Guidelines on massive blood transfusion(lecture-6)
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This document provides guidelines on managing massive blood transfusion. It defines major hemorrhage as loss of more than one blood volume within 24 hours or 50% of total blood volume lost within 3 hours. It recommends initiating a massive transfusion protocol for hemorrhagic shock classes 3 and 4, which follows a 1:1:1 ratio of packed red blood cells to fresh frozen plasma to platelets. It provides transfusion triggers based on lab values and outlines treatment with tranexamic acid and cautions on fluid resuscitation and electrolyte abnormalities during massive transfusion.
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Massive transfusion protocol
This document discusses massive transfusion protocols (MTP) for trauma victims who experience severe bleeding. It describes the presentation of a 64-year-old male trauma patient who suffered injuries from a motor vehicle crash including internal bleeding and fractures. He received over 18 units of blood products during treatment including surgery. The document then provides details on MTPs including their components, guidelines for blood product ratios, and studies investigating optimal resuscitation approaches to reduce mortality from hemorrhage.
Massive transfusion protocol
its sometime difficult to decide in urgent clinical scenarios - Trauma,active bleeding, surgery: What ; when ; how and why to transfuse? answering some of these queries here is my presentation especially made for PG students (will help in answer writing)
Massive Transfusion Protocol + Blood transfusions
Review of blood transfusions (ABO Rh+/- and transfusion reactions) for ICU nurses. Plus, the role of the massive transfusion protocol (MTP).
Massive transfusion
Massive transfusion is defined as replacing over half the patient's blood volume within a day or 10 units of blood within hours. It can occur due to hemorrhagic shock, trauma, or surgery. Complications include acidosis, hypothermia, electrolyte abnormalities, coagulopathy from diluting coagulation factors, and microaggregates forming in the lungs. Treatment priorities are controlling bleeding, restoring volume, and considering component therapy with red blood cells, fresh frozen plasma, cryoprecipitate, and platelet transfusions based on test results. Close monitoring and treatment of underlying issues are important to prevent complications from massive transfusion.
Blood Transfusion
The document discusses various functions and properties of blood, including transport, regulation, and protection. It then summarizes different blood products like packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitated antihemophilic factor. It discusses their indications, storage requirements, and risks of transfusion such as allergic reactions, hemolytic reactions, febrile reactions, bacterial contamination, transfusion-related acute lung injury, and disease transmission.
Massive blood transfusion
The document provides guidelines for managing massive blood transfusion or massive blood loss, defining it as replacing over 50% of total blood volume within 3 hours or 100% within 24 hours. It outlines the components of a massive transfusion protocol including blood products to transfuse and common complications to monitor for such as hypothermia, dilutional coagulopathy, and acidosis. The protocol is a multidisciplinary approach involving consultants, the blood bank, and laboratory to rapidly replace lost blood and clotting factors.
Transfusion therapy
This document discusses transfusion therapy for a 22-year-old man with multiple penetrating chest wounds who has drained 1500mL of blood from his right chest. The most appropriate next step is to arrange transfusion and transfer to the operating theater. Transfusion therapy involves administering blood components like packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate to replace lost blood and clotting factors. The risks and complications of transfusion include acute reactions like hemolytic, febrile, allergic, and transfusion-related acute lung injury as well as delayed issues such as alloimmunization, iron overload, and transfusion-transmitted infections.
Trauma induced coagulopathy
Trauma induced coagulopathy (TIC) starts early due to shock and hypoperfusion which activates the thrombomodulin-protein C pathway. TIC is associated with higher mortality, transfusion requirements, and organ dysfunction. Assessment of TIC requires thromboelastometry rather than standard coagulation tests due to confounding factors like hypothermia, acidosis, and dilution of clotting factors from fluid resuscitation. Treatment focuses on replacing depleted clotting factors, with fibrinogen and prothrombin concentrates highly recommended, as well as consideration of antifibrinolytics and recombinant factor VIIa in specific cases.
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Massive transfusion protocol
This document discusses massive transfusion protocols (MTP) for trauma victims who experience severe bleeding. It describes the presentation of a 64-year-old male trauma patient who suffered injuries from a motor vehicle crash including internal bleeding and fractures. He received over 18 units of blood products during treatment including surgery. The document then provides details on MTPs including their components, guidelines for blood product ratios, and studies investigating optimal resuscitation approaches to reduce mortality from hemorrhage.
