Clinical Use of Blood Products Quiz
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Questions and Answers

What is a primary indication for the use of albumin in clinical settings?

  • To replace specific clotting factors
  • To restore and maintain circulating blood volume (correct)
  • To enhance immune response
  • To treat infections

Which conditions are commonly treated with immunoglobulin products?

  • Immunodeficiency and Autoimmune Disorders (correct)
  • Cirrhosis and Ascites
  • Burns and Trauma
  • Hemophilia A and B

Factor concentrates are most commonly used to treat which of the following?

  • Dialysis-Related Hypotension
  • Hemophilia A and B (correct)
  • Hypovolemic Shock
  • Chronic liver disease

Which of the following is NOT a typical indication for using albumin?

<p>Preventing immune response (C)</p> Signup and view all the answers

What is the role of factor concentrates in the management of bleeding disorders?

<p>Replaces specific clotting factors (A)</p> Signup and view all the answers

What is the primary purpose of the ABO Compatibility Chart in blood transfusions?

<p>To identify compatible blood types for transfusion (D)</p> Signup and view all the answers

Which of the following documents provides guidance on transfusion reactions?

<p>Chapter 10: Transfusion Reactions (A)</p> Signup and view all the answers

What type of blood component does the document from Alberta Health Services dated 2022 focus on?

<p>Red Blood Cells, Leukocyte Reduced (D)</p> Signup and view all the answers

Which condition warrants the use of CMV seronegative blood components?

<p>In immunocompromised patients to reduce the risk of infection (D)</p> Signup and view all the answers

Why is it important to manage platelet refractoriness carefully?

<p>To prevent the rejection of transfused platelets by the immune system (B)</p> Signup and view all the answers

What is the primary function of red blood cells (RBCs)?

<p>To carry oxygen throughout the body (B)</p> Signup and view all the answers

Which blood component is typically indicated for patients with anemia and impaired oxygen delivery?

<p>Red blood cells (D)</p> Signup and view all the answers

What is the maximum time frame allowed for administering a blood unit once it has been spiked?

<p>4 hours (D)</p> Signup and view all the answers

Which blood type is considered the universal donor?

<p>O-negative (C)</p> Signup and view all the answers

For which condition are platelets typically indicated?

<p>Severe thrombocytopenia (D)</p> Signup and view all the answers

What effect does one unit of red blood cells have on hemoglobin concentration in an average adult?

<p>Increases it by approximately 10 g/l (C)</p> Signup and view all the answers

Which of the following blood types can receive donations from AB-positive?

<p>AB-only (D)</p> Signup and view all the answers

What is an indication for administering plasma?

<p>Upholding blood volume and clotting factors (B)</p> Signup and view all the answers

What is the threshold platelet count (PLT) below which transfusion is required for severe cases of ITP that are unresponsive to desmopressin?

<p>PLT &lt; 50 x 10⁹/L (A)</p> Signup and view all the answers

Which type of platelet preparation provides matched products for specific indications?

<p>Apheresis Platelets (C)</p> Signup and view all the answers

What is the storage requirement for platelets after they are issued?

<p>Must be maintained at room temperature (20–24°C) (C)</p> Signup and view all the answers

Which of the following is a primary component of cryoprecipitate used to manage bleeding?

<p>Fibrinogen (D)</p> Signup and view all the answers

What is the indication for administering fresh frozen plasma (FFP)?

<p>Warfarin reversal during surgery (C)</p> Signup and view all the answers

In which circumstance can cryoprecipitate be transfused with any ABO blood group?

<p>In emergencies when supplies are low (A)</p> Signup and view all the answers

What is an essential consideration when transfusing plasma?

<p>ABO compatibility is important to prevent hemolytic reactions (B)</p> Signup and view all the answers

What characterizes pooled platelets compared to apheresis platelets?

<p>Pooled from multiple donors (C)</p> Signup and view all the answers

What is the first step to take when a transfusion reaction is suspected?

