IMH &TM (MTAP 1) Flashcards
1
Q
Blood Donor Process
A
- Re-identify your patient (ex. full name, address, etc.)
- Check the site for bleeding / site to puncture
- After selecting a site to puncture, apply antiseptic agent.
- Apply Tourniquet
- Insert Needle
2
Q
Common Antiseptic Solution
A
PVP IODINE SOLUTION
3
Q
When applying PVP make sure cover the site at least?
A
4 cm of the site
4
Q
After applying PVP to desire site, scrub it in all direction for how many seconds?
A
30 seconds
5
Q
In PVP, After 30 seconds of scrubbing, cover the area with?
A
Gauze Pad
6
Q
After covering and drying the area, perform ________?
A
Phlebotomy
7
Q
What alternative antiseptic sol. if the donor allergy in IODINE?
A
CHLORHEXADINE GLUCONATE SOLUTION
8
Q
What alternative sol. if the donor has allergy to both Iodine and Chlorhexidine solution
A
70% ISOPROPYL ALCOHOL
9
Q
Apply Isopropyl Alcohol on the desire area and scrub it for how many secs. and what motion?
A
30 seconds in Upward and Downward motion
10
Q
How many secs. of scrubbing when Alcohol is used as an antiseptic?
A
60 secs. (30 each)
11
Q
Inch above the anticubital fossa when applying tourniquet
A
3 - 4 inch
12
Q
What first things to do when inserting the needle?
A
Before inserting the needle Inspect the blood bag.
13
Q
Gauge of needle to be use
A
16 gauge needle
14
Q
Insertion of needle
A
Skin to Vein
15
Q
Cause when puncture directly to the vein
A
Blood Spill off (pagsirit ng dugo)
16
Q
Put micropore on a half part of the needle to stabilized and avoid ?
A
Moving the needle
17
Q
Purpose of stress ball?
A
To promote good blood flow and avoid numbness of arm.
18
Q
If doesn’t have a stress ball what thing to do?
A
Instruct the donor to make them fist every 10 secs.
19
Q
Time process of blood collection
A
8 – 12 minutes for 450 – 500mL.
20
Q
Average time process for blood collection
A
10 minutes
21
Q
What cause if the patient bag is not full in 12 mins?
A
It might be CLOTTED
22
Q
What should phlebotomist do if blood is clotted during collection?
A
- Discontinue the collection by removing the needle to remove the blood clot.
- After removing, ask the patient to continue the blood collection in another side of arm.
(If hindi na kaya ng patient)
- Label the bag “Unsuccessful” if the doesn’t achieve the minimum mL of blood.
23
Q
Patient / Donor with clotted blood unit during blood collection.
2 Components are not valid for blood transfusion / Patient use:
A
- Patient Component
- Plasma Component
24
Q
Reason why 2 components are not valid for blood transfusion / patient use?
A
Pagnagkaroon ng clotting during collection, ibigsabihin ang coagulation factor at platelets ay magiging inadequate o sufficient dahil already activated na sa donor.
25
1 Components are valid for blood transfusion / Patient use?
RBC Component
26
Important reminder when phlebotomy perform by phlebotomist
Avoid fishing
27
Cause of Fishing
o It can cause activate hemostasis (In vitro), thus it can activate hemostatic mechanism.
o Lead delay blood collection
28
After collecting whole blood, the donor
component will process using?
Refrigerated
Centrifuged.
29
2 Types of Centrifuged of Donor Blood Unit
1. SOFT / LIGHT SPIN
2. HARD / HEAVY SPIN
30
Types of Centrifuged that Perform in Whole blood unit
SOFT / LIGHT SPIN
31
Types of Centrifuged that Perform in RPC Component
HARD / HEAVY SPIN
32
Soft or Light Spin Component obtained:
* Platelet Rich Plasma
* Packed Red Cell Component
33
Hard / Heavy Spin Component obtained:
* Platelet Poor Plasma (UPPER PORTION)
* Platelet Concentrate (LOWER PORTION)
34
Soft / Light Spin minutes & rpm
2 – 3 minute at 3000 rpm
35
Hard / Heavy Spin minutes & rpm
5 minute at 3500 - 3600 rpm
36
Blood Bank Ref. Temperature
1 – 6 degree celsius.
