorrhage & Transfusion Flashcards
(39 cards)
What is hemorrhage?
Blood loss (the escape of blood outside its containing vessel, acute or chronic)
Hemorrhage can be classified in various ways based on type, sequence, and site.
What are the types of hemorrhage based on the type of lost blood?
- Arterial
- Venous
- Capillary
Each type has distinct characteristics and management strategies.
Describe arterial hemorrhage.
From an artery, characterized by bright red blood that spurts as a jet from a wound, often hard to control
The flow may be profuse and is typically associated with severe injuries.
Describe venous hemorrhage.
From a vein, characterized by a steady flow of dark red blood, easier to control than arterial bleeding
Examples include rupture of varicose veins and bleeding from esophageal varices.
Describe capillary hemorrhage.
Continuous ooze of bright red blood, generally minor and easy to control, but can be serious in conditions like hemophilia
Capillary hemorrhage is characterized by slow, steady bleeding.
What is primary hemorrhage?
Occurs as a result of trauma or during surgery due to injury of a blood vessel, more common in surgeries on malignancies or patients with bleeding disorders
Treatment includes suture, ligation, or cauterization of the bleeding vessel.
What is reactionary hemorrhage?
Occurs within 24 hours after surgery, may be due to slipped ligature, dislodged blood clot, or loss of vasospasm
Treatment may involve compression, blood substitutes, or re-exploration of the surgical field.
What is secondary hemorrhage?
Occurs within 7 to 14 days after surgery, mainly due to infection leading to sloughing and erosion of part of the vessel
Common causes include foreign bodies, pressure from drains, and infection at the surgical site.
What are the signs of external hemorrhage?
Revealed hemorrhage (visible)
It is important to assess and manage external hemorrhage promptly.
What are the signs of internal hemorrhage?
Concealed hemorrhage, typical examples include trauma, ruptured liver or spleen, or hemothorax
Concealed hemorrhage may become revealed through symptoms like hematemesis or melena.
What is the normal blood volume for infants?
80-85 ml/kg body weight
This is generally less than one liter.
What is the normal blood volume for adults?
65-75 ml/kg body weight (around 5 liters)
Understanding blood volume is crucial for assessing hemorrhage.
What are the classes of hemorrhage based on volume loss?
- Class 1: 0-15% (0-750ml)
- Class 2: 15-30% (750-1500ml)
- Class 3: 30-40% (1500-2000ml)
- Class 4: >40% (>2000ml)
Each class has specific physiological responses and management strategies.
What is the treatment for hemorrhage?
- Minimize further bleeding by compression, ligation, cauterization
- Restore blood volume by transfusion
- Treat the cause
Effective management is critical to prevent shock and other complications.
What is the purpose of blood transfusion?
Provision of blood of the best possible quality and safety for the patient receiving it
It is also important to ensure that the act of donation does not harm the donor.
What is the maximum volume of blood that can be collected from a donor?
About 450 ml every 4 months
This volume includes anticoagulant.
What are the main blood types based on antigens?
- Type A: A antigens
- Type B: B antigens
- Type AB: A and B antigens (universal recipient)
- Type O: no antigens (universal donor)
The ABO and Rh systems are crucial for safe blood transfusions.
What is the Rh factor?
Agglutinogen in RBCs found in 85% of people, presence indicates Rh positive
Rh negative individuals can develop antibodies if exposed to Rh positive blood.
What is indirect blood matching?
Used to specify blood group by mixing a drop of blood with A and B sera
Clumping indicates the presence of specific antigens.
What is direct blood matching?
A drop of patient serum against a drop of donor RBCs to confirm compatibility
Compatibility is confirmed when no clumping occurs.
What is packed cell transfusion used for?
Used in anemia and to avoid volume overload
Each unit is about 330 mL and stored under specific conditions.
What is fresh frozen plasma used for?
Contains antibodies, coagulation factors, and proteins for hypoproteinemia, does not need cross-matching
Initial therapeutic dose is 10-15 ml/kg.
When is platelet transfusion indicated?
When platelet count is below 40,000/cmm (thrombocytopenia)
Platelets have a short lifespan and are best collected on the day of transfusion.
What is cryoprecipitate used for?
Provides factor VIII, used in cases of coagulation defects, mainly hemophilia
The dosage is 1U/10kg to increase fibrinogen by 50 mg/dL.
