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transfusion practice
handbook
| Question | Answer |
|---|---|
| This crossmatch-to-transfusion ratio (C:T) is considered appropriate | 2:1 |
| When can the 72 hour limit on a type & screen be extended? | Patient with negative antibody screen and no transfusion or pregnancy within preceding 3 months (can extend up to one month) |
| Define "massive transfusion" | Replacement of 1 or more blood volumes within 24 hours |
| How do you estimate blood volume in an adult? | 70ml/kg or about 5000ml in 70 kg adult |
| What is the leading cause of pregnancy associated death? | postpartum hemorrhage |
| What is the most common cause of clinically significant hemolytic disease of the fetus and newborn? | Antibody to the RhD antigen |
| Why are Kell related cases of hemolytic disease of the fetus and newborn so severe? | The antibodies not only hemolyze RBCs in peripheral blood, but suppress fetal hematopoiesis |
| What is the "critical titer" of anti-D in maternal serum? | 16:1 or greater |
| What if RBCs less than 7 days old are not available for a neonatal exchange transfusion? | Wash the RBCs (potassium) |
| Describe Neonatal alloimmune thrombocytopenia | maternal antibodies to fetal platelet antigens, particularly HPA-1a (Pl(A1) |
| How much of a bump in hemoglobin is expected in a neonatal transfusion of 10ml/kg over 3 hours? | 2 or 3 g/dL |
| How do you reduce risk of hyperkalemia in large volume neonatal transfusion patients? | washing the units or less than 7d old units |
| For children, randomized studies have shown that in stable, critically ill children this level of hemoglobin is tolerated without increase in morbidity or mortality | down to 7gm/dL |
| Which is the more common cause of platelet refractoriness: A. immune cause B. non-immune cause? | B. |
| The most common alloantibodies associated with platelet refractoriness | antibodies to Class I HLA antigens |
| This is a thrombopoetin receptor agonist approved for ITP | romiplostim |
| This process reduces incidence of primary HLA alloimmunization | leukoreduction |
| The most common cause of fatal hemolytic transfusion reactions | misidentification of either the blood unit or the recipient |
| After a transfusion is started, the patient should be closely observed for this period of time | 15 minutes, then periodically until finished |
| Blood should be infused within this timeframe | 4 hours |
| A unit of RBCs that has been allowed to warm beyond this temperature, but not used, cannot be reissued. | 10 degrees C |
| Solution allowed to be infused with blood | normal saline, plasmalyte, FFP |
| Why is lactated ringers not allowed to be infused with blood? | calcium in lactated ringers can cause clotting {binds citrate(anti-coagulant)} |
| Pore size for standard blood filter | 170 to 260 microns |
Created by:
jfshikle
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