<p>Call for help (B)</p> Signup and view all the answers

Which medication is considered the first-line treatment for anaphylaxis during a transfusion reaction?

<p>Intramuscular epinephrine (B)</p> Signup and view all the answers

What is the purpose of administering adjunct medications like diphenhydramine and corticosteroids after epinephrine?

<p>To relieve skin symptoms and prevent biphasic reactions (A)</p> Signup and view all the answers

Which site is recommended for administering intramuscular epinephrine?

<p>Vastus lateralis muscle (D)</p> Signup and view all the answers

What should be done with the blood components and transfusion tags after a suspected reaction?

<p>Notify Transfusion Medicine and retain them for further evaluation (A)</p> Signup and view all the answers

What characterizes a biphasic anaphylactic reaction?

<p>Symptoms reappearing within hours of initial resolution (A)</p> Signup and view all the answers

After stopping a transfusion, what is the most important vital sign to assess?

<p>Heart rate (B)</p> Signup and view all the answers

What is the role of IV fluids in the management of a transfusion reaction?

<p>To maintain vascular access and support hemodynamic stability (B)</p> Signup and view all the answers

What is a common immediate action to take when a patient experiences a Febrile Non-Hemolytic Reaction?

<p>Stop transfusion (A)</p> Signup and view all the answers

Which symptom is NOT associated with an Acute Hemolytic Transfusion Reaction?

<p>Hives (C)</p> Signup and view all the answers

What is a recommended management step for Mild Allergic Reactions during transfusion?

<p>Pause transfusion (B)</p> Signup and view all the answers

In which scenario would you consider administering epinephrine?

<p>Severe Allergic/Anaphylactic Reaction (B)</p> Signup and view all the answers

What should be monitored closely after an Acute Hemolytic Transfusion Reaction?

<p>CBC, electrolytes, coagulation (C)</p> Signup and view all the answers

What is a distinguishing sign of Transfusion-Related Acute Lung Injury?

<p>Hypoxemia (A)</p> Signup and view all the answers

What immediate action should be taken for a patient showing dyspnea and cyanosis during a transfusion?

<p>Position upright (A)</p> Signup and view all the answers

For a patient who is at high risk of Transfusion-Associated Circulatory Overload, what is a suggested management approach?

<p>Administer diuretics (A)</p> Signup and view all the answers

Which of the following is a sign of a Severe Allergic/Anaphylactic Reaction during transfusion?

<p>Hypotension (C)</p> Signup and view all the answers

What should be given to manage fever in a patient experiencing a Febrile Non-Hemolytic Reaction?

<p>Acetaminophen (C)</p> Signup and view all the answers

Which blood component is primarily indicated for patients with thrombocytopenia?

<p>Platelets (A)</p> Signup and view all the answers

What is the primary purpose of CMV seronegative blood components?

<p>To reduce the risk of viral transmission in immunocompromised patients (B)</p> Signup and view all the answers

Which condition typically requires the administration of leukocyte-reduced blood components?

<p>Platelet Refractoriness (A)</p> Signup and view all the answers

In managing transfusion reactions, which vital sign is considered most critical to monitor immediately after stopping the transfusion?

<p>Blood Pressure (A)</p> Signup and view all the answers

What is a common characteristic associated with Febrile Non-Hemolytic Transfusion Reactions?

<p>Temperature increase of more than 1°C (B)</p> Signup and view all the answers

What medication is indicated as the first-line treatment for anaphylaxis during a transfusion reaction?

<p>IM epinephrine (D)</p> Signup and view all the answers

Which site is preferred for administering intramuscular epinephrine?

<p>Vastus lateralis muscle (C)</p> Signup and view all the answers

What should be done with blood components and transfusion tags after a suspected transfusion reaction?

<p>Retain until further directions are given (A)</p> Signup and view all the answers

What adjunct medication may be used after administering epinephrine to prevent or minimize biphasic anaphylactic reactions?