Massive transfusion protocol
its sometime difficult to decide in urgent clinical scenarios - Trauma,active bleeding, surgery: What ; when ; how and why to transfuse? answering some of these queries here is my presentation especially made for PG students (will help in answer writing)
Massive Transfusion Protocol + Blood transfusions
Review of blood transfusions (ABO Rh+/- and transfusion reactions) for ICU nurses. Plus, the role of the massive transfusion protocol (MTP).
Massive transfusion
Massive transfusion is defined as replacing over half the patient's blood volume within a day or 10 units of blood within hours. It can occur due to hemorrhagic shock, trauma, or surgery. Complications include acidosis, hypothermia, electrolyte abnormalities, coagulopathy from diluting coagulation factors, and microaggregates forming in the lungs. Treatment priorities are controlling bleeding, restoring volume, and considering component therapy with red blood cells, fresh frozen plasma, cryoprecipitate, and platelet transfusions based on test results. Close monitoring and treatment of underlying issues are important to prevent complications from massive transfusion.
Blood Transfusion
The document discusses various functions and properties of blood, including transport, regulation, and protection. It then summarizes different blood products like packed red blood cells, platelets, fresh frozen plasma, and cryoprecipitated antihemophilic factor. It discusses their indications, storage requirements, and risks of transfusion such as allergic reactions, hemolytic reactions, febrile reactions, bacterial contamination, transfusion-related acute lung injury, and disease transmission.
Massive blood transfusion
The document provides guidelines for managing massive blood transfusion or massive blood loss, defining it as replacing over 50% of total blood volume within 3 hours or 100% within 24 hours. It outlines the components of a massive transfusion protocol including blood products to transfuse and common complications to monitor for such as hypothermia, dilutional coagulopathy, and acidosis. The protocol is a multidisciplinary approach involving consultants, the blood bank, and laboratory to rapidly replace lost blood and clotting factors.
Transfusion therapy
This document discusses transfusion therapy for a 22-year-old man with multiple penetrating chest wounds who has drained 1500mL of blood from his right chest. The most appropriate next step is to arrange transfusion and transfer to the operating theater. Transfusion therapy involves administering blood components like packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate to replace lost blood and clotting factors. The risks and complications of transfusion include acute reactions like hemolytic, febrile, allergic, and transfusion-related acute lung injury as well as delayed issues such as alloimmunization, iron overload, and transfusion-transmitted infections.
Trauma induced coagulopathy
Trauma induced coagulopathy (TIC) starts early due to shock and hypoperfusion which activates the thrombomodulin-protein C pathway. TIC is associated with higher mortality, transfusion requirements, and organ dysfunction. Assessment of TIC requires thromboelastometry rather than standard coagulation tests due to confounding factors like hypothermia, acidosis, and dilution of clotting factors from fluid resuscitation. Treatment focuses on replacing depleted clotting factors, with fibrinogen and prothrombin concentrates highly recommended, as well as consideration of antifibrinolytics and recombinant factor VIIa in specific cases.
Massive blood transfusion
This document discusses massive or large volume blood transfusions. It defines massive transfusion as replacing a patient's total blood volume within 24 hours, which is 70 mL/kg in adults and 80-90 mL/kg in children. While administering large volumes can cause complications like acidosis, hypokalemia, and coagulation issues, the main risks are from the underlying trauma causing blood loss. The document provides guidelines for managing potential complications and recognizing acute transfusion reactions from mild to life-threatening.
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This document provides guidelines for blood transfusion and alternatives. It recommends considering alternatives to transfusion such as erythropoietin, intravenous/oral iron, cell salvage, and tranexamic acid for non-bleeding surgery patients. For those requiring transfusion, it provides thresholds and dosing guidelines for red blood cells, platelets, fresh frozen plasma, cryoprecipitate, and prothrombin complex concentrate based on bleeding status and test results. All decisions should consider the full clinical situation to avoid under or over-transfusion.
