Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Blood Products & tra
WK 9
| Question | Answer |
|---|---|
| SVN and RVNs role in transfusion medicine | Assisting VS with patient diagnosis Arranging blood collection from donor patients Ordering blood products and equipment from pet blood bank Blood product storage and managment Blood product prep + administration Patient monitoring during + after |
| SVN and RVNs role in transfusion medicine | Liaising with the VS about the blood transfusion patient Client support and education |
| Blood transfusion indications for use | - Acute or chronic anaemia - Hypovolaemia - Acute haemorrhage (traumatic or surgical) - Coagulopathy - Hypoproteinaemia - + more |
| Aims of a blood transfusion Depends on the reason for transfusion and products used ... | - support life - improve oxygen delivery and restore blood volume - replace clotting factors and/or other blood components - provide a bridge to definitive treatment - ultimately improve patient outcomes |
| specific diseases | - Traumatic blood loss - Thrombocytopaenia - Von Willebrand Disease (VWD) - Rodenticide toxicity |
| Blood Products Prescription only medicine (VS) (POM-V) | - Whole blood (WB) - Packed red blood cells (PRBCs) - Platelet concentrate (PC) - Fresh frozen plasma (FFP) - Frozen plasma (FP) - Cryo-precipitate (Cryo-P) - Cryo-supernatant (Cryo-S) |
| When WB is administered, this is known as a | Whole blood transfusion |
| when pRBCs, PC, FFP, FP, Cryo-P or Cryo-S are administered, this is known as | component therapy transfusion |
| From whole blood, you can obtain | packed red blood cells, platelet concentrate and fresh frozen plasma. |
| From fresh frozen plasma, you can obtain | frozen plasma, cryo-supernatant and cryo-precipitate. |
| All blood products can be obtained from the | Pet Blood Bank: choose the best available product based on losses (WB, RBCs, plasma). In emergencies, use the best immediately available option rather than delaying for blood bank or donor delivery if urgent treatment is required for the patient. promptly |
| Fresh Whole Blood (FWB) (>24hrs = stored whole blood (SWB) contents = | Erythrocytes haemostatic proteins plasma proteins immunoglobulins antiproteases thrombocytes clothing factors plasma proteins antibodies |
| Fresh Whole Blood (FWB) Stored Whole Blood (SWB) cases = | Haemorrhage (traumatic or surgical) haemostatic protein deficiency with haemorrhage anaemia |
| Packed Red Blood Cells (pRBCs) Contents = | Erythrocytes |
| Packed Red Blood Cells (pRBCs) Cases = | Anaemia Haemorrhage (traumatic or surgical) |
| Platelet Concentrate (PC) Contents = | Thrombocytes |
| Platelet Concentrate (PC) Cases = | Active/uncontrolled haemorrhage due to thrombocytopaenia/thrombopathia prophylactic treatment prior to surgery |
| Fresh frozen plasma (FFP) Contents | haemostatic proteins (liabile and non-labile) (clotting factors) antiproteases immunoglobulins plasma proteins antibodies |
| Fresh frozen plasma (FFP) Cases = | Coagulopathies Disseminated intravascular coagulopathy (DIC) Adder bites Haemophilia A and B Von Willie Brand Disease Acute haemorrhage shock Haemorrhage due to Angiostrongylus Protein Deficiency |
| Difference between fresh whole blood (FWB) & stored whole blood (SWB). Collected whole blood is known as FWB + is classed as fresh for upto 24 hrs. During this time, FWB should be kept stable room temperature (between 20 - 24 degrees c). After 24 hrs its | FWB is whole blood kept at 20–24°C for 24h. After this it becomes SWB, which needs refrigeration SWB, Factor I, VIII and vWF fall below‑therapeutic levels + platelets are less responsive. SWB stores upto 21 days. |
| pRBCS have a shelf life of | 42 days and must be stored within a temperature monitored refrigerator (4 degrees celcius (+/- 2 degrees celcius). pRBCs are known as component therapy |
| PC has a shelf life of | 5 days and must be stored at stable room temperature (between 20-24 degrees celcius) The Pet Blood Bank also advise to keep PC on a rocker to provide gentile agitation if not used immediately following collection. PC is a natural colloid |
| FFP has a she life of | 1yr + must be stored within a temp monitored freezer (below -18 degrees C). If not used within 1 yr it can be stored as frozen plasma FP for up to 5 yrs within a temperature monitored freezer (below -18 degrees Celsius). FFP and FP are natural colloids. |
