TRANSFUSION PRACTICES Flashcards by Ramon Angelo Fajarito

Procedure whereby wholee blood is separated by physical means into componeents and one or more of them returned to the donor

Apheresis

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Blood drawn from the patient/recipient for re transfusion into him/her at later date

AUTOLOGUS BLOOD

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A facility or ceeeenter ttthat perfoorrms all the fooollowoing functions including:

Recruiting blooodo donors
Screening and selecting blood donors
Blood collection
Testing and prroceessing of blood units

Blood Center

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A center that is involved in the following functions only:

Receiving and storing screened blood and blood components from another authorized blood establishment
Perforrrming compatibility testting
Blood issue forr transfusion

Blood Storage Center

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A therapeutic constituent of blood tthat is separated by physical or mechanical meeans

Blood Component

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A procedure whereby a single donation blood is colleccected in a anttticoaguulant solution

Blood Collection

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A therapeutic substancce derived from human blood including whole blood, blood components and plasma derived products

Blood Productt

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To set tthe measurement of equipmeent against a known standard

Calibrate

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System of collectting and processing blood in containers that have been connected togetheer by tthe manuufactuure before sterilization,, so that there is no possibility of bacterial or viral contamination from outside after the collection.

Closed System

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Specific selection process to determine the suitability of a procedure or material

Evaluation

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A system,, the contents of whichh are exposed to air and outside element duuring preparation and separation of components

Open System

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The organizational structure,, responsibilities, policies, processes, procedures and resourcces established by executive maangement to achieve quality

Quality sYSTEM

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To isolate nonconforming blood, component, or material

Quarantine

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Establishing recorded evidence that proves a high degree if assurance that aspecific process wiill consistently produce an outcome meeting its predetermined specifiaction and quality attributes.

Validation

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Evaluating the performance of a system with regards to its effectiveness based on intended use

Verification

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Donation is considered voluntary and no remunerated if a person gives blood, plasma, orcel;lular ocmponets of his or her own free will and receives no payment for it, either in cash or kind which could be considered a substitute for money. Small tokens, refreshments are compatible with voluntary, non-remunerated donation

Voluntary non-remunerated donation

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under the National
Healthcare Safety Network (NHSN), what was developed with the cooperation of the AABB and the Centers of Disease Control and
Prevention (CDC) to track, to analyze, and ultimately to improve transfusion outcomes.

Hemovigilance Model

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Transfusion Therapy is used primarily to treat 2 conditions

INADEQUATE OXYGEN && Insufficient coagulation protein

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Transfer of blood from one person to another without exposing it to air

Direct (IMMEDIATE) Transfusion

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Removal and discarding of blood rom the recipient and simultaneous replacement with the donor’s blood.

Exchange Transfusion

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Transfer of blood from a donor to a flash or other container to the recipient

Indirect (((MEDIATE) Transfusion

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Transfusion in which a blood is transferred form a person who has recovered from a contagious infection into the vessels of a patient suffering with the same infection and an equal amount of blood is returned from the patient to the well person.

Reciprocal Transfusion

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2 major groups of transfusion complications

Immediate Transfusion Reaction & Delayed Transfusion Reaction

 Reaction occurring within 24 hours of transfusion.  Fever >1° C increase or >38° C  Chills/rigors  Respiratory distress—wheezing, coughing, dyspnea, cyanosis  Hypertension or hypotension  Pain—abdominal, chest, flank or back, infusion site  Skin manifestations—urticaria, rash, flushing, edema  Jaundice, hemoglobinuria  Nausea/vomiting  Abnormal bleeding  Oliguria/anuria

Immediate/Acute transfusion reaction

 Reaction occurring more than 24 hours following transfusion.  Serum hepatitis  Syphilis  Malaria  AIDS/HIV

Delayed Transfusion Reaction

2 Reactions in Delayed Transfusion Reaction

Immune Mediated Reaction and Non immune Mediated Reaction

Reaction that may be due to the component transfused, the patient’ underlying condition or the method of infusion

Non IMMUNE mEDIATED rEACTION

Reactions involving antigen antibody complexes, cytokine release, or complement activation

Immune mediated Reaction

Severe symptoms of an AHTR can occur after the infusion of as little as ____mL of incompatible blood

10 mL

Most common source of HTR

Clerical Error

The destrution of transfused red cells that results in intravascular or extravascular hemolysis or a combination of both

Hemolyttic Transfusion Reaction

Occur from improper handling of the donor’s blood before it is injected into the recipient’s vein.

Extravascular Heemolysis

Rupture of reed cells in the circulation of the recipient

Intravascular Hemolysis

ABO antibodies of the ____ class readily activate the classical pathway of complement, leading to the potential for intravascular hemolysis.

IgM

Intravascular Hemolysis releases what?

Free Hemoglobind and Red Cell Stroma into the plasma.

