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Questions and Answers
What is a primary indication for the use of albumin in clinical settings?
What is a primary indication for the use of albumin in clinical settings?
Which conditions are commonly treated with immunoglobulin products?
Which conditions are commonly treated with immunoglobulin products?
Factor concentrates are most commonly used to treat which of the following?
Factor concentrates are most commonly used to treat which of the following?
Which of the following is NOT a typical indication for using albumin?
Which of the following is NOT a typical indication for using albumin?
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What is the role of factor concentrates in the management of bleeding disorders?
What is the role of factor concentrates in the management of bleeding disorders?
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What is the primary purpose of the ABO Compatibility Chart in blood transfusions?
What is the primary purpose of the ABO Compatibility Chart in blood transfusions?
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Which of the following documents provides guidance on transfusion reactions?
Which of the following documents provides guidance on transfusion reactions?
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What type of blood component does the document from Alberta Health Services dated 2022 focus on?
What type of blood component does the document from Alberta Health Services dated 2022 focus on?
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Which condition warrants the use of CMV seronegative blood components?
Which condition warrants the use of CMV seronegative blood components?
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Why is it important to manage platelet refractoriness carefully?
Why is it important to manage platelet refractoriness carefully?
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What is the primary function of red blood cells (RBCs)?
What is the primary function of red blood cells (RBCs)?
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Which blood component is typically indicated for patients with anemia and impaired oxygen delivery?
Which blood component is typically indicated for patients with anemia and impaired oxygen delivery?
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What is the maximum time frame allowed for administering a blood unit once it has been spiked?
What is the maximum time frame allowed for administering a blood unit once it has been spiked?
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Which blood type is considered the universal donor?
Which blood type is considered the universal donor?
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For which condition are platelets typically indicated?
For which condition are platelets typically indicated?
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What effect does one unit of red blood cells have on hemoglobin concentration in an average adult?
What effect does one unit of red blood cells have on hemoglobin concentration in an average adult?
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Which of the following blood types can receive donations from AB-positive?
Which of the following blood types can receive donations from AB-positive?
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What is an indication for administering plasma?
What is an indication for administering plasma?
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What is the threshold platelet count (PLT) below which transfusion is required for severe cases of ITP that are unresponsive to desmopressin?
What is the threshold platelet count (PLT) below which transfusion is required for severe cases of ITP that are unresponsive to desmopressin?
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Which type of platelet preparation provides matched products for specific indications?
Which type of platelet preparation provides matched products for specific indications?
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What is the storage requirement for platelets after they are issued?
What is the storage requirement for platelets after they are issued?
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Which of the following is a primary component of cryoprecipitate used to manage bleeding?
Which of the following is a primary component of cryoprecipitate used to manage bleeding?
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What is the indication for administering fresh frozen plasma (FFP)?
What is the indication for administering fresh frozen plasma (FFP)?
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In which circumstance can cryoprecipitate be transfused with any ABO blood group?
In which circumstance can cryoprecipitate be transfused with any ABO blood group?
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What is an essential consideration when transfusing plasma?
What is an essential consideration when transfusing plasma?
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What characterizes pooled platelets compared to apheresis platelets?
What characterizes pooled platelets compared to apheresis platelets?
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What is the first step to take when a transfusion reaction is suspected?
What is the first step to take when a transfusion reaction is suspected?
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Which medication is considered the first-line treatment for anaphylaxis during a transfusion reaction?
Which medication is considered the first-line treatment for anaphylaxis during a transfusion reaction?
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What is the purpose of administering adjunct medications like diphenhydramine and corticosteroids after epinephrine?
What is the purpose of administering adjunct medications like diphenhydramine and corticosteroids after epinephrine?
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Which site is recommended for administering intramuscular epinephrine?
Which site is recommended for administering intramuscular epinephrine?
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What should be done with the blood components and transfusion tags after a suspected reaction?
What should be done with the blood components and transfusion tags after a suspected reaction?
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What characterizes a biphasic anaphylactic reaction?
