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J Sarge BB test 5

Blood Bank Test 5

QuestionAnswer
When are samples drawn for donor testing? At the same time as donor units
What tests are done on donor samples? ABO/Rh, Ab screen/Ab ID if necessary
Why are group O individuals considered Universal Donors? No antigens on RBCs
Why are group AB individuals are considered Universal Recipients? No antibodies in serum.
What alternative packed RBCs can be given to a type O patient? None
What alternative packed RBCs can be given to a type A patient? Type O
What alternative packed RBCs can be given to a type B patient? Type O
What alternative packed RBCs can be given to a type AB patient? Type A, B, O
Should Rh negative blood be given to Rh+ patients? It can be safely given, not the best use of this limited resource. Should be kept for Rh negative patients
Name three areas of RBC biology crucial for normal survival and function: 1. Normal chemical composition/structure of RBC membrane 2. RBC metabolism 3. Hgb structure and function
Describe two important characteristics of the RBC membrane and how they impact RBC survival: Deformability (flexibility of membrane) spherocytes/bite cells = destruction. Permeability (controls cell volume) rigid = destruction
Name three items necessary for hemoglobin synthesis: Adequate iron supply; Adequate synthesis of protoporphyrins; Adequate globin synthesis
Describe three pathways involved in RBC metabolism and how a defect in them can affect RBC survival: (1) (1) Pentose phosphate pathway-10% of ATP production. Deficiency = formation of Heinz bodies (RBC less deformable=increased destruction)
Describe three pathways involved in RBC metabolism and how a defect in them can affect RBC survival: (2) (2) Methemoglobin reductase pathway-Maintains the heme iron of Hgb in the 2+ (ferrus) state so it can bind oxygen
Describe three pathways involved in RBC metabolism and how a defect in them can affect RBC survival: (3) (3) Luebering-Rapaport shunt-Permits accumulation of 2,3-diphosphoglycerate [2,3,-DPG] = significant effect on affinity of Hgb for oxygen
Describe the five major changes in blood upon storage: Decrease in pH; Buildup of lactic acid; Decrease in glucose consumption; Decrease in ATP levels; Loss of RBC function
Describe the purpose of ATP and 2,3-DPG in blood storage: ATP=energy and deformability; 2,3-DPG=hemoglobin's affinity for oxygen
Name the four anticoagulants used in the collection of a unit of blood and describe the advantages and disadvantages of each: (1) (1) ACD-Acid Citrate Dextrose; 21 days; Disadvantage-Low pH; Most of 2,3,-DPG is lost in the 1st week of storage
Name the four anticoagulants used in the collection of a unit of blood and describe the advantages and disadvantages of each: (2) (2) CPD-Citrate Phosphate Dextrose; 21 days; Disadvantage-Low 2,3-DPG by 2nd week of storage
Name the four anticoagulants used in the collection of a unit of blood and describe the advantages and disadvantages of each: (3) (3) CPDA-1-Citrate Phosphate Dextrose Adenine; Adenine plus 25% more glucose than CPD; 35 days; Advantage-Longer shelf life; Disadvantage-Low 2,3-DPG by 2nd week of storage
Name the four anticoagulants used in the collection of a unit of blood and describe the advantages and disadvantages of each: (4) (4) CP2D-Citrate Phosphate Double Dextrose; Contains 100% more glucose than CPD; 21 days; Advantage-More glucose; Disadvantage-Low 2,3-DPG by 2nd week of storage; Less shelf-life
Define shelf-life: The amount of time blood or blood components may be stored upon collection
Describe how the shelf-life of a blood component is determined: Based on preservatives and viability requirements
What are the two questions blood donor selection is designed to answer? Will a donation of approximately 500mL of whole blood be harmful to the donor? Could blood drawn from this donor at this time potentially transmit a disease to the recipient?
Explain the importance of clear, unique identification of the donor: Each donor must be clearly and uniquely identified in order to be traced through the entire procedure, and if necessary, recalled
Describe the age limits on a donor and the exception to this rule: Minimum of 17 years of age(Becky said 16 now); no upper age limit; no minimum age for autologous
Name the seven items required when registering a blood donor and describe why each item is necessary: ID and tracing for recall-Donor's name, address, phone number, gender, DOB (also for acceptance); Date of donation-deferral; Donor's consent-written, informed consent (all risks must be explained and opportunity given for donor's questions)
Describe the seven areas covered by a physical examination of the donor. (1) What should their general appearance be? In good health, no signs of alcoholism, drug abuse, cold or disease
Describe the seven areas covered by a physical examination of the donor. (2) What is the weight requirement? Greater than or equal to 110lbs; Donation of unit of blood should not exceed 10% of donor's blood volume
Describe the seven areas covered by a physical examination of the donor. (3) What should the donor's temperature not exceed? 99.5°F/37.5°C
Describe the seven areas covered by a physical examination of the donor. (4) What should the donor's pulse be? 50 to 100 beats per minute
Describe the seven areas covered by a physical examination of the donor. (5) What should the donor's blood pressure be? Systolic 90-180 mm Hg; Diastolic 50-100 mm Hg
Describe the seven areas covered by a physical examination of the donor. (6) What should the donor's Hct and/or Hgb be? Hct-38%; Hgb-12.5g Venipuncture or fingerstick
Describe the seven areas covered by a physical examination of the donor. (7) What should be looked for relating to the donor's skin? Skin lesions, arm check; Inspection of anticubital area of both arms for drug use, skin eruptions like poison ivy, rash or psoriasis
Describe the main areas of questioning on the donor questionnaire to ascertain disease status: Disease history; Receipt of blood/blood products, transplants; Tattoo, piercings; Contact with anyone with hepatitis or HIV; Drug use; Surgery/dental work; Donation within the past 8 week; Pregnant; Risk behavior/STDs
Describe the copper sulfate method of measuring hemoglobin: A drop of blood into a solution of copper sulfate with a SG of 1.053. Hgb too low, the drop floats. Hgb too high, drop sinks too quickly; Should drop within 15 seconds
What is an autologous donor? Donor is donating blood for his or her own future use. Safest blood for transfusion.