<p>Diphenhydramine (D)</p> Signup and view all the answers

What vital signs should be prioritized for reassessment after a suspected transfusion reaction?

<p>All vital signs equally (D)</p> Signup and view all the answers

Which of the following interventions is important in the management of anaphylaxis after epinephrine administration?

<p>Continuous monitoring for 72 hours (C)</p> Signup and view all the answers

What is a significant indication for using albumin in clinical practice?

<p>Hypoalbuminemia in chronic liver disease (C)</p> Signup and view all the answers

Which statement accurately describes the use of immunoglobulin products?

<p>They modulate immune response in autoimmune disorders. (B)</p> Signup and view all the answers

What is the primary purpose of factor concentrates in patient care?

<p>To prevent or control bleeding in hemophilia (A)</p> Signup and view all the answers

In which scenario is the use of cryoprecipitate indicated?

<p>To manage bleeding disorders by supplying fibrinogen (B)</p> Signup and view all the answers

Factor concentrates are often genetically engineered to treat which of the following disorders?

<p>Hemophilia A and B (C)</p> Signup and view all the answers

What symptom is commonly associated with an Acute Hemolytic Transfusion Reaction?

<p>Hypotension (C)</p> Signup and view all the answers

What is the immediate action to take when a patient experiences a Severe Allergic/Anaphylactic Reaction?

<p>Administer epinephrine (B)</p> Signup and view all the answers

Which of the following actions should be taken for a Mild Allergic Reaction during a transfusion?

<p>Administer antihistamine (C)</p> Signup and view all the answers

Which sign is associated with Transfusion-Related Acute Lung Injury?

<p>Hypoxemia (B)</p> Signup and view all the answers

What is a common symptom observed in patients experiencing Febrile Non-Hemolytic Reaction?

<p>Fever (38°C to 39°C) (A)</p> Signup and view all the answers

What management step is recommended if a patient develops dyspnea and hypertension during a transfusion?

<p>Position the patient upright (B)</p> Signup and view all the answers

Which lab tests are important to perform after an Acute Hemolytic Transfusion Reaction?

<p>CBC, electrolytes, and coagulation (D)</p> Signup and view all the answers

What is the recommended management for a patient experiencing Transfusion-Related Acute Lung Injury?

<p>Provide oxygen support (A)</p> Signup and view all the answers

What is recommended for future transfusions if a patient has had a Mild Allergic Reaction?

<p>Premedicate with antihistamines (D)</p> Signup and view all the answers

What immediate management should be taken for a patient showing respiratory distress within 6 hours of a transfusion?

<p>Stop the transfusion and provide oxygen (A)</p> Signup and view all the answers

What platelet count (PLT) level indicates that a transfusion is required regardless of the PLT level for severe cases in ITP unresponsive to desmopressin?

<p>PLT &lt; 50 x 10⁹/L (C)</p> Signup and view all the answers

What is the primary advantage of apheresis platelets compared to pooled platelets?

<p>Matched platelet products for specific indications (C)</p> Signup and view all the answers

Which blood component is primarily used to manage fibrinogen deficiencies?

<p>Cryoprecipitate (C)</p> Signup and view all the answers

What condition necessitates the immediate transfusion of plasma due to its role in coagulation?

<p>Massive hemorrhage (A)</p> Signup and view all the answers

What temperature must platelets be maintained at after being issued?

<p>Room temperature (20–24°C) (A)</p> Signup and view all the answers

Why is ABO compatibility crucial when transfusing plasma?

<p>To prevent hemolytic reactions (C)</p> Signup and view all the answers

Which statement about cryoprecipitate is correct regarding its transfusion compatibility?

<p>Can be transused with any ABO group when necessary (D)</p> Signup and view all the answers

What content is NOT typically found in plasma?