What characterizes a biphasic anaphylactic reaction?
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After stopping a transfusion, what is the most important vital sign to assess?
After stopping a transfusion, what is the most important vital sign to assess?
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What is the role of IV fluids in the management of a transfusion reaction?
What is the role of IV fluids in the management of a transfusion reaction?
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What is a common immediate action to take when a patient experiences a Febrile Non-Hemolytic Reaction?
What is a common immediate action to take when a patient experiences a Febrile Non-Hemolytic Reaction?
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Which symptom is NOT associated with an Acute Hemolytic Transfusion Reaction?
Which symptom is NOT associated with an Acute Hemolytic Transfusion Reaction?
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What is a recommended management step for Mild Allergic Reactions during transfusion?
What is a recommended management step for Mild Allergic Reactions during transfusion?
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In which scenario would you consider administering epinephrine?
In which scenario would you consider administering epinephrine?
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What should be monitored closely after an Acute Hemolytic Transfusion Reaction?
What should be monitored closely after an Acute Hemolytic Transfusion Reaction?
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What is a distinguishing sign of Transfusion-Related Acute Lung Injury?
What is a distinguishing sign of Transfusion-Related Acute Lung Injury?
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What immediate action should be taken for a patient showing dyspnea and cyanosis during a transfusion?
What immediate action should be taken for a patient showing dyspnea and cyanosis during a transfusion?
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For a patient who is at high risk of Transfusion-Associated Circulatory Overload, what is a suggested management approach?
For a patient who is at high risk of Transfusion-Associated Circulatory Overload, what is a suggested management approach?
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Which of the following is a sign of a Severe Allergic/Anaphylactic Reaction during transfusion?
Which of the following is a sign of a Severe Allergic/Anaphylactic Reaction during transfusion?
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What should be given to manage fever in a patient experiencing a Febrile Non-Hemolytic Reaction?
What should be given to manage fever in a patient experiencing a Febrile Non-Hemolytic Reaction?
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Which blood component is primarily indicated for patients with thrombocytopenia?
Which blood component is primarily indicated for patients with thrombocytopenia?
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What is the primary purpose of CMV seronegative blood components?
What is the primary purpose of CMV seronegative blood components?
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Which condition typically requires the administration of leukocyte-reduced blood components?
Which condition typically requires the administration of leukocyte-reduced blood components?
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In managing transfusion reactions, which vital sign is considered most critical to monitor immediately after stopping the transfusion?
In managing transfusion reactions, which vital sign is considered most critical to monitor immediately after stopping the transfusion?
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What is a common characteristic associated with Febrile Non-Hemolytic Transfusion Reactions?
What is a common characteristic associated with Febrile Non-Hemolytic Transfusion Reactions?
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What medication is indicated as the first-line treatment for anaphylaxis during a transfusion reaction?
What medication is indicated as the first-line treatment for anaphylaxis during a transfusion reaction?
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Which site is preferred for administering intramuscular epinephrine?
Which site is preferred for administering intramuscular epinephrine?
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What should be done with blood components and transfusion tags after a suspected transfusion reaction?
What should be done with blood components and transfusion tags after a suspected transfusion reaction?
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What adjunct medication may be used after administering epinephrine to prevent or minimize biphasic anaphylactic reactions?
What adjunct medication may be used after administering epinephrine to prevent or minimize biphasic anaphylactic reactions?
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What vital signs should be prioritized for reassessment after a suspected transfusion reaction?
What vital signs should be prioritized for reassessment after a suspected transfusion reaction?
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Which of the following interventions is important in the management of anaphylaxis after epinephrine administration?
Which of the following interventions is important in the management of anaphylaxis after epinephrine administration?
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What is a significant indication for using albumin in clinical practice?
What is a significant indication for using albumin in clinical practice?
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Which statement accurately describes the use of immunoglobulin products?
Which statement accurately describes the use of immunoglobulin products?
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What is the primary purpose of factor concentrates in patient care?
