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Blood Banking

Clinical Medicine II

What are the 4 components of blood RBC, WBC, platelits, plasma
What are the 3 components of Plasma coag factors, albumin, abs
What is albumin used for transporting molecules throughout the body (usually lipid soluble)
How much donor blood is taken 500ml and then separate into 4 parts, use each separately except WBC-discard
What is the MC blood product used for medical therapy RBC’s
Why do they freeze it so rapidly, to what temp to preserve the coag factors, 15 degrees below 0
Indications for FFP coag deficiencies d/t liver failure, DIC, vit K deficiency, warfarin tox, blood loss
Nl platelit count 150-450,000/uL
Indications for platelet transfusions thrombocytopenia (<50,000) <10,000 if asymptomatic for bleed.
What are causes of thrombocytopenia chemo, increased destruction: DIC, massive blood loss
How much will a unit of platelet concentration increase the platelet count Donors? 5000-10,000/uL 6 donors!
When would WBC transfusions be given leukopenia because of chemotherapy with septic shock
Indications for RBC transfusion ↑O2 carying, hypotension, ↓o2stats, dizziness, weakness, angina, altered mental status
What is the transfusion criteria for replacement <8g/dl
What else depends on need for transfusion rate of blood loss, rapid: body can’t compensate, need blood
When would we perfust albumin need to ↑ osmotic pressure of intra-extra-vasbular back to nl usually d/t hypovolemia and hypoprotenimia
Other blood products available for transfusion leukocyte reduced PRBCs irradiated leukocyte reduced PRBC’s, apheresis platelets,
Are there antigens on O blood no, so have anti-a and anti-b abs
Are there antigens on A blood yes, A surface antigens, and have anti-b Abs
When are ABO blood antibodies produced by 3m after birth
What is the Rh antigen/antibodies 70% born w/ Rh antigen
When are Rh antibodies produced once exposed (don’t have them at birth, only have them once exposed to Rh + blood)
What happens to a Rh – pt with 1st and 2nd exposure to Rh+ blood 1st, not much happens, builds Abs for it, 2nd, memory cells ↑ immune response, can be bad (kill a fetus)
What is a type and screen type the pt’s blood for their type of blood, screen for atypical RBC’s for specific abs .5-1 hr
What is the screening more specifically for an Rh like rxn to antigens in the donor blood→cause an immune response
What is a type and cross type pts blood, crossmatch with a donors blood product actually in the blood blank with the intent to transfuse, add pt’s blood w/ donor blood in test tube looking for agglutination
What do we combine to crossmatch blood pt’s WBC’s and the donor RBC blood looking for agglutination
Universial donor for RBC and FFP O- for RBC and AB+/- for FFP
What happens w/ hemolytic transfusion rxns RBCs burst, K+, Heme, Iron all released into the blood, usually toxic
Clinical presentation of hemolytic transfusion reactions DIC, acute renal failure (↑proteins), shock, triads of fever fland and red/brown urine
What is the clinical triad of hemolytic transfusion reactions fever, fland pain, red/brown urine
Tx hemolytic transfusion rxns med emergency, stop transfusion, maintain airway, saline, notify BB, obtain blood and UAs, vasporessors for hypotension pts
What causes febrile nonhemolytic transfusion reactions Interleukins and TNF alpha substance w/I blood products
Clinical presentation of febrile nonhemolytic transfusion rxns fever, chills, rigors, mild dyspnea
Tx FNTR usually stopping the transfusion, d/t what COULD happen, give tylonol and Benadryl for symptomatic relief
CP delayed hemolytic transfusion rxns slight fever falling hematocrit, mild ↑ unjonjugated billrubin etc. no tx necessary
CP of anaphylaxis to transfusion rxns shock, hypotension, angioedema, respiratory distress
Tx anaphylaxis trx rxns stopi t, epi, IM, maintain airway, saline, vasopressor if necessary
What causes urticarial trx rxns substance in blood prodcuts cause histamine release from mast cells and basophils causing hives
Tx of urticrial trs rxsn stop trx benedrly 25-50mg, no other signs, trx can be resumed
What can cause severe thrombocytomenia lasting days to weeks post infusion sensitivity to previous platelet antigen: HPA-1a called post transfusion purpura (PTP)
Tx PTP high dose corticosteroids or exchange trx, give IVIG, furture trxs, give washed cells or HPA-1a – cells
What is TRALI transfusion related acute lung injury unknown cause
CP of TRALI sudden respiratory distress, INTUBATE!
Risks of transfusions fluid overload, rxns, coag defects to massive trx, citrate tox, chelation of calcium, hyperkalemia, hypothermia, iron overload, air embolism
Shelf life of RBC, FFP, platelets R: 45 days, spiked 4 rhs, F: 1 yrs, 12hrs thawed, Platelets: on shelf 5 days
What is hemolytic dz of newborn mom Rh- baby Rh+ communication during birth, mom develops Rh abs, 2nd birth is Rh+ too, mom’s abs attack baby
How do we prevent hemolytic newborn dz during 1st preggo, rhogam
What does rhogam do kills the babies RBC in mom’s circulation, no Rh’s abs can be produced
Who do we give rhogam to? all mom’s who are Rh –
When do we give Rhogam 1 dose at 26-28 weeks of gestation and one dose w/I 72 hrs of delievery (more if trauma or ↑ amount of blood mixed
Created by: becker15
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