Blood products and massive blood transfusion
This document provides information on various blood products and massive blood transfusion. It defines massive blood transfusion as replacing one entire blood volume within 24 hours or transfusing over 10 units of packed red blood cells in 24 hours. It describes components of blood like whole blood, packed red blood cells, plasma, platelets, and plasma derivatives. It discusses indications, storage, and risks of these products. It also outlines complications of massive transfusion like coagulopathy, hypothermia, acidosis, and circulatory overload and targets for resuscitation like maintaining hemoglobin, coagulation factors, platelets, pH, and temperature.
Massive Blood Transfusion
This document defines massive blood transfusion as replacing over half the patient's blood volume within 24 hours or transfusing over 10 units of packed red blood cells within a few hours. It indicates massive transfusion is used for hemorrhagic shock, trauma, or critical illness. Complications discussed include acute reactions, infections transmission, coagulopathy, hypothermia, electrolyte abnormalities, and volume overload. Guidelines recommend considering multiple factors like physiological status and oxygen needs rather than single transfusion thresholds.
Massive Transfusion in Trauma
1) Massive transfusion (MT) is defined as replacement of over 1 blood volume in 24 hours or over 50% of blood volume in 4 hours in adults, and transfusion of over 40ml/kg in children. MT should be triggered by a senior clinician suspecting hemorrhagic shock in a bleeding patient.
2) Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) can help diagnose trauma-induced coagulopathy, guide transfusion strategy, and reduce blood product use and mortality in trauma patients. They assess the entire coagulation process.
3) Initial actions in MT protocol include controlling bleeding, limiting crystalloids, ordering blood
Blood component therapy
This document provides information about blood transfusion and component therapy. It discusses the need for transfusion when there is inadequate oxygen carrying capacity or coagulation proteins. Whole blood can be separated into components like red blood cells, platelets, plasma, and cryoprecipitate to provide targeted therapy. The storage and indications of various blood components like packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets are described. The document also covers transfusion triggers, guidelines, blood ordering schedules, and blood sparing strategies like autologous donation and acute normovolemic hemodilution.
Transfusion related acute lung injury
Transfusion-related acute lung injury (TRALI) is a potentially fatal syndrome characterized by acute respiratory distress within 6 hours of blood transfusion. It is believed to be caused by anti-leukocyte antibodies in plasma products that cause leukocyte aggregation in the lungs, inflammatory injury, and non-cardiogenic pulmonary edema. TRALI has an incidence of 1 in 5000 transfusions and mortality rate of 5-25%. Risk factors include plasma-rich products, multiparous donors, and underlying patient conditions. Diagnosis involves new pulmonary edema within 6 hours of transfusion in the absence of circulatory overload. Treatment focuses on supportive care, with most patients recovering within 72 hours. Prevention strategies include leukoreduction of blood products
Haemostatic Resuscitation
Haemostatic resuscitation is a vital part of damage control resuscitation for hemorrhagic shock. It involves restoring normal tissue perfusion while preserving effective clotting until definitive hemorrhage control is achieved, usually through surgery or angioembolization. Rotational thromboelastometry provides rapid assessment of coagulation to guide trauma resuscitation, including targeting fibrinogen and platelet levels and administering specific blood products to address deficiencies. Massive transfusion protocols aim to prevent trauma-induced coagulopathy by transfusing red blood cells, plasma, and platelets in a 1:1:1 ratio while also controlling hemorrhage through techniques like damage control surgery.
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1. A 68-year-old woman with a background of chronic myeloid leukemia presented to the emergency department with respiratory distress and fever after receiving a blood transfusion.
2. She was found to have a fever, low oxygen saturation, rapid breathing, and rapid heart rate, suggesting a potential transfusion reaction.
3. Initial management involved stopping the transfusion, monitoring vital signs, and performing investigations to identify the type of reaction and guide further treatment. Prevention of transfusion reactions is important through proper patient identification, following protocols, and identifying high-risk groups.
Trali
Transfusion-related acute lung injury (TRALI) is a rare complication of blood transfusion that causes acute lung injury within 6 hours of transfusion. It is difficult to diagnose due to a lack of clear defining features. TRALI is characterized by acute respiratory distress, hypoxemia, bilateral lung infiltrates on chest imaging, and no evidence of circulatory overload. Transfusion-associated circulatory overload (TACO) presents similarly but is caused by an excessive fluid volume from transfusion that leads to pulmonary edema. Differentiating between TRALI and TACO can be challenging and requires considering factors like fever, blood pressure, fluid balance, and cardiac function.