What is the primary purpose of factor concentrates in patient care?
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In which scenario is the use of cryoprecipitate indicated?
In which scenario is the use of cryoprecipitate indicated?
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Factor concentrates are often genetically engineered to treat which of the following disorders?
Factor concentrates are often genetically engineered to treat which of the following disorders?
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What symptom is commonly associated with an Acute Hemolytic Transfusion Reaction?
What symptom is commonly associated with an Acute Hemolytic Transfusion Reaction?
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What is the immediate action to take when a patient experiences a Severe Allergic/Anaphylactic Reaction?
What is the immediate action to take when a patient experiences a Severe Allergic/Anaphylactic Reaction?
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Which of the following actions should be taken for a Mild Allergic Reaction during a transfusion?
Which of the following actions should be taken for a Mild Allergic Reaction during a transfusion?
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Which sign is associated with Transfusion-Related Acute Lung Injury?
Which sign is associated with Transfusion-Related Acute Lung Injury?
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What is a common symptom observed in patients experiencing Febrile Non-Hemolytic Reaction?
What is a common symptom observed in patients experiencing Febrile Non-Hemolytic Reaction?
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What management step is recommended if a patient develops dyspnea and hypertension during a transfusion?
What management step is recommended if a patient develops dyspnea and hypertension during a transfusion?
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Which lab tests are important to perform after an Acute Hemolytic Transfusion Reaction?
Which lab tests are important to perform after an Acute Hemolytic Transfusion Reaction?
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What is the recommended management for a patient experiencing Transfusion-Related Acute Lung Injury?
What is the recommended management for a patient experiencing Transfusion-Related Acute Lung Injury?
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What is recommended for future transfusions if a patient has had a Mild Allergic Reaction?
What is recommended for future transfusions if a patient has had a Mild Allergic Reaction?
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What immediate management should be taken for a patient showing respiratory distress within 6 hours of a transfusion?
What immediate management should be taken for a patient showing respiratory distress within 6 hours of a transfusion?
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What platelet count (PLT) level indicates that a transfusion is required regardless of the PLT level for severe cases in ITP unresponsive to desmopressin?
What platelet count (PLT) level indicates that a transfusion is required regardless of the PLT level for severe cases in ITP unresponsive to desmopressin?
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What is the primary advantage of apheresis platelets compared to pooled platelets?
What is the primary advantage of apheresis platelets compared to pooled platelets?
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Which blood component is primarily used to manage fibrinogen deficiencies?
Which blood component is primarily used to manage fibrinogen deficiencies?
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What condition necessitates the immediate transfusion of plasma due to its role in coagulation?
What condition necessitates the immediate transfusion of plasma due to its role in coagulation?
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What temperature must platelets be maintained at after being issued?
What temperature must platelets be maintained at after being issued?
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Why is ABO compatibility crucial when transfusing plasma?
Why is ABO compatibility crucial when transfusing plasma?
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Which statement about cryoprecipitate is correct regarding its transfusion compatibility?
Which statement about cryoprecipitate is correct regarding its transfusion compatibility?
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What content is NOT typically found in plasma?
What content is NOT typically found in plasma?
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What is the main function of platelets in the blood?
What is the main function of platelets in the blood?
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What is a typical indication for administering red blood cells (RBCs)?
What is a typical indication for administering red blood cells (RBCs)?
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Which blood type can receive blood from O-negative donors?
Which blood type can receive blood from O-negative donors?
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What is the effect of administering one unit of red blood cells to an average, non-bleeding adult?
What is the effect of administering one unit of red blood cells to an average, non-bleeding adult?
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For which condition are platelets potentially transfused as prophylaxis?
For which condition are platelets potentially transfused as prophylaxis?
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Which blood component is indicated for correcting functional abnormalities in platelets?
Which blood component is indicated for correcting functional abnormalities in platelets?
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What factor determines ABO compatibility in blood transfusions?
What factor determines ABO compatibility in blood transfusions?
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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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Description
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.
