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76 Cards in this Set
- Front
- Back
Donor selection--Age?
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Donor selection age = 17 yrs minimum; no maximum age
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Donor selection--Temp?
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Donor temp = <37.5*C or 99.5*F
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Donor selection--BP?
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Donor selection BP =
Systolic <180 Diastolic <100 |
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Donor selection--Hgb?
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Donor selection Hgb = >/=12.5 g/dL
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Donor selection--Hematocrit?
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Donor selection Hematocrit = >/=38%
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Donor selection--Pulse?
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Donor selection Pulse = Between 50-100 beats/min
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Donor selection--Wt?
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Donor selection Wt = >/=110 lbs (50 kg)
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Donor selection--Interval between whole blood donations?
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Interval between whole blood donations = 8 weeks
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Deferment time:
Surgery: did NOT receive blood products? |
Deferment for surgery (did NOT receive blood products) = Until healing is complete & donor has resumed full range of activity
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Deferment time:
Surgery: DID receive blood products? |
Deferment time for surgery (DID receive blood products) = 12 months
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Deferment time:
Conclusion of pregnancy? |
Deferment post pregnancy = 6 weeks
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Deferment time:
Tattoo? |
Deferment time for tattoo = 12 months
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Deferment time:
Visited malaria endemic area? |
Deferment time post visiting malaria area = 12 months
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Deferment time:
Recipient of human pituitary growth hormone between 1958-1986? |
Deferment time for receiving growth hormone (1958-1986) = Permanently deferred
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Deferment time:
Sexual contact with HIV high-risk? |
Deferment time for sex with HIV high-risk partner = 12 months
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Deferment time:
Chicken pox (varicella-zoster) vaccine? |
Deferment time post chicken pox = 4 weeks
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Deferment time:
Incarceration for more than 72 hours? |
Deferment time, incarceration for >72 hours = 12 months
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Deferment time:
MMR vaccine? |
Deferment time post MMR vaccine = 4 weeks
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Deferment time:
IV drug user? |
Deferment time, IV drug use =
Permenantly deferred |
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What are the symptoms & first aid requirements for MILD donor reactions?
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MILD donor reactions.
Symptoms: Pallor, sweating, hyperventilation, decreased BP, nausea. Treatment: Stop donation, loosen tight clothing, elevate feet, apply cold towel to forehead & neck. If donor does not respond quickly, call for help. |
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Symptoms & first aid for MODERATE donor reactions?
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MODERATE donor reactions.
Symptoms: periods of unconsciousness, decreased pulse, decreased BP, hyperventilation Treatment: apply smelling salts, check BP, pulse & temp until normal again. Administer Oxygen. |
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Symptoms & first aid for SEVERE donor reactions?
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SEVERE donor reaction.
Symptoms: convulsions or seizures, hyperventilation, tetany (muscle spasms) Treatment: get help, ensure adequate airway, give 95% oxygen, observe until release by BB physician. |
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What processing tests must be performed on a donor unit? (Include type & disease screen)
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Tests for donor unit (+type & screen):
ABO & Rh type (including weak D) Antibody screen & ID Syphilis (ie RPR) Viral testing for hepatitis, HIV, CMV & HTLV (HB sAG, HIV-1 Ag, anti-HBc, anti-HCV, anti-HIV-1, anti-HIV-2, anti-HTLV-I/II) Chagas' disease |
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One unit of whole blood can be processed into 1-4 components. Name the components & discuss the procedure for this separation.
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Components of whole blood.
Packed RBC FFP Cryoprecipitate Platelets |
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Whole blood separation procedure?
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Whole blood + anticoagulant (500 mL) --> soft spin (2-3 min/3,200 rpm) = packed RBC with small amount of plasma (250 mL) & plasma/platelets.
Plasma/platelets --> hard spin (5 min/3,600 rpm) = plasma for FFP & Cryoprecipitate (200 mL) & Platelets in 50-70 mL of plasma. |
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What is the maximum/minimum amount of blood drawn from a donor for collection of a whole blood unit?
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Amount of donated blood =
450 +/- 45 mL |
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What is the hermetic seal? What must be done if it is broken?
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Hermetic seal.
Completely enclosed system reducing exposure to m icrobes/contaminants. If broken, the unit mmust be used within 24 hours. |
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What is the expiration of blood/components when the seal is broken if :
Stored at 1-6*C? Stored at 20-24*C? |
Expiration blood/components (broken seal)
Stored @ 1-6*C = 24 hours Stored @ 20-24*C = 4 hours |
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What are the indications for using washed RBCs?
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Washed RBC:
Febrile or allergic reaction; history of plasma protein antibodies or PNH. |
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Indications for using FFP?
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FFP:
Multiple coagulation factor deficiencies or unidentified deficiency. |
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Indications for using single donor plasma?