Complement functions in three capacities in an AHTR

Opsonization Anaphylatoxin generation Red Cell lysis

Promote tissue ischemia and release of tissue factor

mICROVASUCLAR THROMBI

Most prominent in an untreated AHTR

Renal Failure

ERRORS KNOWN TO CAUSE AHTR Collection of blood from the incorrect patient

CONTRIBUTING FACTORS CAUSING ERRORS Insufficientsegregation of units

ERRORS KNOWN TO CAUSE AHTR Incorrect labeling of blood samples

CONTRIBUTING FACTORS CAUSING ERRORS Preprinted sample labels

ERRORS KNOWN TO CAUSE AHTR Misidentification of sample at blood bank

CONTRIBUTING FACTORS CAUSING ERRORS Patients with similar or identical names

ERRORS KNOWN TO CAUSE AHTR Issuance of wrong unit from blood bank

CONTRIUTING FACTORS CAUSING ERRORS Sequential patient identifiers

ERRORS KNOWN TO CAUSE AHTR Alloquoting of wrong unit from blood bank

CONTRIBUTING FACTORS CAUSING ERRORS Verbal and STAT orders

In DHTR, how many hours does symptoms appear

24 Hours

What Ig class causes DHTR?

IgG Antibody

Newly identified red cell alloantibodies demonstrating between ____ hours and ____ days after transfusion

24 Hours and 28 days

Blood group antibodies associated with delayed hemolytic reaction (IN ORDER OF DECREASING FREQUENCY)

Kidd, Duffy, Kell, MNS System

Investigation procedures in Schedule of investigation of suspectede transfusion reaction

Examine for visible hemolysis (a b e) Repeat ABO (a,b,c,d) Repeat RH (a,b,c,d) DAT (a,b)

Is a commonly observed adverse effect of transfusion

Febrile nonhemolytic transfusion reaction

A febrile nonhemolytic reaction is typically manifested by temperature elevation of ________

More than 1C (or 2F)

In patients with prior allergic reactions to tranfusion, premedication with antihistamines ______ minutes before transfusion may be beneficial.

30 Minutes

How many hours after transfusion does respiratory distress and pulmonary edema occur?

1 — 2 hours

Symptoms in respiratory distress and pulmonar edema

Hypoxemia Tachychardia Cyanosis Hypotension Fever

In bacterial contamination of blood products, organisms are capable of grwoth at what temperature? What type of bacteri? and give examples of bacteria?

4 Deg C Gram Negative Bacteria Yersinia Enterolitica Serratia liquefaciens Pseudomonas fluorescens

Gram positive organisms are more often observed in _____ stored at _______

20 deg C to 24 deg C

Occurs when a patient’s cardiopulmonary system exceeds its volume capacity

Transfusion associated circulatory overload (TACO)

A condition that results from the accumulation of excess iron in macrophages in various tisses

Hemosiderosis

In transfusion hemosiderosis, iron intake ______ mg/unit exceeds the daily iron excretion _______ mg/day

250 mg/unit 1 mg/day

What are the iron chelators will we use to prevent iron toxicity?

Deferiprone and Deferoxamine

In posttransfusion purpura (PTP), the patient’s platelet count plummets how many days after the transfusion of blood or blood products containing platelents?

5-12 days

A.K.A Physically or Chemically - Induced Transfusion Reactions

Hypothermia

In hypothermia, the core body temperature of less that _____ usually associated with large volumes of cold fluid transfusion

35 Deg C

Caused by transfusion of over ten units of stored blood causing changes in hemostatic mechanism

Coagulation Defects

K and Citrate are the major source of concer

Biochemical Disorganization

Diseases in delayed rtansfusion reaction

Serum Hepatitis (HEPA B) Homologous Serum Jaundice Syphylis Malaria AIDS/HIV

Type of hepatitis which apparently occurs only after the transfsion of human blood or human blood products contaminated with hepatitis antigen

Homologous serum jaundice

Can be transmitted in the early stage before the serologica ltests are likely to show positive result

Syphilis

Malaria usually appear how many days after transfusion?

5 - 30 days

The parasite in malaria may survive in what temperature

Refrigerated temperature

Mean incubation period between the time fo transfusion and diagnosis of AIDS has been estimated to be how many years?

4-5 years

In classic type 1 hypersensitivity, _____ antibodies in the recipient react with the allergen, which activates ______

IgE Antibodies Mast Cells

Mast cell activation results in degranulstion and the release od ____, ____, and ____.

Histamine Proteases Chemotactic Factors

Major source of bacterial contamination of blood products

Improper cleansing of the donor's skin Transient bacteremia in an asymptomatic donor

3 Parts of post transfusion purpura

Hypothermia Coagulation Defects Biochemical Disorganization

Diseases in DTR

Serum Hepatitis Syphilis Malaria AIDS/HIV

True or False Malaria parasites cannot survive in the body of an infected person for so many years without sign and symptoms

False

Microvascular thrombi promotes what?

Tissue ischemia Release of tissue factor

ADVERSE COMPLICATION OF TRANSFUSION Immune Mediated: Hemolytic CAUSE in ACUTE and DELAYED

Acute : ABO incompatibility Delayes : Primary/Secondary alloimunization