Transfusions

Question 1

WHat 5 things must be done before administering a transfusion?

Answer 1

Check patient ID
Gain Consent
Prescribe the transfusion
Gain IV access
Take a set of Obs

Question 2

What are the symptoms of Transfusion reaction and how should they be treated?

Answer 2

Pyrexia
Tachypnea
Tachycardia
(type II hypersensitivity)

Should be treated by stopping the transfusion, assessing the patient, administering oxygen, calling for senior help and haematology and possibly giving steroid. Adrenaline given by seniors.

Question 3

What are the 4 definitions of massive blood loss?

Answer 3

Loss of blood exceeding circulation volume over 24h

Loss of more than 50% blood over 3 hours

Loss of more than 150ml/min blood

Requirement for transfusion

Question 4

How is Haemorhagic shock classified?

Answer 4

Class I - 1-15% loss
Class II - 15-30% loss
Class III - 30-40% loss
Class IV - >40% loss

(think tennis)

Question 5

What is Tranexamic Acid?

Answer 5

A synthetic form of Lysine which stops the fibrolysis of clots.

It is given within the first 3 hours of massive haemorrhage

Question 6

What are the three types of blood products which can be given and when is each used?

Answer 6

Packed Red Cells - Massive haemorhage or low Hb, mainly replaces HB.

Fresh Frozen Plasma - Also in massive blood loss. Used to replace clotting factors.

Cryoprecipitate - used when fibrinogen is low, fibrinogen must be