Describe what is needed in a predeposit donation: Written statement form Dr.; Pt signed consent; No age limit; No weight requirement (<110 proportional amount drawn); Hgb not <11g/dL Hct not <33%; Every 3 days (most stop 3 day before surgery; Much less medical history
Describe intraoperative autologous transfusion: Blood collected during surgery and reinfused immediately; Aspirated from surgical site; Centrifuged, washed filtered and returned to Pt during surgery
Describe immediate preoperative hemodilution: In the OR, 1 to 3 units of WB collected (replaced with volume expanders) Blood remains in the OR and is infused during surgical procedure
When and why is immediate preoperative hemodilution useful? Heart surgery; Pt Hct is lowered to 28%; Bleeding occurs at a lower Hct (amount of RBC mass lost is less) Reinfused blood is fresh, viable plts, clotting factors, protein; Blood flow though microcirculation is improved due to lower Hct
Describe the care of the donor after collection is finished: Bandage site; Cookies/crackers and juice; Rest if light headed; Advise of need for fluid replacement and limited lifting
Describe a random donor unit and the time required for the donation: Unit of whole blood to be divided into components; 20 to 30 minutes; minimum physical components
Describe a pheresis donor unit and the time required for the donation: Giving particular components; 2 hours; Special medical history; Must meet minimum physical requirements of random donor PLUS additional test on the component being pheresed
Describe a MILD donor reaction to donation: Most frequently encountered; Signs of shock, no loss of consciousness
Describe the signs and symptoms of a mild donation reaction: Nervousness, anxiety; Complaints of feeling warm; Pallor, sweating; Increased or thready pulse; Increased respirations leading to hyperventilation; Decreased BP; Nausea and possibly vomiting
Describe the treatment of a mild donation reaction: Stop donation, remove needle;Breath into a paper bag; Loosen tight clothing;Ensure clear airway;Pull knees up/raise feet; Apply a cold towel to forehead and neck; Spirits of ammonia; Reassure donor; If no response, summon medical help; Do not leave donor
Describe a moderate donation reaction: Same as mild but donor loses consciousness
Describe the signs and symptoms of a moderate donation reaction: Periods of unconsciousness; Decreased pulse rate; Rapid, shallow respirations and hyperventilation; Continued decrease BP
Describe the treatment of a moderate donation reaction: Same as mild; Check BP, pulse, and respirations frequently; Administer 95% O2, 5% CO2; Separate the donor from the general donor area
Describe a severe donation reaction: All mild and moderate plus convulsions;
Describe the signs and symptoms of a severe donation reaction: Hyperventilation tetany Donor still conscious, complains of stiffness and/or tingling fingers, spasms of fingers, progresses to more pronounced convulsions
Describe the treatment of hyperventilation tetany: Remain calm; have donor breathe form a paper bag; do not leave the donor; summon additional help
Describe the signs and symptoms of a severe donation reaction: Mild Convulsion Short lapse of consciousness; voice fadeout; slight involuntary movement of arms and legs
Describe the signs and symptoms of a severe donation reaction: Severe Convulsion Rigid body and tightly clenched teeth; temporary loss of breathing followed by rasping breathing; slight involuntary movement of arms and legs
Describe the treatment of mild and severe convulsions: Gently restrain donor to prevent injury; summon help immediately; remain calm and stay with donor; ensure and adequate airway; may administer 95% O2 and 5% CO2; maintain observation of donor until fully recovered
Describe how to respond to a cardiac or respiratory problem during a donation reaction: Call for medical help immediately; If cardiac arrest start CPR
Define a hematoma: A swelling or a mass of blood confined to an organ, tissue, or space and caused by a break in blood vessel.
Describe how a hematoma should be treated: Remove the needle; Apply pressure to the site and raise the arm for 5 to 10 minutes; Make sure bleeding has stopped and apply bandage; An ice pack can be used
Name the blood bank tests performed on the donor samples: ABO Grouping/Rh Typing; Ab Screen/Ab ID if necessary; Infectious Disease tests
If clinically significant antibodies are detected, what part of the patient's unit of blood can be used and why? Washed RBCs only may be used; Plasma will have Abs; no FFP, no plts, no cryo
Name six diseases donor units are tested for: Syphilis (RPR); Hep B surface Ag; Hep B core Ab; Hep C Ab (EIA & NAT); HIV-1/2/O (EIA & NAT) Human T-cell lymphotropic Virus Type 1 & 2; West Nile Virus
Created by: 1414395397