| cryoprecipitate (Cryo-p) Contents = | Labile clotting factors (I, VIII, XIII, Von Willebrand factor, fibronectin |
| cryoprecipitate (Cryo-p) Cases = | Von Willebrand disease Haemophilia A Hypofibrinogenaemia |
| Cryosupernanatant (Cryo-S) and frozen plasma (FP) Contents = | Plasma proteins Immunoglobulins antiproteases non labile clotting factors (II, V, VII, IX, X, XL, XLL) |
| Cryosupernanatant (Cryo-S) and frozen plasma (FP) Cases = | Haemorrhagic gastroenteritis anticoagulant rodenticide toxicity hepatic coagulopathy haemophilia B resuscitative iv fluid therapy immunoglobulin transfer hypalbuminaemia |
| Cryo-p has a shelf life of | 1-year shelf life and must be stored within a temperature monitored freezer (below -18 degrees Celsius). And is classed as a natural colloid |
| Cryo-s has a shelf life of | 1-year shelf life and must be stored within a temperature monitored freezer (below -18 degrees Celsius). FP has a 5-year shelf-life and must also be stored via this method. And is a natural colloid |
| component therapy advantages | maximises resources utilisation can target specific conditions flexible dosing and administration reduced transfusion volume & decreased risk of fluid overload minimising immune sensitisation immediatley available extended shelf life |
| component therapy disadvantages | complex components, knowledge on each product required multiple storage requirments of various products (different temperature requirments) |
| Whole blood advantages | No complex processing requirments storage is often easier (single storage temperature required) |
| whole blood disadvantages | shorter shelf life suitable in house donor required difficult for inexperienced staff (collection) |
| What is an autotransfusion | Auto‑transfuse patient’s own blood Useful when products unavailable, emergencies or financial limits Life‑saving & cost‑effective Done in‑house aseptically with collection kit Low reaction risk Only if no contamination or neoplasia |
| autotransfusion must be administered as soon as possible and | as much of the patients blood as possible Haemoabdomen may occur secondary to trauma, coagulopathy or surgical complications. |
| Specific Diseases Traumatic Blood Loss | Injury (road traffic severe laceration, dog attack etc) surgical (intra/postoperative haemorrhage fresh whole blood (FWB), stored whole blood (SWB) or packed RBCs required to replace lost blood |
| FWB/SWB = replacement of | volume and oxygen-carrying capacity. |
| pRBCs = replacement of | oxygen-carrying capacity. |
| To raise packed cell volume (PCV) by 1% | 1ml/kg of packed red blood cells. 2ml/kg of fresh/stored whole blood. General dose rate of 10ml/kg of pRBCs expected to raise PCV by around 10% (5% using FWB/SWB) in an anaemic but normovolaemic patient. |
| Anaemia = | low RBCs; other components normal Not the same as whole‑blood loss FWB/SWB less effective than pRBCs for raising PCV Normovolaemic anaemia: IMHA, CKD Hypovolaemic anaemia: haemorrhage Fluids + pRBCs match whole blood with lower reaction risk |
| Thrombocytopaenia A clinical sign, not a disease investigations should aim to establish cause. Caused by = | impaired thrombopoiesis, ↑ destruction/consumption, infection; some drug‑induced; congenital or acquired. Signs petechiation, ecchymosis, epistaxis, GI loss. platelet concentrate FWB/SWB if severe + fluids if hypovolaemic avoid if contamination/neoplasia |
| Thrombopoiesis = | platelet production in bone marrow Drug‑induced thrombocytopaenia can follow: sulfisoxazole, aspirin, diphenylhydantoin, ristocetin, levamisole, methicillin, penicillin May be congenital or acquired |
| Von Willebrand Disease (vWD) Most common haemostatic disorder in the domestic dog. Quantitative or qualitative abnormality of vWF. | Affects any breed; ↑ risk in Doberman, Pointer, GSD, Corgi, Scottish Terrier May be asymptomatic or show haemorrhage, ecchymosis, epistaxis, haemarthrosis Needs prophylactic/emergency control: avoid bleeding, give FFP/Cryo‑P; FWB/SWB if severe |
| Rodenticide Toxicity clinical signs = | Coagulopathy signs petechiation, ecchymosis, haematomas Internal bleeding haemothorax, dyspnoea External bleeding epistaxis, gingival bleeding GI signs melaena, haematemesis Neurological signs weakness, collapse Anaemia signs pale mm, tachycardia |