Fluid resuscitation in trauma
This document discusses fluid resuscitation strategies in trauma patients. It outlines the goals of fluid resuscitation as replacing volume loss, improving blood pressure, and improving tissue perfusion and oxygenation. It describes the evolution from aggressive to restrictive fluid resuscitation strategies, including permissive hypotension which aims to increase systolic blood pressure while keeping it lower than normal until hemorrhage is controlled. The advantages and types of fluids used, including crystalloids, colloids, and blood products are discussed, along with considerations for different patient populations and injury types.
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Includes a short descriptive type presentation with 2008 guidelines on management of massive blood loss and a little touch on management options.
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Blood component therapy involves transfusing only the necessary components of blood needed by a patient. This reduces waste and risks compared to whole blood transfusions. The main components are red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Each component has specific functions and indications for use in treating conditions like anemia, bleeding, or coagulation disorders. Proper collection, storage, and modification of the components helps maintain their viability and functions.
blood and blood products
Blood and blood products were presented. Key points included:
1. Blood functions to transport vital substances throughout the body.
2. Blood typing and cross-matching must be done correctly to avoid transfusion reactions.
3. Several blood products exist including packed red blood cells, platelets, and plasma derivatives that are used to treat different conditions.
4. Blood transfusions can have complications and must only be done when necessary following all safety protocols.
Rational use of blood component
This document discusses rational blood use and its components. It provides historical context on blood transfusions dating back to 1492. It then covers developments like the discovery of blood groups in 1901 and the establishment of the first blood bank in the 1930s. The document outlines the processing of donated blood into components like packed red blood cells, platelets, and plasma. It discusses indications for transfusions and special considerations like managing Rh-negative patients. Finally, it reviews potential complications of transfusions such as hemolytic and allergic reactions.
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This document discusses patient blood management (PBM), which is a multidisciplinary approach to optimizing patient care and reducing unnecessary blood transfusions. It has three pillars: optimizing erythropoiesis, minimizing bleeding, and harnessing physiological reserves of anemia. The evidence shows PBM can reduce transfusions by 39% without increasing risks. It has led to reduced transfusions and costs in various settings like cardiac and orthopedic surgery. PBM programs require a multidisciplinary team approach led by specialties like anesthesiology. Overall, PBM provides better patient outcomes while reducing allogeneic blood use.
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The document discusses various blood components and products used in pediatric transfusion medicine. It describes whole blood and derived blood products like red blood cell concentrates, platelet concentrates, granulocyte concentrates and plasma components. It provides guidelines for transfusing these products in neonates and children based on hemoglobin levels and clinical conditions. It also discusses potential adverse effects of transfusions and their management.
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This document discusses massive or large volume blood transfusions. It defines massive transfusion as replacing a patient's total blood volume within 24 hours, which is 70 mL/kg in adults and 80-90 mL/kg in children. While administering large volumes can cause complications like acidosis, hypokalemia, and coagulation issues, the main risks are from the underlying trauma causing blood loss. The document provides guidelines for managing potential complications and recognizing acute transfusion reactions from mild to life-threatening.
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This document provides guidelines for blood transfusion and alternatives. It recommends considering alternatives to transfusion such as erythropoietin, intravenous/oral iron, cell salvage, and tranexamic acid for non-bleeding surgery patients. For those requiring transfusion, it provides thresholds and dosing guidelines for red blood cells, platelets, fresh frozen plasma, cryoprecipitate, and prothrombin complex concentrate based on bleeding status and test results. All decisions should consider the full clinical situation to avoid under or over-transfusion.
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This document provides information on various blood products and massive blood transfusion. It defines massive blood transfusion as replacing one entire blood volume within 24 hours or transfusing over 10 units of packed red blood cells in 24 hours. It describes components of blood like whole blood, packed red blood cells, plasma, platelets, and plasma derivatives. It discusses indications, storage, and risks of these products. It also outlines complications of massive transfusion like coagulopathy, hypothermia, acidosis, and circulatory overload and targets for resuscitation like maintaining hemoglobin, coagulation factors, platelets, pH, and temperature.
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This document defines massive blood transfusion as replacing over half the patient's blood volume within 24 hours or transfusing over 10 units of packed red blood cells within a few hours. It indicates massive transfusion is used for hemorrhagic shock, trauma, or critical illness. Complications discussed include acute reactions, infections transmission, coagulopathy, hypothermia, electrolyte abnormalities, and volume overload. Guidelines recommend considering multiple factors like physiological status and oxygen needs rather than single transfusion thresholds.
Massive Transfusion in Trauma
1) Massive transfusion (MT) is defined as replacement of over 1 blood volume in 24 hours or over 50% of blood volume in 4 hours in adults, and transfusion of over 40ml/kg in children. MT should be triggered by a senior clinician suspecting hemorrhagic shock in a bleeding patient.
2) Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) can help diagnose trauma-induced coagulopathy, guide transfusion strategy, and reduce blood product use and mortality in trauma patients. They assess the entire coagulation process.
3) Initial actions in MT protocol include controlling bleeding, limiting crystalloids, ordering blood
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This document provides information about blood transfusion and component therapy. It discusses the need for transfusion when there is inadequate oxygen carrying capacity or coagulation proteins. Whole blood can be separated into components like red blood cells, platelets, plasma, and cryoprecipitate to provide targeted therapy. The storage and indications of various blood components like packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets are described. The document also covers transfusion triggers, guidelines, blood ordering schedules, and blood sparing strategies like autologous donation and acute normovolemic hemodilution.
Transfusion related acute lung injury
Transfusion-related acute lung injury (TRALI) is a potentially fatal syndrome characterized by acute respiratory distress within 6 hours of blood transfusion. It is believed to be caused by anti-leukocyte antibodies in plasma products that cause leukocyte aggregation in the lungs, inflammatory injury, and non-cardiogenic pulmonary edema. TRALI has an incidence of 1 in 5000 transfusions and mortality rate of 5-25%. Risk factors include plasma-rich products, multiparous donors, and underlying patient conditions. Diagnosis involves new pulmonary edema within 6 hours of transfusion in the absence of circulatory overload. Treatment focuses on supportive care, with most patients recovering within 72 hours. Prevention strategies include leukoreduction of blood products
Haemostatic Resuscitation
Haemostatic resuscitation is a vital part of damage control resuscitation for hemorrhagic shock. It involves restoring normal tissue perfusion while preserving effective clotting until definitive hemorrhage control is achieved, usually through surgery or angioembolization. Rotational thromboelastometry provides rapid assessment of coagulation to guide trauma resuscitation, including targeting fibrinogen and platelet levels and administering specific blood products to address deficiencies. Massive transfusion protocols aim to prevent trauma-induced coagulopathy by transfusing red blood cells, plasma, and platelets in a 1:1:1 ratio while also controlling hemorrhage through techniques like damage control surgery.
Blood transfusion reactions and complications
1. A 68-year-old woman with a background of chronic myeloid leukemia presented to the emergency department with respiratory distress and fever after receiving a blood transfusion.
2. She was found to have a fever, low oxygen saturation, rapid breathing, and rapid heart rate, suggesting a potential transfusion reaction.
3. Initial management involved stopping the transfusion, monitoring vital signs, and performing investigations to identify the type of reaction and guide further treatment. Prevention of transfusion reactions is important through proper patient identification, following protocols, and identifying high-risk groups.
Trali
Transfusion-related acute lung injury (TRALI) is a rare complication of blood transfusion that causes acute lung injury within 6 hours of transfusion. It is difficult to diagnose due to a lack of clear defining features. TRALI is characterized by acute respiratory distress, hypoxemia, bilateral lung infiltrates on chest imaging, and no evidence of circulatory overload. Transfusion-associated circulatory overload (TACO) presents similarly but is caused by an excessive fluid volume from transfusion that leads to pulmonary edema. Differentiating between TRALI and TACO can be challenging and requires considering factors like fever, blood pressure, fluid balance, and cardiac function.
Fluid resuscitation in trauma
This document discusses fluid resuscitation strategies in trauma patients. It outlines the goals of fluid resuscitation as replacing volume loss, improving blood pressure, and improving tissue perfusion and oxygenation. It describes the evolution from aggressive to restrictive fluid resuscitation strategies, including permissive hypotension which aims to increase systolic blood pressure while keeping it lower than normal until hemorrhage is controlled. The advantages and types of fluids used, including crystalloids, colloids, and blood products are discussed, along with considerations for different patient populations and injury types.