37
Blood Bank Ref. Quality Control must maintain:
+/- 0.5 degree celsius
38
Quality Control of blood bank ref temp must be maintain, normal range between:
1.5 – 5.5 degree celsius
39
Monitoring the temperature of blood bank ref:
Every 8 hours, Every Shift or 3 times a day.
40
What components required REFREGIRATOR
Temperature for storage?
RBC Containing Components
Example:
1. Whole Blood Cell
2. Washed Red Blood Cell
3. Packed Red Blood Cell
4. Liquid Plasma
(W - W- P - L)
41
What components required FREEZER Temperature for storage?
PLASMA Containing Component
Example:
1. Fresh Frozen Plasma
2. Frozen Red Cell
3. FFP
4. Cryoprecipitate
42
Freezer Temperature
- 20 degree celsius or colder
43
What components required ROOM temperature for storage?
1. Platelet Concentrate with continues agitation
2. WBC or Granulocyte Concentrate without agitation
44
Room Temperature
20 – 24 degree celsius
45
PLATELET CONCENTRATE stand at room temperature for how many hours?
1 hour
46
After 1 hour of standing at room temp, the platelet concentrate subject it to ____?____ at room temp.
Constant Agitation 3 – 5 days.
47
Purpose of Agitation
Would prevent platelet from adhering to one another or Platelet aggregation
48
Require Transporting Temperature
1 – 10 degree celsius
49
FROZEN COMPONENT: Must be transported with ?
Dry Ice
50
RBC COMPONENTS: Must be transported with?
Wet Ice
51
PLATELET & WBC: must be transported with?
Without Ice
52
What if the blood is transported without ice and its RBC Component?
REJECT!! (KATULAD NG PAG REJECT MO SA KANYA) HIHIIHIHI
53
The transport temperature affects the?
Integrity of the donor component unit.
54
CC of Fresh Whole Blood
450 - 500 cc
55
CC of FFP
200 cc
56
CC of PPP (Platelet Poor Plasma)
200 cc
57
CC of PRP (Platelet Rich Plasma)
200 - 250 cc
58
CC of PRBC
200 - 250 cc
59
CC of Platelet Concentrate
50 - 70 cc
60
CC of Cryosupernate
180 - 200 cc
61
CC of Cryoprecipitate
15 - 20 cc
62
Source of glucose, nutrients or food for the cell
Plasma RETAINED in the Pack RBC
63
It's contain all coagulation factors needed by the patient.
FFP / PPP
64
After cold thawing process, it can be separate 2 component:
Lower & Upper Component
65
Lower Component
Plasma
66
Upper Component
Precipitate
67
Cryoprecipitate procedure:
Frozen plasma is transfer at ?
Ref. Temperature
68
CRYOPRECIPITATE :
(UPPER OR LOWER LAYER)
Lower Layer
69
CRYOSUPERNATE:
UPPWE OR LOWER LAYER)
Upper Layer
70
Contains same coagulation factors present in FFP, but some coagulation factor in the component have decrease already.