| Rodenticide Toxicity Treatment = | Stabilise patient: oxygen, control bleeding Give Vit K1: essential antidote; prolonged course Decontaminate: emesis if appropriate activated charcoal Supportive care: transfusion (FFP, pRBCs FWB/SWB), fluids Monitor clotting times: repeat until normal |
| Feline Blood Transfusions Feline blood types = | type A, type B, type AB, type Mik. |
| Most common = | Type A |
| very rare = | type AB |
| Direct transfusion from donor cat to recipient cat most common | A - A B - B AB - AB (or A - AB) |
| Cats have naturally occurring antibodies to the | antigens associated with other blood types. All transfusions should be blood typed and cross-matched to check compatibility and reduce the risk of transfusion reaction. |
| What is a xenotransfusion | transfusion of canine blood in a critically ill feline patient to immediatley increase oxygen carrying capacity |
| how does xenotransfusion work | Canine RBCs raise feline PCV but last only 4–7 days feline RBCs last 30 for nonemergency/chronic non‑regenerative anaemia use feline RBCs/whole blood 0 reactions reported Some cats have natural anti‑canine antibodies → theoretical severe reaction risk |
| Preparation of the Patient Requiring a Transfusion | Confirm diagnosis (Vet) Know required blood product Place IV/IO catheter (for transfusion only) Gather full clinical history Perform blood typing Cross‑match Order correct product from Pet Blood Bank Monitor patient |
| Canine Blood Type Compatibility | DEA 1.1 negative donor → negative patient: YES DEA 1.1 negative donor → positive patient: emergency only (depletes valuable stock) DEA 1.1 positive donor → negative patient: NO (sensitises patient) DEA 1.1 positive donor → positive patient: YES |
| What Are Antigens & Erythrocyte Antigens | Antigens are surface molecules that trigger immune responses; found on drugs, pathogens, pollens, plasma proteins, blood cells. Erythrocyte antigens are those on RBCs; their presence determines an individual’s blood type |
| Why Blood Type Dogs Before Transfusion? | A first transfusion sensitises a dog: DEA‑1 negative given DEA‑1 positive blood → immune system forms antibodies. Not fast enough to harm first transfusion, but future DEA‑1 positive blood will cause a reaction. Hence blood type + cross‑match always. |
| Sensitisation & Transfusion Reactions in Dogs | If a sensitised DEA‑1 negative dog receives DEA‑1 positive blood again, existing antibodies bind antigens → rapid RBC destruction → transfusion reaction. This is why matching and cross‑matching are essential before every transfusion |
| DEA‑1 Negative Dogs as Donors | DEA‑1 negative dogs lack the DEA‑1 antigen, so their RBCs won’t sensitise recipients. They are considered universal donors and preferred for safe transfusion practice, especially for DEA‑1 negative patients. |
| blood typing - canine determines the presence or absence of species specific inherited antigens present on the surface of erythrocytes (DEA) carried out ... | easily in house using a typing kit reliable and practical in emergencies allows for the detection of DEA-1 positive or DEA-1 negative blood in dogs (a b AB blood types in cats |
| see image of typing kit a second line indicates the dog is DEA 1 positive A pale line would indicate a weakly DEA 1 positive dog no second line would indicate | the dog is DEA 1 negative control line should be visible indicating test has been succesful |
| Canine Cross‑Matching | Assesses compatibility beyond blood type; detects other antigens. Major: recipient plasma vs donor RBCs (recipient antibodies). Minor: donor plasma vs recipient RBCs (donor antibodies). Needed to confirm safe transfusion; kits/manual methods available. |
| When to Cross‑Match Dogs | First transfusion: cross‑match often not done as patient isn’t sensitised. Always cross‑match for any second transfusion or if history unknown. If unsure, cross‑match before transfusion. |
| Cross‑Matching & Plasma Transfusions | Cross‑matching usually not needed for plasma transfusion because donor plasma shouldn’t contain antibodies; dogs and cats cannot donate if they’ve previously received blood. |
