Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

haematology > lecture 9- transfusion 2 > Flashcards

lecture 9- transfusion 2 Flashcards

(71 cards)

Start Studying
1
Q

what is a transfusion

A

an organ transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what 2 factors are need to be considered in safe blood transfusion

A

protection of donor

protection of recipient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

in terms of protecting the donor, which factors need to be considered

A 
age 17-70 years old
>8 stone, 51Kg
normal health
volunteer
medical history check
anaemia check
sign declaration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what may be checked of the donor, at the point of donation

A

blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what type of anaesthetic is used on the donor

A

local

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the conditions for blood storage after blood has been taken from the donor

A

anticoagulated, sterile bag
CPD + adenine + glucose + mannitol
additional samples taken for testing
everything labelled with same bar code number
donor red cells stored between 2-6 degrees until use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is donor blood shelf life

A

35-42 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the blood tested for, for protection of the recipient

A 
ABO and Rhesus group
clinically important red cell antibodies
HIV I and II
HTLV
syphilis
hepatitis B and C
CMV- in some cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the aim of blood transfusion

A

to get the right blood
to the right patient
at the right place
at the right time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is meant by positive patient identification

A

identification of wrist band (with full name, DOB and hospital no.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what type of wrist band should unconscious patients be given

A

typenex wristband

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what happens if a patients wrist band is removed

A

must be replaced by the same person who removed it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the rules that must be followed when obtaining a blood sample from a patient

A

one patient at a time
ID by wristband and interrogation
mix sample and label by hand at bedside
label with full ID details and sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what must NOT be done when obtaining a sample from a patient

A

dont pre-label tubes

dont use addressograph labels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what must be filled in on a blood request card

A 
full patient ID- 3 points minimum ID
obstetric and transfusion history
blood group and antibodies
number of units and type of blood component required
location at which blood is required
when blood component is required
reason for request
special requirements
prescribing and requesting (MSBOS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are requirements when collecting blood from a blood bank

A

bring patient detail evidence- not lab report
check card details match
check blood bag label matches
check blood unit number (bar code no. of unit)
check blood still in date
check blood looks ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the requirements when administrating blood to a patient

A

prescribed by doctor/registered nurse
final bedside check
start transfusion within 30 mins of removing unit from blood bank (if not then return to blood bank)
only warm in blood warmer
dont add drugs
change giving set every 12 hours
flush cannula before using for anything else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how often must a transfusion patient be observed

A

base line 30 minutes before transfusion starts
during first 15 minutes
after 1 hour, then every hour
one hour after transfusion has finished

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why do acute haemolytic transfusion reactions occur

A

usually due to ABO incompatibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how fast do acute haemolytic transfusion reactions take place

A

usually within first 15 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

name all the acute haemolytic transfusion reactions

A 
agitation
pain at infusion site
pain in abdomen, flank or chest
flushing
feeling of apprehension/doom
intravascular haemolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the signs of a reaction to a transfusion

A 
fever
hypotension
oozing from wounds of puncture sites
haemoglobinaemia
hemoglobinuria 
raised temperature
nausea 
sweating
rashes
bruising
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

why do delayed transfusion reactions take place

A

due to non detectable blood group antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how long after a transfusion does a delayed transfusion reaction take place

