Critical Thinking Exercises. 1. Prepare a chart for each of the following blood components including a) Description of product b) Indications for use Blood components: Blood Cells Platelet Concentrate - Frozen Plasma Granulocyte Concentrate Frozen-washed deglycerolized red blood cells Cryoprecipitate 2. Select the appropriate blood product for the following cases and give reasons for choice: a) 20-year-old male in Emergency Room gunshot wound to chest with massive blood loss. Blood pressure: 80/40, Pulse: 120, Respirations rapid and shallow. Lab values: Hgb 7.5 gm/dL, Hct 24%. b) 54 year old female with leukemia. Blood in urine, peticheae on trunk, arms and legs. Lab values: Hgb 10 gm/dL, Hct 29%, Platelet count 2,000 mm3. c) 75 year old female (height 1.5 M weight 45 Kg) in Outpatient clinic with chronic anemia unresponsive to previous therapy. Symptoms: shortness of breath, fatigue, and dizziness. Lab values: Hgb 7.0 gm/dL, Hct 22%, Platelet count 175,000 mm3. d) 65-year-old male, post-op open heart surgery for coronary bypass. 600 ml per hour bloody chest tube drainage and oozing from the surgical incision. Ten units of blood were transfused during surgery. Lab values: Hgb 11 gm/dL, Hct 32%, Platelet count 80,000 mm3, Protime 18.0 sec (norm 10-14), PTT 79 sec (norm 20-35). e) 27-year-old female was admitted for C-section. Blood loss during surgery approximately 1200 ml. Obstetrician requests two units of blood for transfusion ASAP. He notes on the order form that patient experienced previous very severe allergic reaction to blood transfusion two years ago, and patient has history of IgA deficiency. Lab values: Hgb 7.0 gm/dL, Hct 21%, Platelet count 122,000 mm3, Protime normal. f) A patient received massive chemotherapy and developed severe neutropenia as a result of the chemotherapy. The patient is now suffering from a severe life threatening bacterial infection unresponsive to antibiotics. g) A patient with severe liver disease develops dysfibrinogenemia. h) A 50-woman with leukemia is scheduled for chemotherapy. The lab reports a 7.0 g/dl hemoglobin and a platelet count of 5,000/ L. History indicates she has experienced two non- hemolytic transfusion reactions. She does report shortness of breath and bruising..

1. Critical Thinking Exercises.
1. Prepare a chart for each of the following blood components including
a) Description of product
b) Indications for use Blood components:
Blood Cells Platelet Concentrate -
Frozen Plasma
Granulocyte Concentrate
Frozen-washed deglycerolized red blood cells Cryoprecipitate
2. Select the appropriate blood product for the following cases and give reasons for choice:
a) 20-year-old male in Emergency Room gunshot wound to chest with massive blood loss. Blood
pressure: 80/40, Pulse: 120, Respirations rapid and shallow. Lab values: Hgb 7.5 gm/dL, Hct
24%.
b) 54 year old female with leukemia. Blood in urine, peticheae on trunk, arms and legs. Lab
values: Hgb 10 gm/dL, Hct 29%, Platelet count 2,000 mm3.
c) 75 year old female (height 1.5 M weight 45 Kg) in Outpatient clinic with chronic anemia
unresponsive to previous therapy. Symptoms: shortness of breath, fatigue, and dizziness. Lab
values: Hgb 7.0 gm/dL, Hct 22%, Platelet count 175,000 mm3.
d) 65-year-old male, post-op open heart surgery for coronary bypass. 600 ml per hour bloody
chest tube drainage and oozing from the surgical incision. Ten units of blood were transfused
during surgery. Lab values: Hgb 11 gm/dL, Hct 32%, Platelet count 80,000 mm3, Protime 18.0
sec (norm 10-14), PTT 79 sec (norm 20-35).
e) 27-year-old female was admitted for C-section. Blood loss during surgery approximately 1200
ml. Obstetrician requests two units of blood for transfusion ASAP. He notes on the order form
that patient experienced previous very severe allergic reaction to blood transfusion two years
ago, and patient has history of IgA deficiency. Lab values: Hgb 7.0 gm/dL, Hct 21%, Platelet
count 122,000 mm3, Protime normal.
f) A patient received massive chemotherapy and developed severe neutropenia as a result of the
chemotherapy. The patient is now suffering from a severe life threatening bacterial infection
unresponsive to antibiotics.

2. g) A patient with severe liver disease develops dysfibrinogenemia.
h) A 50-woman with leukemia is scheduled for chemotherapy. The lab reports a 7.0 g/dl
hemoglobin and a platelet count of 5,000/ L. History indicates she has experienced two non-
hemolytic transfusion reactions. She does report shortness of breath and bruising.