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Includes a short descriptive type presentation with 2008 guidelines on management of massive blood loss and a little touch on management options.
Blood components
Blood component therapy involves transfusing only the necessary components of blood needed by a patient. This reduces waste and risks compared to whole blood transfusions. The main components are red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. Each component has specific functions and indications for use in treating conditions like anemia, bleeding, or coagulation disorders. Proper collection, storage, and modification of the components helps maintain their viability and functions.
blood and blood products
Blood and blood products were presented. Key points included:
1. Blood functions to transport vital substances throughout the body.
2. Blood typing and cross-matching must be done correctly to avoid transfusion reactions.
3. Several blood products exist including packed red blood cells, platelets, and plasma derivatives that are used to treat different conditions.
4. Blood transfusions can have complications and must only be done when necessary following all safety protocols.
Rational use of blood component
This document discusses rational blood use and its components. It provides historical context on blood transfusions dating back to 1492. It then covers developments like the discovery of blood groups in 1901 and the establishment of the first blood bank in the 1930s. The document outlines the processing of donated blood into components like packed red blood cells, platelets, and plasma. It discusses indications for transfusions and special considerations like managing Rh-negative patients. Finally, it reviews potential complications of transfusions such as hemolytic and allergic reactions.
Damage Control Resuscitation
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The New Face of Damage Control
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Patient Blood Management
This document discusses patient blood management (PBM), which is a multidisciplinary approach to optimizing patient care and reducing unnecessary blood transfusions. It has three pillars: optimizing erythropoiesis, minimizing bleeding, and harnessing physiological reserves of anemia. The evidence shows PBM can reduce transfusions by 39% without increasing risks. It has led to reduced transfusions and costs in various settings like cardiac and orthopedic surgery. PBM programs require a multidisciplinary team approach led by specialties like anesthesiology. Overall, PBM provides better patient outcomes while reducing allogeneic blood use.
Blood & Blood Products
The document discusses various blood components and products used in pediatric transfusion medicine. It describes whole blood and derived blood products like red blood cell concentrates, platelet concentrates, granulocyte concentrates and plasma components. It provides guidelines for transfusing these products in neonates and children based on hemoglobin levels and clinical conditions. It also discusses potential adverse effects of transfusions and their management.
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Blood component therapy involves separating whole blood into its components through centrifugation, including red blood cells, platelets, fresh frozen plasma, and cryoprecipitate. This allows specific components to be transfused based on patient needs, reduces waste, and enables blood from one donor to help multiple recipients. Key components are red blood cells, platelets, fresh frozen plasma, and cryoprecipitate, each with different functions, storage, and transfusion guidelines.
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1. The document discusses blood products and their indications for transfusion in cases of blood loss. It covers topics like pregnancy and blood volume, signs of blood loss, replacement ratios, and varieties of blood components.
2. Indications for transfusing specific blood products like packed red cells, platelets, fresh frozen plasma, and cryoprecipitate are provided based on factors like hemoglobin level and clinical signs of bleeding or shock.
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This document discusses blood transfusion and blood products. It begins by defining blood transfusion as transferring blood or blood products between individuals. It then describes the main types of transfusion as homologous and autologous. The document goes on to provide a brief history of blood transfusion and discusses indications for transfusion such as acute blood loss or anemia. It also outlines donor criteria and collection/storage of blood and blood products like packed cells, plasma, platelets, and artificial substitutes. Complications of transfusion and massive transfusion are noted.
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Blood is a circulating fluid composed of plasma, red blood cells, white blood cells, and platelets. It transports nutrients, oxygen, waste, and immune cells throughout the body. Blood transfusions may be used to treat blood loss or deficiencies, with risks including allergic reactions, fever, and rare but serious immune reactions if the blood types are incompatible. Proper identification, consent, ordering, and monitoring procedures are required for safe transfusion.