<p>Red blood cells (B)</p> Signup and view all the answers

What is the main function of platelets in the blood?

<p>Mediating primary hemostasis (D)</p> Signup and view all the answers

What is a typical indication for administering red blood cells (RBCs)?

<p>Acute blood loss (B)</p> Signup and view all the answers

Which blood type can receive blood from O-negative donors?

<p>O-positive (A), B-negative (B), A-positive (C), AB-negative (D)</p> Signup and view all the answers

What is the effect of administering one unit of red blood cells to an average, non-bleeding adult?

<p>Increase hemoglobin by approximately 10 g/l (B)</p> Signup and view all the answers

For which condition are platelets potentially transfused as prophylaxis?

<p>Severe thrombocytopenia (D)</p> Signup and view all the answers

Which blood component is indicated for correcting functional abnormalities in platelets?

<p>Platelets (B)</p> Signup and view all the answers

What factor determines ABO compatibility in blood transfusions?

<p>Blood group antigens (B)</p> Signup and view all the answers

Flashcards

RBCs Indication

Increase oxygen-carrying capacity in patients with anemia and impaired oxygen delivery.

RBC Dose

Increases hemoglobin by ~10 g/L in an average adult.

RBC Storage

Proper storage is critical; improper storage risks bacterial contamination and reduced effectiveness.

ABO Compatibility (Blood)

A compatibility system to ensure blood types are compatible for transfusions.

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Platelet Indication

Given for bleeding, decreased platelet production, or abnormal platelets.

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Platelet Prophylaxis

Given to prevent complications from low platelet counts during chemotherapy or bone marrow failure.

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Platelets Function

Mediate primary hemostasis (blood clotting).

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Blood Components

Specific parts of whole blood used in transfusions. (RBCs, plasma, platelets, cryoprecipitate)

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Cryoprecipitate Purpose

Cryoprecipitate is pooled from multiple donors to provide a sufficient dose of clotting factors for patients, especially those with clotting disorders.

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Albumin's Role

Albumin is used to restore and maintain circulating blood volume when a colloid is needed.

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Hypoalbuminemia Causes

Hypoalbuminemia, or low albumin levels, can result from conditions like chronic liver disease, malnutrition, or nephrotic syndrome.

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Immunoglobulin Product Function

Immunoglobulin products are used to support or modify the immune system in various conditions.

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Factor Concentrates: When Used

Factor concentrates are used to replace specific clotting factors, like Factor VIII or IX, in patients with hemophilia or other clotting disorders.

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Platelet Transfusion Thresholds

Platelet counts below 50 x 10⁹/L suggest active bleeding, surgery, or invasive procedures; counts under 100 x 10⁹/L may require special considerations like ECMO or severe bleeding.

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Life-threatening bleeding

A condition where transfusion is needed regardless of platelet count, especially for severe cases in ITP (Immune Thrombocytopenia Purpura) or when desmopressin isn't effective.

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Pooled Platelets

Platelets collected from four different donors with the same ABO blood group.

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Apheresis Platelets

Platelets collected from a single donor, offering matched platelet products.

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Plasma

The liquid part of blood containing clotting factors, albumin, and immunoglobulins.

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Fresh Frozen Plasma (FFP)

Plasma that's frozen quickly and thawed before use for managing bleeding disorders, warfarin reversal, or massive hemorrhage.

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Cryoprecipitate

A blood component rich in clotting factors, primarily used for fibrinogen deficiencies, often in trauma or surgery.

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ABO Compatibility (Platelets)

Platelets have A and B antigens, but not Rh antigens. Identical or compatible platelets may not always be available.

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Febrile Non-Hemolytic Reaction (FNHTR)

A transfusion reaction characterized by fever (38°C to 39°C) without other symptoms.

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Acute Hemolytic Transfusion Reaction (AHTR)

A severe transfusion reaction where the body attacks transfused blood cells, causing fever, pain, rapid heart rate, low blood pressure, and dark urine (hemoglobinuria).