A

5-10 days post transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are the effects of a delayed transfusion reaction
rare, usually not life threatening extravascular haemolysis
26
what are the 2 mechanisms of red cell destruction
extravascular intravascular
27
what is the process of extravascular red cell destruction
normal red cell breakdown occurs in liver/spleen cells aged/damaged Hb broken down into haem and globin molecules of haem are converted to bilirubin degraded in liver free Hb in circulating blood is avoided
28
what is the process of intravascular red cell destruction
red cells broken down within blood vessels free haem removed by binding to haptoglobin haptoglobin levels in circulation are reduced haem-haptoglobin complex removed by reticuloendothelial system
29
what is the mechanism of acute intravascular haemolysis
Ab's in patient plasma Ab bind to Ag on donor red cell membrane If Abs are complement fixing, complement proteins bind to red cell membrane complement activation leads to membrane damage rapid haemolysis of donor red cell
30
what are the causes of acute intravascular haemolysis
disseminated intravascular coagulation (DIC) acute renal failure shock death
31
what does SHOT stand for
serious hazards of transfusion
32
name the different SHOT
incorrect component being requested and issues to patient failure of bedside check to pick up errors wrong pack from blood bank wrong blood in tube transmission of disease
33
what are the causes of the adverse affects of blood transfusion
infectious agents transfused red cells transfused white cells transfused platelets transfused plasma transfused coagulation concentrates other causes
34
what are the 3 types of infectious agents that could cause the adverse effects of blood transfusion, give examples for each
viral- Hep B, C, HIV, CMV bacterial- yersinia, treponema protozoal- malaria, toxoplasma
35
why would we transfuse red cells
correction of anaemia active bleeding
36
when would anaemia need to be corrected by transfusion
when Hb levels are 70-80g/l post-op (NR 115-165g/l) patient symptomatic patient history Hb 80-90g/l with cardiovascular disease not correctable by any other method
37
when would we use a red cell transfusion due to active bleeding
trauma perioperative bleeding
38
what happens as a result of an acute haemolytic transfusion reaction
intra vascular haemolysis destruction of red cells
39
what is meant by allo-immunisation as an adverse affect of red cell transfusion
antibody production
40
what meant by febrile reactions in adverse affects of red cell transfusion
reactions to donor white cell (uncommon as blood is now filtered to remove white cells)
41
what meant by urticaria in adverse affects of red cell transfusion
reactions to donor plasma proteins
42
name 3 other adverse effects of red cell transfusion
bacterial infections iron overload volume overload
43
why is all donor blood now filtered to remove white blood cells
white blood cells were implicated in several different types of adverse reactions
44
in which patients would we transfuse white blood cells
for desperately ill patients with: bone marrow failure severe neutropaenia (<0.5 x 10^(9)/L) abnormal neutrophil function with persistent infection genetic- chronic granulomatous disease
45
how is the risk of transfusing variant CJD reduced
donor blood is filtered to remove white blood cells
46
what does TRALI stand for
transfusion related acquired lung injury
47
what is TRALI
serious syndrome characterised by sudden acute respiratory distress following transfusion donor has granulocyte specific antibodies enzymes released increase permeability of capillaries results in sudden pulmonary oedema within 6 hours of transfusion
48
name 2 adverse effects of leucocyte transfusion
pulmonary infiltration- sequestration of WBC in lungs adult respiratory distress syndrome (can cause death)
49
what is TA-GvHD
transfusion associated graft versus host disease rare complication of blood transfusion immunologically competent donor T lymphocytes mount an immune response against the recipient's lymphoid tissue
50
what are the reasons for transfusing platelets
to prevent bleeding in patients with thrombocytopaenia (condition with low platelet count)- preventing and stopping haemorrhage abnormalities of platelet function dilutional thrombocytopaenia vascular surgery autoimmune thrombocytopaenia purpura
51
what is dilutional thrombocytopaenia
when a patient recieves a massive blood transfusion (e.g. 15 units of blood) due to severe blood loss this is a low platelet count
52
what is autoimmune thrombocytopaenia purpura
clinical syndrome in which a decreased number of circulating platelets (thrombocytopenia) manifests as a bleeding tendency, easy bruising (purpura)
53
state the adverse effects of platelet transfusion
febrile reactions allergic reactions anaphalactic shock bacterial infections transmission of virus alloimmunisation
54
what is meant by a febrile reaction
type of transfusion reaction that is associated with fever but not directly with hemolysis
55
what ratio of platelet transfusions show an allergic reaction
1 : 30
56
what regulations are in place to prevent bacterial infections from platelet transfusions
platelets tored at room temperature 20-24˚C shelf life 5 days
57
give an example of a virus transmitted by transfusing platelets
CMV (cytomegalovirus)
58
what is meant by alloimmunisation
red cells present in platelet concentrates
59
what is FFP
fresh frozen plasma blood product made from the liquid portion of whole blood
60
why would FFP be transfused/used
multiple coagulation defects DIC- disseminated intravascular coagulation TTP- thrombotic thrombocytopaenia purpura liver disease massive transfusion (maintain PT and APTT)
61
what are the adverse effects of plasma transfusion
``` anaphylactic shock allergic reactions febrile reactions transfusion-related lung injury allo-immunisation acute haemolysis ABO antibodies in plasma viral transmission risk of vCJD hypothermia cardiac arrest ```
62
why would you transfuse coagulation factor concentrates such as factor VIII and IX
haemophillia A and B
63
why would you transfuse coagulation factor concentrates such as recombinant factor VIIa
massive haemorrhage coagulation factor inhibitors
64
why would you transfuse coagulation factor concentrates such as a prothrombin complex
severe over anticoagulation treatment of rare bleeding disorders, factor X and factor II deficiency sometimes liver disease
65
what are the adverse effects of coagulation concentrates
viral infection hepatitis B HIV inhibitors
66
why would you transfuse human albumin solution (HAS)
burns patients emergency treatment of shock patients with low serum albumin levels
67
why would a patient have low serum albumin levels
liver disease renal disease sepsis surgery
68
what are the adverse effects of transfusing human albumin solution (HAS)
allergic reactions intra cranial haemorrhage bleeding circulatory overload air embolism thrombophlebitis at transfusion site toxicity hypothermia cardiac arrest hypersensitivity reactions
69
what are the alternatives to allogenic blood transfusions
preoperative preparations operative haemostasis autologous blood transfusion red cell salvage recombinant factor VIIa blood substitutes
70
how would we improve hospital blood transfusion practice
hospital transfusion teams specialist practitioner of transfusions transfusion specialist nurses promote good transfusion practice train hospital staff
71
how is transfusion practice regulated
medicines and healthcare products regulation agency (MHRA) national patient safety agency serious hazards of transfusion reporting scheme hospital transfusion committees

haematology (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions