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Blood Bank Exam 3 Lecture 18
Transfusion Practices
58
Biology
Undergraduate 3
02/21/2015

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Term
What 4 things does the Oxygen content of blood depend on?
Definition
Hemoglobin concentration
Binding coefficient of Oxygen for hemoglobin
Percent saturation of hemoglobin
Quantity of Oxygen dissolved in the plasma
Term
True or False:
Normally, blood gives up only 25% of its oxygen
Definition
True
Term
Increased _____ for oxygen and Decreased ____ of oxygen results in greater extraction of Oxygen from hemoglobin from the oxygen dissociation curve shifting to the right
Definition
Demand
Supply
Term
When there is not enough Oxygen and the body goes into anaerobic metabolism and produces increased lactic acid, what does this lead to?
Definition
Systemic acidosis
Impaired Cardiac Performance
Decreased Perfusion
Further tissue ischemia
Term
What are 2 things you should consider before transfusing RBCs?
Definition
Giving Oxygen
Reducing Demand (bed rest)
Term
Generally, 1 unit will raise the average adult hemoglobin by how much?
Definition
1 g/dL
Term
Generally, 1 unit will raise the average adult hematocrit by how much?
Definition
3-5%
Term
True or False:
All information must be checked again at bedside by 2 nurses and signed
Definition
True
Term
If not used, the unit MUST be RETURNED to the BB within how many minutes or it must be tossed?
Definition
30 Minutes
Term
Can't run blood with any other susbstance except what?
Definition
0.9% Saline
Term
Why can't you run blood with any other substance than 0.9% Saline?
Definition
Other substances or drugs can:
Hemolyze blood
Change pH
Ringers can activate clotting
Term
What is used to control infusion rate?
Definition
Electromechanical diffusion devices
Term
What do you do in surgery of trauma to prevent cardiac arrest associated with the infusion of cold blood or if patient has cold antibody?
Definition
Warm Blood
Term
True or False:
Blood too warm can cause hemolysis
Definition
True
Term
Should you use a microwave to warm up blood?
Definition
No
Term
At what time do most serious problems show up?
Definition
within the first few minutes
Term
Adverse reactions must be documented and reported to whom?
Definition
Transfusion committee
Term
What type of blood do you give in an emergency setting if you do not the blood type?
Definition
O
Term
What Rh type of blood do you give in an emergency setting if it is a woman of child bearing age?
Definition
Negative
Term
True or False:
It is better with a young female to switch ABO group than give Rh + blood
Definition
True
Term
For a A negative woman what is better to give her: O negative or A positive?
Definition
O negative
Term
If it is an emergency situation and you do not know their blood type and it is a male patient and there is not enough negative blood to give for the whole transfusion what do you give?
Definition
Rh + right away to save Rh = for other patients
Term
What is one of the most transfused patient groups?
Definition
Neonatal - birth to 4 months
Term
For Neonatal what do you exchange transfusion for to prevent kernicterus?
Definition
hyperbilirubinemia
Term
For HDN what can exchange do?
Definition
Lower bilirubin
remove ABY coated cells
Free Maternal ABY
Term
True or False:
Blood must be compatible with maternal IgG ABY as well as ABO and Rh of infant
Definition
True
Term
What type of blood should you use for Neonatal?
Definition
Fresh pooled (less than 7 days) to have more 2,3-DPG and less Potassium
Term
Use CPDA-1 RBCs resuspended in compatible FFP to a final hematocrit of what?
Definition
45-50%
Term
Additive solutions such as adenine can be ______ to immature kidneys
Definition
Toxic
Term
90% of neonatal transfusions are for what?
Definition
iatrogenic blood loss
Term
You transfuse for neonatal when what percent reduction in volume occurs
Definition
5-10%
Term
Babies with RDS, keep hematocrit as what percent to provide greater oxygen transport since lungs aren't working
Definition
40%
Term
True or False:
Do NOT transfuse when normal infants drop hematocrit unless they have symptoms of RDS or HDN
Definition
True
Term
If on original testing the infant does NOT possess alloantibodies from mom, what type of blood can be used for up to 4 months of age?
Definition
uncrossmatched
Term
What type of blood is given for premature infants or for inutero?
Definition
CMV Negative
Term
True or False:
CMV is much more serious in babies and can cause death
Definition
True
Term
With Neonatal GVHD what type of blood is used?
Definition
Irradiate blood
Term
Rh negative moms have their IAT repeated and are given RHIG at how many weeks?
Definition
28
Term
Do you perform a titer on the Rh negative mom if the IAT is positive or negative?
Definition
Positive
Term
What type of transfusion can you give if HDN is detected and the baby is too immature to deliver
Definition
Intrauterine transfusion
Term
One uses an ultrasound to get into the umbilical cord because what type of access is often a problem?
Definition
Vascular
Term
Define Massive Transfusion
Definition
One or more blood volumes in 24 hours
Term
For massive transfusions what type of blood do you use?
Definition
Whole blood and colloid solutions
Term
True or False:
Many clinical signs previously ascribed to massive transfusion are really tissue trauma or hypoperfusion
Definition
True
Term
True or False:
The pH of stored blood is lower and has more potassium
Definition
True
Term
True or False:
Massive transfusion does not generally cause acidemia or hyperkalemia
Definition
True
Term
True or False:
Large volume of refrigerated blood can cause a risk for cardiac toxicity due to hypothermia
Definition
True
Term
Poor oxygenatiion is due to what?
Definition
Inadequate blood flow and and blood pressure
Term
Stored blood has less of what than fresh blood?
Definition
2,3-DPG
Term
Transfused RBCs regenerate what percentage of normal 2,3-DPG levels in 3-8 hours
Definition
50%
Term
Transfused RBCs regenerate 50% of normal 2,3-DPG in how many hours?
Definition
3-8
Term
True or False:
It is best not to transfuse Autoimmune hemolytic anemia patients if die to serologic difficulties are encountered
Definition
True
Term
If die to serologic difficulties are encountered for an Autoimmune hemolytic anemia patient, what must be determined?
Definition
If there are any underlying allos
Term
Define Hypertransfusion in relation to Sickle Cell patients
Definition
Blood given frequently to maintain hematocrit at 30% and to keep Hemoglobin S at about 30%
Term
True or False:
Because Sickle Cell patients get so many transfusions, it is best to phenotype and if possible give AGN compatible RBCs to prevent alloimmunization
Definition
True
Term
What should you do to the RBCs to be given to sickle cell patients to prevent HLA ABYs and subsequent febrile transfusion reactions?
Definition
Leukodeplete the RBCs
Term
What should you use for patients with Thalassemia to lengthen the time between transfusions?
Definition
Neocytes
Term
What is the concern about for patients with Thalassemia?
Definition
Iron Overload
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