Code Transfusion
Code transfusion! Who are you going to call?
What is 1. STAT line 2. Transfusion med
What IV solution(s) is compatible with blood products?
Hypotension during hemodialysis
What is albumin?
Steps to take at the bedside first sign or suspicion of a possible transfusion reaction.
What is .. Stop the transfusion immediately at the first sign or suspicion of a possible transfusion reaction. Clamp the blood administration IV tubing, disconnect from the patient and flush the IV access.
When should vital signs be checked during a transfusion?
Pre transfusion, 15 minutes after starting, at 45 minutes, and post-transfusion
Which labs should be repeated every 60 minutes during Code Transfusion? 3/5
What is CBC, INR, fibrinogen, electrolytes, and calcium
What is the recommended infusion time for a unit of red blood cells in non-urgent cases?
GBS
What is IVIG?
Primary hypotensive reaction characterized as..
What is drop in systolic and/or diastolic blood pressure by 30mm Hg or more compared to baseline pre-transfusion blood pressure.
Type and screen is valid for _______.
What is 96 hours?
What is the initial dose of tranexamic acid to administer during a code transfusion?
What is 1 g IV bolus, then 1 g IV over 8 hours
How many units of blood can be infused using one Y-type administration set before it must be changed?
4 units
Reversal of apixaban in case of life-threatening bleeding.
What is Human prothrombin complex?
Temperature increase...
Greater than or equal to 1 degree C from pretransfusion baseline or greater or equal to 38 degrees C
You acknowledge an order to administer blood what are your next steps? List minimum 4
What is..1. look for valid type and screen
2. look for valid e-consent
3. release blood in epic
4. call transfusion med
5. prepare blood tubing
Purpose of Calcium Chloride 1g IV bolus
What is calcium citrate- it binds to the patient's calcium when blood products are administered, causing hypocalcemia.
What is the maximum time a blood product can be out of the controlled temperature location before it must be used or returned?
30 minutes
To help control acute bleeding episodes (helps with blood clotting).
What is fibrinogen?
What is TRALI? Name three symptoms
What is Transfusion-related acute lung injury. Resp distress, fever, chills,tachycardia, hypotension.
What are the symptoms of citrate toxicity? Name 2
hypocalcemia, muscle cramps.
Trauma triad of death
What is hypothermia, metabolic acidosis, coagulopathy
No scan workflow.
What is The nurse will telephone the TML and check the following information with the TML technician, confirming with read-back;
After confirmation has been obtained with TML technician, the nurse is able to proceed with the transfusion and documentation by entering in the verified information into the blood flowsheet in epic.
IVIG- start with _________ bottle first.
What is smallest?
What should be sent to TML for investigation after a reaction?
What is send the clamped IV tubing and blood product or blood derivative to the Transfusion Medicine Laboratory in a plastic bag via porter.
In an emergency, when the patient's blood type is not known and the need for red cell transfusion is urgent, what will be issued?
What is un-crossmatched group O red cells?
Fun fact: O negative is the universal blood type. O positive red blood cells are not universally compatible to all types, but they are compatible to any red blood cells that are positive (A+, B+, O+, AB+) In major traumas with massive blood loss, many hospitals transfuse O positive blood, even when the patient’s blood type is unknown. The risk of reaction is much lower in ongoing blood loss situations and O positive is more available than O negative.