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Mild Allergic Reaction

A transfusion reaction causing itching, hives, and rash. Usually treated with antihistamines.

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Severe Allergic/Anaphylactic Reaction

A life-threatening transfusion reaction causing hives, airway obstruction, low blood pressure, and respiratory distress. Requires immediate medical attention and epinephrine.

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Transfusion-Related Acute Lung Injury (TRALI)

A serious lung injury after a transfusion, causing shortness of breath, low blood oxygen, and respiratory distress within 6 hours.

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Transfusion-Associated Circulatory Overload (TACO)

A reaction caused by too much fluid being transfused, leading to shortness of breath, blue skin, high blood pressure, and fluid in the lungs.

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What is the immediate action for a Febrile Non-Hemolytic Reaction (FNHTR)?

Stop the transfusion, notify transfusion medicine, and administer acetaminophen for fever.

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What is the immediate action for an Acute Hemolytic Transfusion Reaction (AHTR)?

Stop the transfusion immediately, notify transfusion medicine, run blood tests, and monitor the patient closely.

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What is the immediate action for a Transfusion-Related Acute Lung Injury (TRALI)?

Stop the transfusion, provide oxygen, and call for emergency help if needed.

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What is the immediate action for Transfusion-Associated Circulatory Overload (TACO)?

Stop the transfusion, position the patient upright, and administer diuretics for high-risk patients.

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What is the purpose of blood transfusions?

Blood transfusions are used to replace blood components lost due to trauma, surgery, or medical conditions. They are also used to increase oxygen-carrying capacity and improve blood clotting.

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What are the main components of blood?

The main components of blood include red blood cells (RBCs), plasma, platelets, and white blood cells. These components perform distinct functions in maintaining health and are often transfused individually based on a patient's needs.

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What is ABO compatibility?

ABO compatibility refers to the matching of blood types between donor and recipient in blood transfusions. It ensures that the recipient's immune system doesn't attack the donor blood cells, preventing a potentially fatal reaction.

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Why are platelets important in transfusions?

Platelets, also known as thrombocytes, are essential for blood clotting, preventing excessive bleeding. Platelet transfusions are given to patients with low platelet counts, such as those undergoing chemotherapy or suffering from bleeding disorders.

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What are the different types of blood components?

Blood components include packed red blood cells (RBCs) for oxygen delivery, plasma for clotting factors and volume expansion, platelets for clotting, and cryoprecipitate for specific clotting factors. Each is given based on individual patient requirements.

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Transfusion Reaction: First Steps

Immediately stop the transfusion, maintain the vascular access site with a new infusion set and compatible IV solution, assess vital signs, and recheck patient identification.

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Transfusion Reaction: Who to Notify?

Contact the authorized prescriber (MRHP) and Transfusion Medicine/Laboratory to report the suspected transfusion reaction. They will guide further actions.

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Transfusion Reaction: Evidence Preservation

Keep all blood components, tubing, solutions, and transfusion tags for review by Transfusion Medicine/Laboratory.

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Anaphylactic Shock Treatment: First-Line

Immediately stop the transfusion, Do not restart. Administer Intramuscular epinephrine as the first-line treatment for anaphylaxis, given in the vastus lateralis muscle.

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Anaphylactic Shock: Adjunct Medications

Administer additional medications like diphenhydramine to decrease skin symptoms and corticosteroids to prevent or minimize biphasic reactions.

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Biphasic Anaphylactic Reaction

Anaphylaxis that resolves after epinephrine treatment but the patient becomes symptomatic again up to 72 hours later, even without further exposure to the allergen.

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Transfusion-associated Anaphylactic Shock

A rare but serious reaction to a transfusion, involving an immediate, generalized allergic response.

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IV Fluids in Anaphylaxis

Intravenous fluids are used as an adjunct treatment to maintain blood volume and hemodynamic stability during anaphylaxis.