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The document discusses blood transfusion in farm animals. It begins by outlining some key questions that will be answered, such as the precautions that should be taken when performing a blood transfusion, if blood can be stored in refrigeration, common anticoagulants added and how to calculate dosages. It then provides historical context on blood transfusion. Key points include the first successful animal to animal transfusion in 1665 and the discovery of blood groups in 1901 which helped make transfusions safer. The document concludes by discussing donor cow requirements, clinical signs of anemia, common anticoagulants used like sodium citrate and heparin and how to determine an animal's need for a transfusion based on packed
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This document provides guidelines for blood transfusion practices. It discusses the history of blood transfusions from the early 1900s developments to modern practices. It outlines the components of blood that can be transfused including red blood cells, platelets, fresh frozen plasma, and cryoprecipitated anti-hemophilic factor. Thresholds and indications for transfusing each component are provided based on factors like hemoglobin level and platelet count. Proper procedures for blood transfusions including consent, preparation, and compatibility checking are also outlined.
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1. Blood groups exist in many animal species and involve antigens on red blood cells. Cross-matching is important to avoid transfusion reactions.
2. Whole blood, packed red blood cells, fresh frozen plasma, and platelet-rich plasma can be transfused to treat various conditions like anemia, coagulation disorders, and thrombocytopenia.
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Blood transfusion involves carefully matching donor and recipient blood types to prevent dangerous antigen-antibody reactions. Key aspects include typing for the ABO and RH blood group systems, compatibility testing between donor and recipient blood, and cross-matching to confirm safety prior to transfusion. Proper collection, testing, and storage of blood is also important to ensure its viability and safety for transfusion. Guidelines provide triggers for transfusing specific blood components like red blood cells, platelets, and plasma based on clinical factors and lab values. Massive bleeding requires rapid volume replacement and transfusion to maintain adequate blood volume and composition.
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- Anaemia in pregnancy is defined as haemoglobin levels below certain thresholds depending on trimester. Oral iron is usually the first treatment, with parenteral iron or blood transfusion indicated if oral iron is not effective.
- Active management of the third stage of labour and delivery in hospital for high risk women can help minimize blood loss. Blood transfusions require consent but in emergencies it can be obtained retrospectively.
- For major obstetric haemorrhage, protocols should replace blood components before fluids and aim for specific haemoglobin, platelet and coagulation targets through transfusion of red blood cells, plasma, platelets and cryoprecipitate. Recombinant factor VIIa may be considered for refract
6.shockblood transfusion)
Thank you for the questions. I've enjoyed learning more about blood transfusions through our discussion.
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Blood Component Therapy: What a clinician needs to know !
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this guideline based on recent articles by major education establishments concerned with building national guidelines. please dont be hurry to make comments about use of IV aminophylline. aminiphylline used under some extra care and when other treatment options are failing. benefits of those treatments yet remain controversial. IV aminophylline has its own risks including the possibility of toxicity.
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here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
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This is the fifth lecture. it is based on guidelines by NHS UK. the guidelines based are freely available in internet. the source and the used literature are trusted and accurate. i hope this level of a knowledge about the management side of the DKA touches the all areas of patient survival. patho-physiology not discussed here but will be discussed in another lecture in details. to a intern and final year MBBS students or ERPM students must process a level of knowledge described by the lecture. definitely more you read more knowledge you get. get the idea in the lecture and principles of management. so you will be much accurate in a ward. always take superior advice while managing emergencies.
Disease notification system in Sri Lanka
This document discusses Sri Lanka's notifiable disease reporting system. It explains that the system requires medical practitioners to report cases of infectious diseases on a mandatory list to public health authorities. The list includes diseases like cholera, plague, yellow fever, dengue, tuberculosis and more. It outlines the legal basis for the system and notes any practitioner who does not notify can be punished. Notifications should be made based on clinical suspicion without waiting for lab results. Data is collected centrally and used to monitor disease outbreaks. The goal is to help control the spread of infectious diseases in the country.
Potassium imbalance and management
This document discusses potassium imbalance and its management. It provides reference ranges for normal serum electrolyte levels including potassium. It then discusses causes, classifications, signs, and treatments for both hyperkalemia and hypokalemia. For hyperkalemia, it outlines approaches for managing severe cases including using calcium, insulin, beta-agonists, and dialysis. For hypokalemia it discusses causes like drugs and investigations to identify the cause before outlining oral and IV supplementation approaches.
