Intro Wk: Transfusions

Question 1

Ddx for inc temp and HR, dec BP, collapse 15mins into blood transfusion

Answer 1

Wrong blood: stop transfusion, A-E and IV fluids, repeat G+S and XM

Bacterial contamination: same as above plus culture bag and pt then start IV empirical abx

Question 2

What is febrile non-haemolytic transfusion reaction?

Answer 2

Rise in temp <=1°C w/o circulatory collapse and haematuria likely due to cytokine release during storage

If temp keeps rising and BP falls think about a more serious reaction

Question 3

Tx for FNHTR

Answer 3

Slow the transfusion and give paracetamol

Question 4

Tx for Allergic Reaction

Answer 4

Slow the transfusion and give antihistamine

Question 5

How soon do you have to give anti-D to D- mum after delivery of a D+ baby?

Answer 5

72hrs

Question 6

What test do you do along giving the mother anti-D?

Answer 6

Kleihauer test: to see if more anti-D is required following baseline dose

Acid solution denatures HbA but not HbF - work out ratio of the two

Question 7

How do you tx a sensitised mother w a D+ baby?

Answer 7

Intrauterine transfusion /mnth

Question 8

How can we monitor baby for anaemia?

Answer 8

Doppler US of MCA

Question 9

What pathology can anti-D abs cause in the neonate?

Answer 9

Anaemia + Jaundice (since the placenta is no longer removing the bilirubin)

Question 10

How long can blood be taken out of the fridge for then safely put back?

Answer 10

30mins

Question 11

What temp are blood products stored at?

Answer 11

Red Cells: 4+/-2°C

Platelets: 22°C

FFP + Cryo: -30°C

Question 12

What is the maximum length of time over which you can infuse a unit of blood to a pt?

Answer 12

4hrs

Question 13

What is the universal donor for RBCs and FFP?

Answer 13

RBCs: O-
FFP: AB+

Question 14

When are women usually given anti-D in pregnancy?

Answer 14

500IU @ 28+34wks