| When Full/Major Cross‑Match Is Required | Full/major cross‑match required when giving whole blood. Cats must always receive a full/major cross‑match before any blood transfusion due to strong natural alloantibodies. |
| Manual cross matching is used if = | used if no kit; takes up to 1 hour. Checks for haemolysis and agglutination. Positive = donor unsafe; do not transfuse. Negative = donor likely safe. Assesses compatibility beyond typing; ensures transfusion safety. |
| preparation prior to transfusion prior to beginning the transfusion, you must check = | Correct product/unit Confirm patient blood type + cross‑match Product in date Correct volume Visual check Storage log if needed Prep steps (defrost/warm) Confirm administration route: IV or IO |
| defrosting and product warming | Plasma is frozen → defrost to room temp or in 37°C water bath (monitor with thermometer). pRBCs/SWB refrigerated → warm to room or body temp in 37°C bath (monitor). DO NOT MICROWAVE any blood products |
| set up your product ready for administration = | Maintain aseptic technique Pierce bag with giving set (20 drops/ml) Fill line without loss Check for air bubbles Hang ready Flush catheter with 0.9% saline Connect line and start transfusion |
| Administration of the Transfusion Stable patients - initial rate = | 0.25 - 0.5ml/kg/hr for first 15 to 30 minutes. Vigilant monitoring for transfusion reaction. If no reaction observed, increase rate to 5-10ml/kg/hr. |
| Administration of the Transfusion Emergency patients = | pRBCs may be administered at shock rate. Slower rates recommended in circulatory collapse (1-2ml/kg/hr). |
| Transfusion Monitoring | Have emergency drugs/equipment ready Place patient in visible kennel Observe continuously 0–30 min Record at 5,15,30,60,120,180,240 min if stable Transfusion ≤4 hrs No food/water or other meds Litter tray for cats Walk dogs beforehand |
| Minimum monitoring/observations for all transfusions (see table on pp) Additional monitoring/observations required for some transfusion patients = | pain, anaesthetic monitoring, mechanical ventilation, behaviour etc. |
| Post-Transfusion | Recheck parameters, PCV, TP, coag Flush line with 0.9% saline Disconnect and dispose set Bung catheter if not reused Disinfect + flush catheter Continue monitoring Discuss aftercare: future transfusion risk, ID tag, PBB, prevention |
| what is a transfusion reaction | Adverse event reacting to transfused product, usually RBCs Varies in cause, severity, onset Mild to life‑threatening Immunological or non‑immunological |
| types of transfusion reactions | Immunological = Acute OR Delayed Non‑immunological = Acute OR Delayed |
| Acute immunological | Non-haemolytic febrile transfusion reaction (NHFTR). Acute haemolytic transfusion reaction (AHTR). Allergic/anaphylactic reaction. Transfusion-related lung injury (TRALI). |
| Acute Non-immunological | Non-immunological haemolysis. Transfusion-associated circulatory overload (TACO). Citrate toxicity. Hypothermia. Transfusion transmitted infection (TTI). |
| managment of the reaction | Alert VS immediately; stop transfusion. Discuss case; VS may slow rate. Give oxygen if needed. Give meds per VS (antihistamines, steroids, epinephrine, IVFT, bronchodilators). Monitor and record. Report reaction to PBB if product from them |
| the pet blood bank | Manufacture canine blood products Supply transfusion kits/equipment Cross‑match service Technical advice Blood sharing scheme CPD Transfusion guides/calculator Feline services in development |
| pet blood bank - donor criteria for dogs = | fit & healthy between 1 & 8 yrs old weigh at least 25kg (lean mass) good temperatment born & raised in UK or Ireland for whole life not on any medication upto date vaccinations & preventative healthcare fed commercial diet |
| pet blood bank - donor criteria for dogs = | never previously had a blood transfusion have normal blood test results test negative for infectious diseases some breeds are extremely vlauble (eg Airedale terrier, boxer, Doberman, greyhound, lurcher ect) |
| The above breeds are valuable as some breeds, for example, the Greyhound, have a high | red blood cell count. Additionally, some of the listed breeds often have DEA-1 negative blood and demand for this blood is high because it can be administered to any dog in an emergency. |
Created by:
lucy.fox