Blood Transfusion Basics
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Questions and Answers

Besides red blood cells, which other cellular components are found in whole blood?

White blood cells and platelets.

What is the primary indication for transfusing packed red blood cells?

Symptomatic and chronic anemia or blood loss due to injury or surgery.

A patient with thrombocytopenia requires a transfusion. Which specific blood component would be most appropriate?

Platelets.

If a patient is bleeding due to a vitamin K deficiency, which plasma component would be most beneficial to administer?

<p>Fresh frozen plasma.</p> Signup and view all the answers

Name two specific coagulation factors that are found in cryoprecipitate.

<p>Factor VIII and von Willebrand factor.</p> Signup and view all the answers

Besides HIV, what other transmissible diseases are commonly tested for in blood transfusions, as mentioned in the text?

<p>HBV, HCV, and Syphilis</p> Signup and view all the answers

What immediate action should be taken if a patient shows signs of a blood transfusion reaction?

<p>Stop the transfusion immediately.</p> Signup and view all the answers

What is the primary purpose of administering normal saline (NS) after a blood transfusion?

<p>To flush the maintenance line.</p> Signup and view all the answers

Besides epinephrine, name two other medications that might be given to address a blood transfusion reaction?

<p>Diphenhydramine and corticosteroids.</p> Signup and view all the answers

Describe the specific type of reaction that can occur due to incompatible blood and can be fatal.

<p>Acute hemolytic reaction.</p> Signup and view all the answers

What does the P wave in an ECG complex represent?

<p>Depolarization of the atria.</p> Signup and view all the answers

What is the role of the QRS complex in an ECG?

<p>It represents the depolarization of the ventricles.</p> Signup and view all the answers

What does the T wave in an ECG complex signify?

<p>Repolarization of the ventricles.</p> Signup and view all the answers

How many limb leads are utilized by an ECG machine?

<p>Six</p> Signup and view all the answers

What is the standard paper speed for an ECG recording?

<p>25 mm/s</p> Signup and view all the answers

In a normal ECG rhythm, what must precede each QRS complex?

<p>A P wave</p> Signup and view all the answers

Describe how to determine if a rhythm is regular on an ECG strip?

<p>Mark the R wave tips on paper, move the strip so your mark lines up with another R wave, and see if subsequent R wave tips line up.</p> Signup and view all the answers

What is the formula for calculating heart rate on a regular ECG rhythm?

<p>300 divided by the number of large squares between two consecutive R waves.</p> Signup and view all the answers

What is the normal range for the cardiac axis in degrees?

<p>Between -30 and +90 degrees</p> Signup and view all the answers

If Lead I is positive and AvF is negative, what type of axis deviation is present?

<p>Left axis deviation</p> Signup and view all the answers

If Lead I is negative and AvF is positive, what type of axis deviation is present?

<p>Right axis deviation</p> Signup and view all the answers

What does the P wave on an ECG represent?

<p>The depolarization of the atria</p> Signup and view all the answers

What is the normal duration of the PR interval?

<p>0.12-0.20 seconds</p> Signup and view all the answers

A Q wave is considered pathological if it is greater than what fraction of the R wave amplitude?

<p>One quarter</p> Signup and view all the answers

What is a normal duration for the QRS complex?

<p>0.08-0.10 seconds</p> Signup and view all the answers

Besides the length, what characteristic of the ST segment suggests that the segment is significant in limb leads?

<p>More than 1mm up or down from baseline</p> Signup and view all the answers

An upright T wave on a ECG, is expected in most leads with the exception of which leads?

<p>AvR and V1</p> Signup and view all the answers

What does a peaked T wave typically suggest?

<p>Hyperkalemia</p> Signup and view all the answers

What is the normal range for the QT interval?

<p>0.36-0.44 seconds</p> Signup and view all the answers

What is the primary difference between bone marrow aspiration and bone marrow biopsy?

<p>Bone marrow aspiration collects a liquid sample of bone marrow, while bone marrow biopsy obtains a core sample of solid tissue.</p> Signup and view all the answers

List two common sites for performing bone marrow aspiration.

<p>The posterior iliac crest and the anterior iliac crest are two common sites.</p> Signup and view all the answers

Name a hematologic disorder that may warrant a bone marrow aspiration.

<p>Leukemia is one hematologic disorder that may require a bone marrow aspiration.</p> Signup and view all the answers

What is an absolute contraindication for performing a bone marrow aspiration?

<p>A localized infection or cellulitis at the procedure site is an absolute contraindication.</p> Signup and view all the answers

During the preparation phase, what is one key aspect of patient education before a bone marrow aspiration?