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What are blood components?

Specific parts of whole blood directly used in transfusions, like red blood cells, platelets, plasma, and cryoprecipitate.

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What are blood products?

Derived from blood components, but with additional processing, like albumin, immunoglobulins, and clotting factors.

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ABO Compatibility

A system ensuring blood type compatibility for transfusions, preventing immune system attacks on donor blood.

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Universal Donor

O-negative blood type, compatible with all other blood types.

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Universal Recipient

AB-positive blood type, can receive blood from all other blood types.

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Platelet Count for Bleeding

A platelet count below 50 x 10⁹/L suggests active bleeding, surgery, or invasive procedures requiring a platelet transfusion.

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Platelet Count for High-Risk Procedures

A platelet count below 100 x 10⁹/L might require special considerations for high-risk procedures or critical bleeding areas (e.g., brain, spinal cord), even without active bleeding.

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Plasma's Function

Plasma, the liquid component of blood, is rich in proteins and clotting factors. It plays a crucial role in managing bleeding disorders.

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Platelet Transfusions

Given to patients with low platelet counts to prevent excessive bleeding, often during chemotherapy or bleeding disorders.

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Transfusion Reaction

An adverse reaction to a blood transfusion, ranging from mild allergic reactions to life-threatening complications.

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Anaphylactic Shock

A severe, life-threatening allergic reaction to a transfusion, causing airway obstruction, low blood pressure, and respiratory distress.

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Anaphylactic Shock: First-Line Treatment

Immediately stop the transfusion. Do not restart. Administer Intramuscular epinephrine as the first-line treatment for anaphylaxis, given in the vastus lateralis muscle.

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What to do for FNHTR?

Stop the transfusion, notify transfusion medicine, and administer acetaminophen for fever.

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What to do for AHTR?

Stop the transfusion immediately, notify transfusion medicine, run blood tests, and monitor the patient closely.

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What to do for TRALI?

Stop the transfusion, provide oxygen, and call for emergency help if needed.

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What to do for TACO?

Stop the transfusion, position the patient upright, and administer diuretics for high-risk patients.

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Hypoalbuminemia

Low albumin levels in the blood, often caused by conditions like chronic liver disease, malnutrition, or nephrotic syndrome.

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Immunoglobulin Products

These products are used to support or modify the immune system. They can be used to replace missing antibodies, fight autoimmune disorders, or prevent immune reactions to foreign substances.

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Factor Concentrates

These are blood products containing specific clotting factors, like Factor VIII or IX, which are often used to treat hemophilia or other bleeding disorders.

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What is Cryoprecipitate used for?

Cryoprecipitate is a concentrated blood product rich in clotting factors, especially fibrinogen, often used to treat patients with fibrinogen deficiency or severe bleeding.

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Albumin: When is it used?

Albumin is a protein used to restore and maintain circulating blood volume, especially when a colloid is needed. It is commonly used for conditions like hypoalbuminemia, burns, trauma, and hypovolemic shock.

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Study Notes

Blood Components and Products

  • This presentation covers various blood components and products, their indications, storage, compatibility, and administration procedures.

Lesson Objectives

  • Differentiate indications for various blood components/products.
  • Review steps for checking blood components/products.
  • Review safe administration and monitoring procedures for blood components/products.
  • Identify complications/reactions of blood transfusions and the correct interventions for reaction management.

Definitions

  • Blood Components: Specific parts of whole blood used directly for transfusions (e.g., red blood cells, plasma, platelets, cryoprecipitate).
  • Blood Products: Derived from blood components with additional processing (e.g., albumin, immunoglobulins, clotting factors).

