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Blood Transfusions - Coggle Diagram

- - - - FEver 38-38.9 and 1-2 degree rise
    - - Stop transfusion
      - Determine haemolysis not taking place
        Symptoms / sign
        DAT
      - Admin antipyretics
  - - - Temp greater or equal to 39
      - Or rise of 2 or more from baseline
      - OR systemic symptoms
  - - - Incidence 1-3 %
    - - Mild
        
        Hives
        
        Itching
      - Moderate
        
        Additional symptoms esp resp
    - - Mild
        
        Anti-histamine and restart transfusion
      - Moderate
        
        Discontinue transfusion
  - - - Uncommon
    - - Rapid onset
      - Shock
      - Hypotension
      - Angiooedema
      - Resp distressed
    - - Presence of class-specific IgG anti-IgA antibodies in pts who have absoloute IgA deficiency
      - Anti Haptoglobin Ig
      - Passive transfer of penut allergen by blood product
  - - - ABO incompatibility - wrong blood wrong pt
    - - Fever and chills
      - Flank pain
      - Oozing of blood from puncture sites
      - Haemoglobinuria (DIC)
    - - DAT pos
      - LDG, bilirubuin
      - Haptoglobins
  - - - After re-exposure to foreign red cell antigen previously encountered
      - Pregnancy
      - Transfution
      - Transplantation
      - Anti-JKA
    - - 3-30 day after transfusion
  - - - Low body weight
      - Renal impairement
      - Cardiac failrue
      - Hypoalbuminaemia
      - Fluid overload
    - - Required
        
        Up to 12 hr post transfusion:
        A. Acute respiratory compromise and or
        B. Acute/ worsening pulmonary oedema (clinical, CXR, Cardiac fx test(
      - Additional
        
        CVS system changes
        JVP
        Hypertension
        
        Fluid overload
        Positive fluid balance
        Response to diuretic
- - - - Age 18-70 (new donors until 65)
      - Weight > 50kg (7st 12lbs)
      - General health
      - Specific illnesses excluded
        Serious CVD
        Bleeding disorders
      - Active donor infx
      - Exclusions
        
        Every injected drugs
        
        Sex for money
        
        Drugs
        
        Travel exposures
        Visits to malarial, Chagas disease
        
        Individual risk assessment
  - - - 500ml
      - Use
        
        WBC and plateetes lose function after 24hr
        
        Increases red cell mass and circulating volume
        
        Fresh and stored WB in military / civilian trauma units
      - Generally unavailable
      - Not optimum method of transfusion in most situations
  - - - HIV
      - HCV
      - HBV
      - HEV
      - HTLV
      - TPHA
      - West nile virus DNA (seasonal)
      - CMV
    - - Male 13.5
      - Female 12.5
  - - - 470ml Blood + 63ml anticoagulant
      - Red cells
        Plasma
        Buffy coat - Platelets
    - - Saline
      - Adenin
      - GLucose
      - Manniton
      - SAG-M
      - Expiry date 35 days
- - - - Acute haemorrhage
      - Severe symptomatic anaemia (below 6 and not usually above 10)
    - - TRICC
        
        Restrictive transfused at <7gm/dL
        
        Restrictive is effective and possibly superior to liberal strategy
        Liveral strategy did not improve outcome and resulted in transfusions of 2V 0 (median)
        
        Liveral 10
        Restrictive 8gm/dL
      - Why Give 2 When 1 Will Do?
        
        Single unit RBC transfusion
    - - Wrong Blood for wrong person
      - Mislabelling at sampling / at transfusion
      - Transfusion reactions ⭐ EXAMS
      - Transfusion transmitted infections
    - - Don't
  - - - Pooled (30%)
        
        Perpared from buffy coat of whole blood donation (4 donation)
      - Apheresis (70%)
        
        Concentrates from one donor using a cell separatory
    - - Prophylactic Transfusion
        
        Prevention of bleeding
        
        Thrombocytopenia
        
        Platelet disorders
      - Therapeutic Transfusion
        
        Haemorrhage with pre-existing thrombocytopenia
        
        Major haemorrhage /trauma
    - - Dose is a bag of pooled donations or a bag from one donor
      - Transfuse ONE at a time
      - A response in an increase in count by at least 20 x 10^9/L
    - - Febrile pts with <20
      - Bleeding, undergoing or recent surg <50
      - Major trauma, neuro and ophthalmic surgery <100
      - All pt with <10
  - - - Tx of coag failure in Liver disease
      - Massive haemorrhage
    - - Virally inactivated by Solvent Detergent (SD) tx
      - Single doner, frozen within 8hr collection