Not my type
What are the three letters of the alphabet used to classify blood type?
O, A and B
What is the term for having a low erythrocyte, neutrophil and platelet count?
Pancytopenia
Pan - all
cyto - cell
penia - deficiency
How long is group and hold valid for and why?
72 hours - it expires after this time due to the potential for development of antibodies after transfusion of blood products.
Mr. Button is having a PRBC transfusion. You check his observations and his temperature is 36.9C. On commencement of transfusion his temperature was 35.8C. What actions might you take?
Pause the infusion
Full A-G assessment including observations and patient sympmtoms
Escalate care per CERS pathway
Restart infusion as per medical review
What does the '+' or '-' in blood type signify?
The presence or absence of the Rhesus D protein on the surface of red blood cells
Name four symptoms of profound anaemia.
Pallor, fatigue/lethargy, dizziness, chest pain/tightness, headache, hypotension, tachycardia, tachypnoea, syncope
Describe the correct process for performing identity and product checks for a blood product transfusion?
2 nurses must check the patient name, DOB and MRN by asking the patient, and stating what is documented on the patient's armband, fluid chart and the blood product and transfusion sheet.
2 nurses must independently state the patients name, DOB, MRN, blood type and the component number and blood type, confirming this is compatible with the patient and that the transfusion sheet matches the labelled blood product.
What is the cause of an acute haemolytic reaction?
Incompatibility between the patient and donor blood. This might occur as a result of A/B/O mismatch or other antigens/antibodies.
Russell George is blood type A+. Which blood types is he compatible with?
A+, A-, O+, O-
What is the standard reference range for a 'normal' platelet count?
150-400 x 10^9
A) At what haemoglobin level do we transfuse PRBCs,
and
B) what other methods can be trialled before transfusing is appropriate?
A) it is patient dependent, and will be influenced on the person's comorbidities and transfusionthresholds
B) iron infusion, vitamin B12, erythropoietin are options other than PRBC transfusion but only if appropriate for the patient's specific cause of anaemia
Ms. Pinkham received a single unit of PRBC three days ago. Today you enter her room to bring her breakfast and she looks flushed and mildly jaundiced. You check her observations and find the following:
- T 38.9C, RR 26, HR 140, BP 110/65, SpO2 95%, pain score 8/10.
What is most likely happening for Ms. Pinkham?
A delayed haemolytic transfusion reaction
Chuck Clark is blood type B-. Which antigens are present on the surface of his red blood cells, and which antibodies are present in his plasma?
Anitgens: B
Antibodies: Anti A, Anto RhD
What is the reference range for what is considered a healthy Hb, neutrophil and platelet count?
Hb - varies based on my factors but generally 115-160 g/L
Neutrophil - 4-11x 10^9
Platelet - 150-400 x 10^9
Slick Rick is thrombocytopenic with a platelet count of 14. His medical team have planned to keep his platelets > 10 or > 20 if febrile. Why is the threshold higher if Mr. Rick is febrile?
Some infections can directly destroy platelets or cause the body to reduce its own platelet count.
Hyperthermia can trigger platelet apoptosis (cell death).
How might we differentiate an anaphylactic reaction from a Transfusion Related Acute Lung Injury (TRALI)?
Clue: consider how each might present and be treated.
Anaphylaxis is a severe acute allergic reaction which would presents with bronchospasm and airway oedema, skin reaction and hypotension.
TRALI is an acute reaction to transfusion, which might occur within 6 hours of transfusion, caused by antibodies activating neutrophils in the lungs. It presents with shortness of breath, hypoxia and pulmonary oedema.
Anaphylaxis should respond to adrenaline, antihistamines and steroids.
TRALI should respond to lasix, oxygenation and ventilation as required.