Cryosupernate
71
Cryosupernate: DECREASE:
* Factor VIII:C
* Factor I
* Factor XIII
* VWF
* Fibronectin
71
HIGH IN CRYOPRECIPITATE
* Factor VIII:C
* Factor I
* Factor XIII
* VWF
* Fibronectin
72
WHOLE BLOOD REQUIRED TIME FOR PROCESSING COMPONENTS
6 - 8 Hours
73
Whole Blood anticoagulants used within 6 hours
ACD (Acid, Citrate, Dextrose)
74
(3) Oxygen Carrying Components/Products
1. Red cell concentrates
2. Leukocyte-poor red blood cells
3. Frozen-thawed red cells
75
Platelet Products (2)
1. Platelet rich plasma (PRP)
2. Platelet concentrates (PC)
75
Plasma Products (4)
1. Fresh frozen plasma (FFP)
2. Frozen plasma (FP)
3. Cryoprecipitate
4. Stored plasma
76
Plasma Derivatives Plasma Derivatives (5)
1. NSA
2. PPF
3. ISG
4. FACTOR VIII CONC.
5. RHOGAM FACTOR IX CONC.
77
(COMPONENTS TRANSFUSION THERAPHY)
One unit may be used for ?
Multiple Transfusion
78
Combination of cell and plasma.
Whole Blood
79
21 days shelf life in whole blood. (3)
1. CPD
2. CP2D
3. ACD
80
Commonly use anticoagulant additives solution in hospital
CPD – A1
81
Commonly for Apheresis procedure
ACD
82
Shelf Life of HEPARIN
2 days
83
Shelf Life of:
CPD – AS – 1
CPD AS – 3
CPD AS – 5
42 days
84
Shelf Life of CPD - A1
35 days
85
CPD – AS – 1
(Adsol)
86
CPD AS – 3
(Nutrisol)
87
CPD AS – 5
(Optisol)
88
Characteristics of whole blood that no longer viable after 24 hrs. of storage
WBC & PLTS
89
Labile factor significance decrease after?
2 days of storage
90
LABILE FACTOR DECRESE (2)
1. Factor 5
2. Factor 8
91
Storage Temp. of Whole Blood
1 - 6 degree celsius
92
Indication of Whole Blood:
Active bleeding, hemorrhagic shock and exchange transfusion.
Indicated when both oxygen-carrying capacity and volume expansion are required.
93
IMMEDIATE EFFECTS OF ONE UNIT OF WHOLE BLOOD
Increase hematocrit by 1 – 3%.
94
EFFECT OF BLOOD TRNASFUSION/ INCREASE
HEMATOCRIT
After 6 hours blood transfusion, the doctor will order a CBC:
POST BLOOD TRANSFUSION CBC
95
measure hematocrit, hemoglobin
POST BLOOD TRANSxFUSION CBC
96
Whole blood 1 unit transfuse an increase hematocrit is consider as:
SUCCESFUL TRANSFUSION
97
How many percent of RBC remain viable in the patient after transfusion which will cause significant effect, increase in hematocrit?
70% of RBC
98
NO EEFECT SEEN/ NO INCREASE IN HEMATOCRIT: FAILED TRANSFUSION
1. Less than 70% of RBC doesn’t survive
2. Most of RBC unable to circulate.
99
Shelf life is only fallowed the component preparation is done under?
Close system / Sterile Environment
100
What if component is accidentally expose from close system to open system?
Automatically label as expired in 24 hours.
101
Common cause of Transfusion Reaction
Febrile reaction / Fever patient because of bacterial reaction.
102
COMPONENT OF RBC ADDITIVE SOLUTION
* Saline Adenine
* Adenine
* Mannitol
* Glucose
S-A-M-G (Samgyup yerrrrn!)
103
Pack RBC Shelf Life
OPEN SYSTEM – 24 hrs
104
Pack RBC Storage Temp.
1 – 6 degree celsius
105
Pack RBC Content:
Hematocrit should be 80% or less
(There still plasma retain would serve as glucose)
106
Pack RBC Indication:
Restore oxygen carrying capacity (anemia)
107
PRBC IMMEDIATE EFFECT OF ONE UNIT
Increase Hematocrit by 3% and Increase hemoglobin by 1g.