Blood Components

  • Red Blood Cells (RBCs): Increase oxygen-carrying capacity. Indicated in anemia with impaired oxygen delivery. Examples include acute blood loss, chronic anemia, and bone marrow suppression.
  • Platelets: Smallest blood cells; mediate primary hemostasis. Indications for platelet transfusions include bleeding, decreased platelet production, or functionally abnormal platelets; prophylactically if platelet count is falling. Platelet counts and specific conditions like severe thrombocytopenia, active bleeding, surgery, high-risk procedures or critical bleeding areas (e.g., brain, spinal cord), and special conditions like ECMO or severe microvascular bleeding may also trigger platelet transfusions.
  • Plasma: Rich in proteins and clotting factors; crucial for managing bleeding disorders. Indications include coagulation disorders (e.g., liver disease, massive transfusions), warfarin reversal during bleeding or urgent surgery, or massive hemorrhage as part of trauma or surgical protocols. Administered as fresh frozen plasma (FFP), thawed before use.
  • Cryoprecipitate: Rich in clotting factors; used for managing bleeding in patients with coagulation disorders, such as fibrinogen deficiencies. Often used in trauma or surgery settings when fibrinogen levels are critically low.

RBCs: Dose and Storage

  • One unit of blood typically increases hemoglobin concentration by approximately 10 g/L in an average, non-bleeding adult.
  • Improper storage increases bacterial contamination and product efficacy. Administration must occur within 4 hours of the unit being spiked.

RBCs: ABO Compatibility

  • ABO Compatibility: A, B, AB, and O blood types, and Rh factor considerations. Positive blood types can only be given to positive blood types. Negative blood types are more flexible. O-negative is the universal donor, and AB-positive is the universal recipient.

Platelet Preparations

  • Pooled Platelets: From four different donors with the same ABO blood group.
  • Apheresis Platelets: From a single donor; offers matched platelet products for specific indications.

Platelets: ABO Compatibility & Storage

  • Platelets have A and B antigens but not Rh antigens.
  • ABO identical or compatible platelets may not always be available.
  • Issued platelets must be administered immediately at room temperature (20-24°C) and must not be refrigerated.

Blood Products

  • Albumin: Used to restore and maintain circulating blood volume when using a colloid is clinically appropriate. Indications include hypoalbuminemia (e.g., chronic liver disease, malnutrition, or nephrotic syndrome), burns and trauma, hypovolemic shock, cirrhosis and ascites, and dialysis-related hypotension, among other factors.
  • Immunoglobulin Products: Used to support or modify immune function. Indications include immune deficiency (replacement therapy), autoimmune disorders (modulation of immune response), and alloimmune disorders (preventing or treating conditions where the immune system reacts to foreign antigens).
  • Factor Concentrates: Replace specific clotting factors (e.g., Factor VIII or IX) used for conditions like hemophilia A and B, or for other clotting disorders.

Pre-Transfusion Process

  • Informed Consent: Obtained from the patient
  • Order: Completed transfusion order
  • Assessment: Of the patient
  • Type and Screen/Crossmatch: Performed to ensure compatibility for transfusion.
  • Baseline Vitals: Recorded prior to transfusion

Equipment For Administration

  • IV access
  • Filters (170-260 micron): for blood and platelets
  • Vented unfiltered infusion set: for bottled products.
  • Infusion line without med ports
  • Y piece
  • Normal Saline reaction line
  • Vital signs machine, thermometer
  • Emergency medications
  • Emergency equipment (e.g., oxygen, supplies to manage allergic reactions).

Steps for Checking Blood

  • Confirmation: Verify patient identification with transfusion order, component/product, container numbers, expiry, and any abnormalities (leaks, hemolysis, particulates). For blood components, check ABO-Rh type compatibility.
  • Bedside: Confirm patient ID, transfusion tag, and patient's TSIN number matches.

Patient Education and Monitoring

  • Symptoms to report by patients: Include hives, itching, feeling feverish or chills, difficulty in breathing, back pain or pain at the infusion site, and any feeling different from usual.
  • Monitoring vital signs: Prior to, immediately after, and during transfusion to detect early signs of reactions.

