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THIS SI ABOUT BLOOD BROUP AB YOUR WILL FIND MUCH MORE INSIDE

THIS SI ABOUT BLOOD BROUP AB YOUR WILL FIND MUCH MORE INSIDE

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  • 1. DR ABDULLAH BANGWAR PG SU-III
  • 2. o The most common transplanted organ world wide is blood o Blood should be transfused in its various products rather than as a whole o The conditions in which whole blood is needed are :  Trauma &  Surgery where the all products of blood are being lost, Otherwise various products can be transfused as per requirement
  • 3. This policy has dual advantage i. Un-necessary transfusion of other products can be avoided & other patients can get benefit from them ii. Complications of transfusion can be reduced in this way
  • 4. o For collection of 500 ml of blood,70 ml anticoagulant CPD-A1 solution is added which contain: ~ citric acid ~ sodium citrate ~ sodium biphosphate ~ dextrose ~ adenine
  • 5. 1) Potassium level rises at rate of 1 meq/day. Blood stored for >21 days will have 21 meq more k+ than fresh blood 2) Increase in level of lactic & pyruvic acid causing acidosis 3) PO2 decrease & Pco2 increase 4) Level of NH3 raises after 8-5 days of storage & reaches max level at 21 days, pt with hepatic encephalopathy should not be transfused with stored blood as it worsen the condition
  • 6. 5) Clotting factors remain viable for 24 hours 6) One pint of blood will raises Hb level approximately by one gram (0.8gm) 7) WBCs are rapidly destroyed in stored blood 8) At 4C, platelet survival & function are reduced, but can be stored at 22C for 5-7 days
  • 7. 1) SURGICAL: ~ Accidental hemorrhage ~ Hemorrhage from GIT tumors ~ UC ~ Bleeding PUD ~ Hemorrhoids 2) PRE-OPERATIVE: Any pt whose HB is < 8 gm% is considered unfit for anesthesia 3) PER-OPERATIVE: Any major surgery
  • 8. 4) POST-OPERATIVE: If pt is anemic due to infection or hemorrhage (reactionary, secondary), blood should be transfused 5) SEVERE BURNS: Specially deep burn in which there is loss of serum & RBCs destruction 6) BLEEDING DISORDERS: Thrombocytopenia & hemophilia 7) Aplastic/ hypoplastic anemias
  • 9. 1. Positive identification of pt at bed side 2. Comparison of name of pt & blood group on blood bag and slip provided by blood bank 3. Check ABO & Rh group compatibility 4. Cross match is must but in emergency situ we can just rely on grouping b/c cross match takes time 5. Check vitals
  • 10. 6. Rate of blood flow should be 40 drops/min, but can be transfused rapidly in sever blood loss 7. Transfusion note should be mentioned 8. Emergency medicines should be in hands at the time of transfusion 9. Screening for HIV 1 & 2, HBV, HCV, CMV in special circumstances
  • 11. 10. Blood donor should be fit with no evidence of any active infection
  • 12. 1.cells 2.plasma
  • 13. 1. CELLS: a) Packed Red Cell are indicated in: ~ severe anemia ~ elderly patients ~ children ~ Pt in which there is danger of volume overload ( CCF, THALASSEMIA ) b) PLATELETS: Thrombocytopenia (DIC, DANGUE HEMORRHAGIC SHOCK)
  • 14. 2.PLASMA: a) Purified Protein Fraction (PPF) Suitable for protein replacement e.g. burn & severe protein loss It can be stored for several month at 4C b) Fresh Frozen Plasma (FFP) plasma obtained from fresh blood & rapidly frozen at -50C
  • 15.  FFP is good source of all clotting factors  It is treatment of choice for conducting surgery in pt with abnormal coagulation due to sever liver failure, clotting factor deficiency, hemophilia, christmas disease & acute warfarin toxicity  It can be stored for 2 years c) Cryoprecipitate: It is very rich source of antihemophilic factor (factor VIII) & Fibrinogen, So it is useful in pt with DIC & hemophilia-A
  • 16. d) Fibrinogen: Used in DIC e) SAG-MITOL BLOOD: Process in which all plasma is removed and replaced by crystalloid solution containing S-Sodium chloride A-Adenine G-Glucose M-Manitol This maintain good cell viability, contain no protein & is useful for anemia
  • 17. A) TRANSFUSION REACTION 1. Acute immune hemolytic reaction 2. Delayed hemolytic reaction 3. Nonimmune hemolytic reaction 4. Allergic reaction 5. Febrile reaction 6. Graft-vs-host disease(GVHD) 7. TRALI
  • 18. B) Overloading & CCF C) Air embolism D) Transmission of diseases E) Iron overload F) Hyperkalemia G) Citrate toxicity H) Metabolic acidosis I) Hypothermia J) hyperamonemia
  • 19.  Replacement of total blood volume in less than 24 hours OR acute transfusion of more than half of patient’s estimated blood volume per hour
  • 20.  Pre-deposit  Blood salvage  haemodilution