<p>Patients should be informed about the procedure, its purpose, and potential risks.</p> Signup and view all the answers

Which position should a patient be in for bone marrow aspiration from the posterior iliac crest?

<p>The patient should be in the lateral decubitus or prone position.</p> Signup and view all the answers

What is one therapeutic indication for performing a bone marrow aspiration?

<p>Stem cell harvesting for bone marrow transplantation is one therapeutic indication.</p> Signup and view all the answers

Identify one relative contraindication that must be considered before a bone marrow aspiration.

<p>Severe coagulopathy or thrombocytopenia should be assessed as a relative contraindication.</p> Signup and view all the answers

What is the purpose of using an antiseptic solution before performing a bone marrow aspiration?

<p>To reduce the risk of infection at the procedure site.</p> Signup and view all the answers

Why might sedation be necessary for some patients during a bone marrow aspiration?

<p>Sedation may be needed to alleviate anxiety and discomfort, particularly in children or anxious patients.</p> Signup and view all the answers

What is the recommended technique for inserting the aspiration needle into the bone?

<p>The needle should be positioned perpendicular to the bone surface and advanced with a twisting motion.</p> Signup and view all the answers

After performing a bone marrow aspiration, what is the immediate step to take to manage the site?

<p>Apply pressure to the site to stop any bleeding and cover it with a sterile dressing.</p> Signup and view all the answers

What are two common complications associated with bone marrow aspiration?

<p>Pain or discomfort at the procedure site and minor bleeding or bruising.</p> Signup and view all the answers

What is one critical aspect to ensure before starting a bone marrow aspiration procedure?

<p>Confirming the indications for the procedure is essential.</p> Signup and view all the answers

Why is it important to monitor a patient for complications after a bone marrow aspiration?

<p>To promptly manage any rare but serious complications that may arise, such as hemorrhage or infection.</p> Signup and view all the answers

What minimal amount of marrow aspirate is typically taken during the procedure?

<p>1-2 mL of marrow aspirate is usually collected.</p> Signup and view all the answers

What should be done with the marrow sample after it is collected?

<p>Transfer the sample to appropriate containers, like glass slides and EDTA tubes, for further testing.</p> Signup and view all the answers

How can excessive aspiration during the procedure affect the quality of the marrow sample?

<p>Excessive aspiration can dilute the marrow with blood, compromising the quality of the sample.</p> Signup and view all the answers

Study Notes

Blood Product Transfusion

  • Definition: A routine medical procedure where donated blood is given to a recipient through a narrow tube within a vein.

Purpose of Blood Transfusion

  • Provides blood or blood components when:
    • Blood loss due to injury or surgery
    • Medical condition affecting blood or components

Whole Blood

  • Composition:
    • Red blood cells
    • White blood cells
    • Plasma
    • Platelets
    • Clotting factors
  • Indications:
    • Significant blood loss
    • Exchange transfusion

Packed RBCs

  • Composition:
    • Red blood cells with minimal plasma
    • Some platelets and white blood cells
  • Indications:
    • Symptomatic and chronic anemia
    • Blood loss from injury or surgery

WBCs

  • Composition:
    • White blood cells (leukocytes) suspended in 20% plasma
  • Indications:
    • Rarely used
      • Sepsis in neutropenic patients not responding to antibiotics
      • Persistent fever
      • Granulocytopenia

Platelets

  • Composition:
    • Platelets
    • Plasma
  • Indications:
    • Thrombocytopenia
    • Platelet dysfunction
    • Aplastic anemia
    • Prophylactic transfusion

Fresh Frozen Plasma

  • Composition:
    • Plasma
    • All coagulation factors
  • Indications:
    • Bleeding in patients with coagulation factor deficiencies
    • Vitamin K deficiency
    • Liver failure
    • Disseminated intravascular coagulation (DIC)

Cryoprecipitate

  • Method: Separated by freezing FFP, thawing to 1-6°C, centrifuging, re-freezing, and storing at -30°C
  • Composition: Enriched with Factors VIII, vWF, and fibrinogen
  • Indications:
    • Fibrinogen deficiency
    • Von Willebrand Disease (VWD)
    • Hemophilia A
    • DIC

Pre-Transfusion Tests

  • ABO grouping
  • Rh typing
  • Antibody screening and identification
  • Cross-matching
  • Transmissible disease testing (HIV, HBV, HCV, Syphilis)

Preparation

  • Prepare the patient:
    • Ask about previous blood transfusions/reactions
    • Explain the procedure, benefits, and risks
    • Instruct the patient to report symptoms (chills, nausea, itching, rash, dyspnea, back pain, unusual symptoms)