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Single donor plasma:
To treat stable clotting factor deficiencies |
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Indications for using platelet concentrates-random donor & single donor?
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Platelet concentrates (random & single donor):
Thrombocytopenia |
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Indications for using cryoprecipitated anti-hemophiliac factor & fibrinogen (fibrin glue)?
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Cryoprecipitated anti-hemophiliac factor & fibrinogen (fibrin glue):
Factor VIII, XIII, &/or fibrinogen deficiency |
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Indications for using WBC concentrates?
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WBC concentrates:
correct severe neutropenia (<500 PMN/mL) |
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Indications for using packed RBCs?
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Packed RBCs:
Restore oxygen-carrying capacity. |
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Indications for using whole blood?
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Whole blood:
Major blood loss (>25% of blood volume lost); treat cardiopulmonary bypass patients intra-operatively or up to 6 hours post-surgery. |
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Indications for using leukocyte poor RBC?
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Leukocyte poor RBC:
Avoid febrile reactions (reduced exposure to MHC antigens on WBC). |
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Indications for using granulocyte concentrate?
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Granulocyte concentrate:
Correct severe neutropenia. |
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Indications for using Factor VIII concentrate?
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Factor VIII:
Treat hemophilia A. |
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Indications for using Factor IX concentrate?
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Factor IX:
Treat hemophilia B/Christmas disease |
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Indications for using blood substitutes?
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Blood substitutes:
Patient's personal beliefs; examples include hgb encapsulation, SF"hS (stroma free hgb solution), PFS (perfluoro chemicals); all carry oxygen w/o using intact RBCs. |
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Indications for using plasma protein fraction?
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Plasma protein fraction:
Plasma volume expansion (80-85% albumin & 15-29% globulin). |
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Indications for using synthetic volume expanders?
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Synthetic volume expanders:
Plasma volume expansion (ex. normal saline, ringer's, electrolyte solution, dextran) |
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Indications for using frozen RBCs?
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Frozen RBCs:
Rare blood type. |
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Indications for using irradiated RBCs?
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Irradiated RBCs:
for immunocompromised patients; prevent GVHD (Graft vs. host disease). |
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Shelf life & storage temp?
Washed RBC FFP Platelet concentrates Cryoprecipitated anti-hemophiliac factor |
Shelf life & storage temp:
Washed RBC: 24 hrs, 1-6*C FFP: 1 yr, frz at -18*C 24 hrs thawed at 1-6*C Platelet concentrates: 5 days at 20-24*C w/aggitation Cryoprecipitated anti-hemophiliac factor: 1 yr frozen, -18*C 6 hrs thawed, 20-24*C (closed system) 4 hrs poooled, 20-24*C (open system) |
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Shelf life & storage temp?
WBC concentrates Packed RBCs Frozen, thawed & deglycerolized RBCs Irradiated RBCs |
Shelf life & storage temp:
WBC concentrates: 24 hrs, room temp Packed RBCs: CPD--21 days, 1-6*C CPDA-1---35 days, 1-6*C CPD-AS---42 days, 1-6*C Frozen, thawed & deglycerolized RBCs: 10 yrs frozen, -65 to -150*C 24 hrs deglycerolized, 1-6*C Irradiated RBCs: 28 days from irradiation or original outdate, whichever is 1st, 1-6*C |
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What is the cryoprotective agent for frozen RBCs?
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Cryoprotective agent for RBCs:
High amounts of glycerol (40% w/v), at -65*C Low amounts of glycerol (14% w/v), at -15*C |
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How are frozen RBC prepared for transfusion? What % of original RBCs must be recovered?
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RBC preparation for transfusion; % original RBC recovered.
Wash with decreasing concentrations of NaCl (12% NaCl, 1.6% NaCl, final wash with 0.9% NaCl & 0.2% dextrose) 80% RBCs must be recovered |
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What is the optimum temp for shipping blood?
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Optimum temp for shipping blood: 1*-10*C
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What does 2,3 DPG stand for & what RBC function does it affect?
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2,3 DPG.
2,3 diphosphoglycerate Important in the release of oxygen from Hgb. |
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ATP is important for what RBC parameters?
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ATP.
Important for RBC viability & membrane integrity. |
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As the donor unit ages, what changes occur:
Levels of 2,3 DPG pH Plasma K Plasma Na Cytokine levels Changes in the oxygen disasssociation curve to compensate? |
Aging unit reactions:
2,3 DPG = Decreases pH = Decreases Plasma K = Increases Plasma Na = Decreases Cytokine levels = Increases Changes in Oxygen disassociation curve = Shifts to right if Hgb has decreased affinity to oxygen (ex. high 2,3 DPG levels); Oxygen gets released to tissues Shifts to left if Hgb has increased affinity to oxygen (ex. low 2,3 DPG levels); Oxygen is not released to tissues. |
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When inspecting blood each day, what do you look for? What do changes suggest?
