transfusion quiz “their lives in your hands” doctors
TRANSCRIPT
Transfusion QuizTransfusion Quiz
““Their Lives in Your Hands”Their Lives in Your Hands”
DoctorsDoctors
What % of blood components have What % of blood components have to be traced according to the UK to be traced according to the UK
Blood Safety and Quality Blood Safety and Quality Regulations 2005?Regulations 2005?
50% 80%
100% 95%
What does SHOT stand for?What does SHOT stand for?
Serious Hazards of TRALI
Serious Hazards of Transfusion
Serious Harms of Transfusion
Some Hotels Offer Training
Where do the majority of errors Where do the majority of errors occur?occur?
In the laboratory
Removing blood from the blood fridge
At the bedside
In the ward manager’s fridge
What minimum identifiers are What minimum identifiers are required on a transfusion sample?required on a transfusion sample?
Full Name, date of birth and hospital
number/NHS number
Name and date of birth Hospital number, date of birth and address
Date of birth and hospital number
Transfusion samples have to Transfusion samples have to be:be:
Collected by the Doctor and labelled by the Nurse at the site of
collection
Collected and labelled by the same person at the site of collection
Collected and labelled by the same person from the case notes
Collected and labelled by the same person at the Nursing station
““Labelling of sample” errors Labelling of sample” errors usually happen because:usually happen because:
The request form was not checked correctly
The patient identification was not
checked
The patient was awkward
The patient had somebody else’s wristband on
How long is blood allowed out of How long is blood allowed out of the fridge before it has to be the fridge before it has to be
transfused to a patient?transfused to a patient?
1 Hour
30 minutes 4 hours
2 Hours
For routine transfusions, how many For routine transfusions, how many units can be sent from the Blood units can be sent from the Blood
Bank fridge at one time?Bank fridge at one time?
3 units
2 unitsAs many as you
want
1 unit
Indications codes are used in Indications codes are used in transfusion to:transfusion to:
Prescribe blood
Order bloodRequest a group
and save test
Collect blood
Platelet concentrates should be Platelet concentrates should be ordered for bone marrow failure, in ordered for bone marrow failure, in the absence of bleeding, when the the absence of bleeding, when the
platelet count falls below:platelet count falls below:
<50 x 109/L
<10 x 109/L <30 x 109/L
>20 x 109/L
In bone marrow failure, to prevent In bone marrow failure, to prevent bleeding associated with invasive bleeding associated with invasive
procedures “eg insertion of procedures “eg insertion of intravenous lines”, the platelet intravenous lines”, the platelet
count should be raised to:count should be raised to:
>20 x 109/L> 50 x 109/L
>100 x 109/L >30 x 109/L
What are the minimum blood What are the minimum blood observations necessary when observations necessary when
transfusing a patient?transfusing a patient?
Start (Baseline), finish and 15 minutes into the
transfusion
Hourly
Every 30 minutes
Start (baseline), finish and 45 minutes into the
transfusion
In bone marrow failure to prevent In bone marrow failure to prevent bleeding associated with surgery to bleeding associated with surgery to
brain or eyes the platelet count brain or eyes the platelet count should be raised to:should be raised to:
> 50 x 109/L
> 100 x 109/L > 30 x 109/L
>20 x 109/L
In massive transfusion the aim In massive transfusion the aim is to maintain the platelet count:is to maintain the platelet count:
> 20 x 109/L> 50 x 109/L
> 100 x 109/L > 30 x 109/L
In Neonatal Allo-Immune In Neonatal Allo-Immune Thrombocytopenia for bleeding or Thrombocytopenia for bleeding or
as prophylaxis treatment the as prophylaxis treatment the platelet count should be:platelet count should be:
> 20 x 109/L> 50 x 109/L
> 100 x 109/L > 30 x 109/L
One therapeutic dose of One therapeutic dose of platelets is equivalent to:platelets is equivalent to:
10 ml/kg body weight
25 ml/kg body weight 5 ml/kg body weight
15 ml/kg body weight
FFP should be used for the FFP should be used for the immediate reversal of the immediate reversal of the
Warfarin effect:Warfarin effect:
When the INR is 1.3When the INR is slightly raised
When the INR is 6.0In the presence of life threatening bleeding
To determine how much FFP is To determine how much FFP is required for your patient you required for your patient you
should:should:
Calculate the amount required using
the formula 15 ml/kg body weight
Order 2 packs of FFP Order 4 packs of FFP
Calculate the amount required using the formula 10 ml/kg
body weight
Cryoprecipitate is indicated in:Cryoprecipitate is indicated in:
DIC where there is bleeding and a
fibrinogen level >2.1g/L
DIC where there is bleeding and a fibrinogen
level >1g/L
DIC where there is bleeding and a fibrinogen
level <1g/L
DIC where there is bleeding and a fibrinogen
level <0.1g/L
Cryoprecipitate is now supplied Cryoprecipitate is now supplied by the NBS in by the NBS in
single units and in:single units and in:
Double units
Pools of 10 units Pools of 15 units
Pools of 5 units
In adults, 2 pools of In adults, 2 pools of Cryoprecipitate are generally Cryoprecipitate are generally
equivalent to:equivalent to:
A therapeutic dose
2x a therapeutic dose Insufficient FVIII
requirement
Half a therapeutic dose
1 day post surgery, Hb of 7.5, 1 day post surgery, Hb of 7.5, patient not symptomatic, no patient not symptomatic, no significant risk factors: how significant risk factors: how
many units of blood should be many units of blood should be given?given?
3 units
2 Units None
1 unit