Organophosphate poisoning national guideline
publication by Dr-C.Here the given information are based on recommendations by sri lankan medical specialists who have dealt with the issue for a long time. it is quite obvious using agro chemical to deliberate self harm is a tendency in developing countries. it is common in agricultural ares.all the information are correct according to my knowledge. all the materials used to publish the slideshow are international publications. you have the full right to download and read. my personal request is to submit your ideas to me. and suggest different topics. i like to see your responses. i hope you would manage patients like these some day though it is so sad to see such incidents. be confident. do good. do not harm. be kind. keep us in your memories.
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Asthma Management guidlines.
The ERS/ATS Task Force guidelines provide an updated definition of severe asthma, discuss severe asthma phenotypes, and make recommendations for evaluating and treating severe asthma.
When asthma diagnosis is confirmed and comorbidities addressed, severe asthma is defined as requiring high-dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to control asthma or asthma that remains uncontrolled despite this therapy.
Severe asthma is heterogeneous, with phenotypes including eosinophilic asthma. Recommendations include using sputum eosinophil counts and exhaled nitric oxide to guide therapy, as well as treating with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and
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Guidelines on massive blood transfusion(lecture-6)
- 1. Guidelines on Massive blood transfusion Lecture-6 By Dr-C
- 2. Major hemorrhage It is defined in many ways. Here we have taken the definition by www.transfusionguidelines.org/ Loss of more than one blood volume within 24 hours (around 70 mL/kg, >5 liters in a 70 kg adult) 50% of total blood volume lost in less than 3 hours Bleeding in excess of 150 mL/minute. clinically a major hemorrhage is-bleeding that cause the systolic blood pressure to be lowered below 90mmHg causing the pulse rate more than 110bpm.
- 3. definitions Some of literature says a major hemorrhage is- 1)>40% or equal blood loss 2)4 liters in 24 hours 3)2 liters in 3 hours 4)>150ml/min (NHS UK)
- 4. 30-40% blood loss needs blood transfusion Take blood for grouping and cross matching. If the patient needs immediate transfusion issue group O blood. Females less than 50 years of age should receive group O Rh negative blood. When the grouping and cross matching done relevant type of blood can be given Most of the hospitals have a protocol dedicated to massive blood loss and blood transfusion. Most of the time called as MASSIVE TRANSFUSION PROTOCOL.
- 5. Classification of hemorrhagic shock
- 6. In above mentioned classification class 3 and 4 need blood transfusion Massive transfusions follow the rule of packed RBC:FFP:Platelts=1:1:1 Before transfusions always take blood for base line investigations. Grouping and cross match, Hb, coagulation profile. take a FBC and a coagulation profile every 5 units of blood. Transfusion ratio 1:1:1 { 4 units of RBC’s, 4 units (2 bags or 600mls) of FFP & 4 units (1 pooled/ apheresed bag) of platelets} If patient comes with in first hour of the trauma always consider to give tranexamic acid IV
- 7. IV tranexamic acid Maximum benefit from Tranexamic Acid if given within first hour after injury. Do not give more than 3 hours after injury 1g Tranexamic Acid iv over 10minutes followed by 1g Tranexamic acid iv over 8 hours
- 8. Transfusion Triggers (in presence of bleeding) Platelets < 75 x 109/L = 1 bag of platelets Platelets < 50 x 109/L = 2 bags of platelets INR > 1.5 = 2 bags FFP INR > 2.0 = 4 bags FFP Fibrinogen < 1.5g/L = 6 bags of cryo Fibrinogen < 1.0g/L = 12 bags of cryo Fibrinogen < 0.5g/L = 18 bags of cryo RBC’s as guided by blood loss and laboratory values
- 9. Resuscitation with cristaloids is recomeneded buy don’t give more than the needs. Aggressive fluid resuscitation isn’t recommended in major trauma now. As cross matching takes time till the negative O blood can be transfused. Hypocalcaemia and hyperkalaemia can occur especially with hypothermia and acidosis. Treat them Always call on call surgical unit and arrange measures to control bleeding surgically.
- 10. Further reading The royal Melbourne hospital- massive transfusion guidelines Norflock and Norwich hospital guidelines on massive transfusion NHS UK https://www.blood.gov.au/pubs/pbm/module1/transfusion.html