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Inspecting blood.
Check color, clots, expiration dates, leaks May suggest bacterial contamination or tampering |
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How if refrigerator temp monitored?
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Temperature monitored with
continuous recorder with an alarm system |
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How can RBCs be rejuvenated after expiration date? For how long?
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Rejuvenate RBC.
PIPA (phosphate, inosine, pyruvate, adenine) can be added. Rejuvenates RBCs for 24 hours. |
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What is the average # of platelets in each bag of platelet concentrate? In an apheresis unit?
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Avg # of platelets.
In platelet concentrate = 5.5 x 10*10 In apheresis unit = 3 x 10*11 |
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What is the pH requirement for a unit of platelets?
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pH for platelets:
>/= 6.2 |
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What is an autologous unit & why would it be donated?
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Autologous.
A donation of blood reserved for the donor's own use at a later time. donated when patients will undergo a planned surgery. Requirements for autologous donors are significantly different from allogenic donors. |
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Why are units irradiated?
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Irradiated.
Gamma irradiation prevents proliferation of T lymphocytes thereby preventing GVHD. |
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Which coagulation factors are stable?
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Stable coag factors:
Fibrinogen (I) Prothrombin (II) VII IX, X, XI, XII, XIII |
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Which coagulation factors are labile?
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Labile factors:
V VIII von Willebrand's |
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T or F
FFP is used to replace both labile & stabile coagulation factors. |
True: FFP is used to replace both labile & stable coag factors.
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How many units of Factor VIII shpould be in each bag of cryoprecipitate?
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Units of Factor VIII in each bag of cryoprecipitate:
80-150 IU |
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What is the expected effect in the recipient after receiving:
1 unit of packed RBCs? 1 unit of platelets (random donor)? 1 unit of platelets (single donor by apheresis)? 1 unit of whole blood? |
Expected effect.
1 U packed RBC = Increase Hct 2-3%; Increase Hgb 1-1.5 g/dL 1 U platelets (random)=Increase count by 5,000-10,000 for each unit given 1 U platelets (single donor/apheresis)=Increase count by 30,000-60,000/unit 1 U whole blood=Increase Hct 3% & Hgb 1 g/dL |
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List 4 factors removed by plasmapheresis.
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4 factors removed by plasmapheresis:
Immune complexes Auto or alloantibodies Inflammatory mediators Protein-bound toxins |
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What is Rh immune globulin (Rhogam, RhIgG)? How is it prepared? Why is it given to patients?
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Rh immune globulin (Rhogam, RhIgG).
Anti-D prepared from human plasma. Little to no risk of viral transmissioin. Given to a Rh neg unsensitized mother of a Rh pos baby within 72 hrs post partum or about 28 wks antenatal. |
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How long do RBCs survive normally? What % of RBCs in a unit of blood should be viable in the patient 24 hrs after transfusion?
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RBC survive; % in unit viable 24 hrs after transfusion.
Life of RBC=120 days. 75% RBC survival 24 hrs after transfusion |
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How fast should blood products be infused?
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Rate of infusion.
Slowly for the first 10-15 min; the unit must be transfused w/n 4 hours |
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When should blood be warmed?
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Warm blood.
Rapid or exchange transfusion Patients with PCH or cold agglutinins reactive at 37*C |
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What is a transfusion reaction?
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Transfusion reaction.
An unfavorable/adverse reaction to a transfusion. |
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What causes the following transfusion complications:
Circulatory overload? Febrile non-hemolytic reaction? Allergic reaction? |
What causes the following transfusion complications:
Hemolytic transfusion reaction? Anaphylactic reaction? |
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Circulatory overload: excess volume
Febrile non-hemolytic reaction: Antibodies to MHC antigens located on WBCs Allergic reactions: IgE mediated reaction |
Hemolytic transfusion reaction:
Intravascular: interaction of antibody with antigen on RBC membrane resulting in complement activation that leads to hemolysis. Seen with ABO and Kidd antibodies. Extravascular: Incomplete complement binding or RBCs sensitized with antibodies. Cells removed by macrophages in the spleen Anaphylactic reactions: Immediate hypersensitivity; usually anti-IgA in patient |
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What other undersirable effects may transfusions have?
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Other undersirable effects:
Infections GVHD Pulmonary edema Iron overload |
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How long must blood samples be kept for both the donor unit & recipient past transfusion? How long must the records be kept?
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Blood samples/records kept.
Blood: at least 14 days Records: indefinitely |
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What solutions may be infused/used to dilute blood components?
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Dilute solutions.
0.9% saline or 5% albumin |