A Review On Hematology and Oncology Emergencies

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Slides on the discussion points during Intensive Course for Final MMed (Emergency Medicine) 2010

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<ul><li>1.Hematology Emergencies Intensive Course Final Year MMED Candidates 2009-2010 Chew Keng Sheng School of Medical Sciences UNIVERSITI SAINS MALAYSIA</li></ul> <p>2. Whole Blood </p> <ul><li>Rarely used today (individual blood components provided separately) </li></ul> <ul><li>Indications </li></ul> <ul><li><ul><li>Autologous transfusion </li></ul></li></ul> <ul><li><ul><li>Exchange transfusion (ie, sickle cell anemia) </li></ul></li></ul> <ul><li>Comments </li></ul> <ul><li>Risk of transfusion reaction is &gt;2 times than with packed red blood cells (PRBCs) </li></ul> <ul><li>Risk of allergic reaction is 1% </li></ul> <p>3. Packed Red Blood Cells </p> <ul><li>Preparation </li></ul> <ul><li>Plasma removed from whole blood and remaining RBC mass is washed </li></ul> <ul><li>Washing RBCs removes leukocytes, platelets, proteins, and other antigenic components of whole blood </li></ul> <ul><li>Type and cross-match </li></ul> <ul><li>ABO blood group antigen system and Rhesus system </li></ul> <p>4. </p> <ul><li>Production of anti-D antibody occurs in Rh individuals who have exposure to small amounts of D antigen </li></ul> <ul><li>A) Maternal-fetal mixing (Rh mother and Rh+ fetus) </li></ul> <ul><li>B) Anti-D immunoglobulin required in Rh mothers with exposure to D antigen within 72 hours of exposure </li></ul> <p>Packed Red Blood Cells (2) 5. </p> <ul><li>Indications </li></ul> <ul><li>Generally, transfusion is rarely indicated when Hb &gt;10 g/dL and is almost always indicated in when Hb level &lt; 6 g/dL </li></ul> <ul><li>The determination of transfusion in patients whose Hb is 6-10 g/dL should be based on any ongoing indication of organ ischemia, the rate and magnitude of any potential or actual bleeding and the patients intravascular volume status. </li></ul> <p>Packed Red Blood Cells (3) 6. </p> <ul><li>Indications </li></ul> <ul><li>Transfusion for Hb &gt;6 g/dL in healthy nonsurgical patients is generally not indicated because oxygen delivery in healthy adults is maintained even with Hb as low as 6-7 g/dL. </li></ul> <ul><li>Transfusion usually recommended prior tomajor surgerywhen hemoglobin levels are</li></ul>