Equipment

  • Blood product
  • Blood administration set
  • 250 mL Normal Saline (NS) for infusion and IV pole
  • Venipuncture set
  • Alcohol swab
  • Clean gloves
  • Gauze, syringe
  • Medications (acetaminophen, diphenhydramine)
  • Blood warmer (if needed)
  • Vital signs materials

Procedure

  • Obtain blood product promptly from the blood bank
  • Venipuncture using a #18 or #20 cannula
  • Monitor the patient for the first 15 minutes
  • Administer blood slowly
  • Document relevant data
  • Stop transfusion and clamp the tube
  • Continue primary IV solution, flushing with NS
  • Take vital signs after transfusion

Blood Transfusion Reactions

  • Stop the transfusion immediately
  • Support airways and circulation
  • Monitor vital signs
  • Maintain intravenous access (use a new IV line if needed)
  • Administer medications (epinephrine, diphenhydramine, corticosteroid)
  • Check if the correct blood product was given
  • Notify medical officer and transfusion service
  • Incompatible blood: Acute hemolytic reaction is a potentially fatal condition.

Blood Transfusion Reactions: Types

  • Mild: Facial flushing, hives/rash
  • Severe: Anxiety, wheezing dyspnea, fever, chills, headache, tachycardia, tachypnea, hemopurpura, chest pain, apprehension, low back pain

ECG

  • Electrocardiography (ECG) is a simple, noninvasive procedure measuring the heart's electrical activity.

  • Types of ECG:

    • Resting ECG
    • Stress/exercise ECG
    • Ambulatory ECG (Holter)

  • ECG Components:

    • P wave: Atrial depolarization
    • QRS complex: Ventricular depolarization
    • T wave: Ventricular repolarization

  • ECG Procedure: Electrodes are attached to the arms, legs, and chest, connected to a recording machine.

  • ECG Leads:

    • Limb leads (I, II, III, aVR, aVL, aVF) provide limb viewpoints
    • Chest leads (V1, V2, V3, V4, V5, V6) create chest viewpoints

  • ECG Interpretation: Includes calibration, rhythm, rate, cardiac axis, segments(P, PR, QRS, ST, T, and QT interval) analysis.

  • Normal Values:

    • Heart Rate (with age)
    • Cardiac Axis (normal range: -30 to +90)

  • P Wave: normally 2.5mm wide and 2.5mm high. Large P waves indicate Right atrial enlargement, wide P waves indicate Left atrial enlargement.

  • PR interval: 3-5 small squares (0.12-0.20 seconds)

  • Q wave: less than 1/4 of the R-wave (small Q-wave is normal)

  • QRS complex: normally 0.08-0.10s (3-less than 3 small squares)

  • ST segment: isoelectric part between the S-wave and T-wave

  • T wave: reflects ventricular repolarization. Upright in all leads except AvR and V1

Bone Marrow Aspiration

  • Definition: A procedure that obtains a small amount of liquid bone marrow by puncturing the bone with a needle.

  • Sites:

    • Iliac crest
    • Sternum
    • Spine of lumbar vertebrae
    • Tibia (infants)

  • Indications:

    • Evaluation of hematological disorders (anemia, leukopenia, thrombocytopenia, leukemia, myeloma, lymphoma)
    • Evaluation of iron stores and metabolism
    • Suspected bone marrow metastases
    • Investigation of unknown fevers or specific infections (e.g., leishmaniasis, malaria, tuberculosis)

  • Preparation:

    • Anesthesia: Local anesthetic (lidocaine) is used, with intradermal injection followed by deeper injection into periosteum.
    • Positioning: Patient positioned prone or laterally, or supine

  • Equipment:

    • Gloves, gown, gauze, bandages
    • Povidone iodine antiseptic
    • Lidocaine solution, with or without adrenaline
    • Scalpel blade
    • Syringes
    • Jamshidi needle
    • Ultrasound guide (optional)

  • Procedure:

    • Locate and mark posterior iliac spine
    • Disinfect skin with iodine
    • Inject periosteum with lidocaine
    • Make small incision
    • Insert Jamshidi needle, rotate in a clockwise direction
    • Aspirate sample and examine under microscope

  • Complications:

    • Hemorrhage
    • Needle breakage
    • Infection
    • Pain and discomfort

  • Contraindications:

    • Hemorrhagic disorders (e.g., hemophilia)
    • Disseminated intravascular coagulation (DIC)
    • Skin infection or recent radiation therapy at the sampling site
    • Bone disorders (e.g., osteomyelitis, osteogenesis imperfecta)

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Blood Product Transfusion PDF

Description

Test your knowledge on blood transfusion procedures and components. This quiz covers crucial topics, including indications for packed red blood cell transfusions, reactions to transfusions, and the benefits of different blood products. Ideal for students and professionals in healthcare.

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