Monitoring (Adult)

  • Baseline vitals: within 15 minutes of initiating transfusion.
  • Initial slow rate: 50 millilitres/hour (mL/h).
  • Close patient monitoring: Remain at bedside the first 5 minutes after initiation.
  • Reassess: After 15 minutes; increase flow to prescribed rate if no reaction occurred.

Returning Blood Components and Products

  • Blood components (RBCs, Plasma, Platelets, Cryoprecipitate) are returned to the Transfusion Medicine/Lab if not started within 60 minutes of delivery.
  • Blood components are returned if the patient no longer needs them.

Post Transfusion (Adults)

  • Complete transfusion within 4 hours.
  • Flush IV line with normal saline.
  • Disconnect blood tubing
  • Document vital signs at the end of transfusion.
  • Dispose of empty components as per procedure.
  • Consult Transfusion medicine if reaction suspected.
  • Complete transfusion administration flowsheet.
  • Record any patient education and/or adverse reactions (including intervention details if necessary).

Overview of Transfusion Reactions

  • Febrile Non-Hemolytic Reaction (FNHTR): Fever (38°C - 39°C) without other symptoms.
  • Acute Hemolytic Transfusion Reaction (AHTR): Fever, pain, tachycardia, hypotension, and hemoglobinuria.
  • Allergic Reactions: Mild itching, rash, and hives to more severe allergic/anaphylactic reactions presenting with airway obstruction, hypotension, and respiratory distress.
  • Transfusion-Related Acute Lung Injury (TRALI): Signs of respiratory distress, such as dyspnea, hypoxemia, and respiratory distress within 6 hours.
  • Transfusion-Associated Circulatory Overload (TACO): Respiratory distress and signs of circulatory overload, such as dyspnea, cyanosis, hypertension, and pulmonary edema.

Febrile and Hemolytic Reactions

  • Signs and Symptoms: Specific symptoms associated with these reactions (Fever, pain, tachycardia, hypotension, etc.).
  • Immediate Actions: Actions to take (Stop transfusions, notify physician, etc.).
  • Management: Specific management protocols (Supportive care, medication, labs.)

Allergic Reactions

  • Signs and Symptoms: Specific symptoms of different allergic reaction severity.
  • Immediate Actions: Actions to take.
  • Management: Specific protocols for management.

Respiratory Complications

  • Transfusion-Related Acute Lung Injury (TRALI): Respiratory distress, hypoxemia, dyspnea (shortness of breath) within 6 hours.
  • Transfusion-Associated Circulatory Overload (TACO): Respiratory distress, hypertension, dyspnea, cyanosis, and pulmonary edema.
  • Immediate Actions: Stop transfusion, provide oxygen, emergency response, position upright, administer diuretics, monitor patient.
  • Management: Supportive care, differential diagnosis from other responses, consider slower infusion rate, and diuretics for high-risk patients.

Transfusion Reaction Management

  • Immediately stop transfusion and call for help
  • Maintain vascular access
  • Assessment of vital signs
  • Recheck patient ID, TSIN band, and blood label
  • Notify authorized prescriber and transfusion medicine laboratory.
  • Ensure all related equipment is retained

Transfusion Reactions: Emergency Medications

  • Stop transfusion
  • Promptly administer ordered emergency medications
  • Provide ventilatory support
  • IM epinephrine first-line treatment for anaphylaxis. Give in vastus lateralis muscle.
  • Adjunct medications: Diphenhydramine, corticosteroids (for treating skin symptoms, and potentially biphasic reactions), IV fluids.

References

  • Includes various links to specific policies and guidelines from Alberta Health Services and Canadian Blood Services. Providing full reference to the provided documents.

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Test your knowledge on the clinical applications of albumin, immunoglobulin products, and factor concentrates in treating various conditions. This quiz also covers blood transfusion compatibility and management of bleeding disorders. Ideal for students and professionals in healthcare.

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