108
LEUKOPOOR RED BLOOD CELLS Shelf Life:
24 hours / 1 day
109
LEUKOPOOR RED BLOOD CELLS Storage Temp:
1 – 6 degree celsius
110
LEUKOPOOR RED BLOOD CELLS Content:
5 x 106 residual WBC
111
LEUKOPOOR RED BLOOD CELLS Indication:
Anemia with history of febrile reactions;
To decrease alloimmunization to WBC or HLA antigens or CMV transmission.
112
It is transfuse among patient with anemia with history of febrile reaction
leukopoor RBC
113
WBC has antigen and HLA (human leukocyte antigen) – It can promote ______ ?
Alloimmunization to the patient, this can lead to febrile/ fever reaction.
114
HOW TO AVOID FEBRILE/ FEVER REACTION
Need low WBC count and the donor unit.
115
If the CMV within the cell of healthy people like blood donor, it consider as?
Asymptomatic
116
HOW TO AVOID CMV TRANSMISSION
Reduce WBC count
117
Layer that selectively remove when centrifugation and rich in white blood cells.
Buffy Coat layer
118
Washing procedures using?
Saline or Glycerol
119
Centrifugation: (Open System or Close System)
Open System
120
Washing Procedure:(Open System or Close System)
Open System
121
Removed excess WBC
Washing procedures using saline or glycerol
122
Mechanical separation using?
Leukoreduction Filter
123
The best technique in reducing the WBC population
Mechanical separation using leukoreduction filter
124
What um in first generation filters ?
170 um (the one used)
125
What um in second generation filters?
20-40 um
126
What um in third generation filters?
3-log filter
127
CELLS / COMPONENT IN THE BLOOD FILTERED IN LEUKOREDUCTION FILTERS (5)
1. Fibrin Clot
2. Giant Platelet
3. Macrocytes – large RBC
4. Large WBC fragments
5. Most of the WBC
128
CELLS PASS THROUGH THE FILTERS (3)
1. Normal Platelet
2. Normal RBC
3. WBC same size with normal RBC
129
RESTORE expired donor unit
REJUVENATED RED BLOOD CELLS
130
REJUVENATED RED BLOOD CELLS Contains:
P-I-G-P-A
(Phosphate, Inosine, Glucose, Pyruvate, Adenosine)
131
PIGPA – become?
P-I-P-A, the glucose has been removed.
132
Essential for cell function, survival
ATP & 2,3 DPG
133
ATP
Energy
134
2,3 DPG
Function of the RBC
135
Addition of Rejuvenation solution (PIGPA-Phosphate, Inosine, Glucose, Pyruvate, Adenosine) to regenerate _____ ?
ATP and 2,3- DPG
136
REJUVENATED RED BLOOD CELLS Shelf Life:
3 days after expiration date
137
REJUVENATED RED BLOOD CELLS Storage Temp:
1 – 6 degree celsius
138
InRejuvenated RBC for transfusion, wash properly and transfuse within?
24 hours
139
The only FDA – approved rejuvenation solution.
Rejuvesol
140
If the donor unit is “rare”(ex. AB-) but it is already expired, you can rejuvenate the blood by adding ?
Rejuvesol
141
WASHED RED BLOOD CELLS Shelf Life:
24 hours / 1 day
142
WASHED RED BLOOD CELLS Storage Temp.
1 – 6 degree celsius
143
QC REQUIREMENTS OF WASHED RBC
1. Plasma must be removal
2. Plasma contain offending protein/ antibodies
144
2 Types of Crossmatching
Major Crossmatching &
Minor Crossmatching
145
Patient serum is tested
against the donor red cell.
Major Crossmatching
146
Patient of antibody that will react to antigen of donor red cell.
Major Crossmatching
147
Patient red cell test to donor serum.
Minor Crossmatching
148
NO LONGER PERFORMED AS A PART OF ROUTINE PRE TRANSFUSION, ONLY DONE IF REQUESTED OF DOCTOR.
Minor Crossmatching
149
Replace in Minor Crossmatching
ANTIBODY SCREENING/ DONOR SERUM ANTIBODY SCREENING
150
