C599 TEST FINAL PAPER WITH COMPLETE
SOLUTIONS
◉ What is crossmatching?
- How is this ordered?
- Where does the blood go?
Answer: Patient and donor blood mixed to determine compatability
- ordered as a number of units
- Can be held in blood bank or delivered to OR
◉ Blood is never given unless what?
Answer: Approved by the anesthesiologist - they are the gatekeepers
according to the hospital's blood utilization committee and must
approve all blood administration in the OR
◉ What should blood be given with?
Answer: Normal saline
◉ How do we determine blood loss?
Answer: - suction canister (ask scrub tech)
- 4x4 = 10mL
- fully soaked lap = 100-150ml
,◉ Estimated blood volume:
- premature neonate
- full term neonate
- infant
- male adult
- Female adult
Answer: - 95 ml/kg
- 85 ml/kg
- 80 ml/kg
- 75 ml/kg
- 65 ml/kg
◉ Allowable blood loss as done in the M&M book & on the blood
admin ppt:
Answer: RBCvolume(currentHct) = EBV * (current Hct)
RBCvolume(LowHct) = EBV * (lowHct)
ABL = RBCv(current) - RBCv(lowHct)
Note this also works for EBL if they give you values.
,◉ When is transfusion usually recommended?
Answer: Hgb < 8 g/dL
Hct < 24%
Limit will be higher if pt has comorbidities
◉ How much will 1 unit of PRBCs increase Hgb and Hct in the
average adult?
Answer: Hgb by 1 g/dL
Hct by 2-3%
◉ What is the onset of a hemolytic transfusion reaction signaled by?
Answer: rapidly increasing temp, tachy, HTN OR
Hypotension, oozing surgical field, hematuria
◉ What is possible to occur rapidly with a hemolytic transfusion
reaction?
Answer: Shock, kidney failure, DIC
◉ TRALI symptoms can occur within what time frame?
, Answer: 6 hours
◉ Steps to take when hemolytic transfusion reaction occurs:
Answer: 1.Stop transfusion, call attending, notify blood bank,
support patient hemodynamics
2.Recheck unit against attached paperwork and patient id bracelet
3.Draw blood sample for blood bank(pink), coags(blue), and platelet
count(purple)
4.Insert catheter to check for hemoglobinurea
5.Osmotic diuresis with mannitol and iv fluids
◉ The AABB recommends against warming what?
What do studies show?
Answer: Platelets and cryo
No studies have shown it to be harmful
◉ Is it okay to use a blood filter that has previously filtered blood for
platelets infusion?
Answer: No, this is contraindicated
◉ What size filter do you use for platelet transfusion?
Answer: 170-200 micron filter, anything smaller will filter out the
platelets
SOLUTIONS
◉ What is crossmatching?
- How is this ordered?
- Where does the blood go?
Answer: Patient and donor blood mixed to determine compatability
- ordered as a number of units
- Can be held in blood bank or delivered to OR
◉ Blood is never given unless what?
Answer: Approved by the anesthesiologist - they are the gatekeepers
according to the hospital's blood utilization committee and must
approve all blood administration in the OR
◉ What should blood be given with?
Answer: Normal saline
◉ How do we determine blood loss?
Answer: - suction canister (ask scrub tech)
- 4x4 = 10mL
- fully soaked lap = 100-150ml
,◉ Estimated blood volume:
- premature neonate
- full term neonate
- infant
- male adult
- Female adult
Answer: - 95 ml/kg
- 85 ml/kg
- 80 ml/kg
- 75 ml/kg
- 65 ml/kg
◉ Allowable blood loss as done in the M&M book & on the blood
admin ppt:
Answer: RBCvolume(currentHct) = EBV * (current Hct)
RBCvolume(LowHct) = EBV * (lowHct)
ABL = RBCv(current) - RBCv(lowHct)
Note this also works for EBL if they give you values.
,◉ When is transfusion usually recommended?
Answer: Hgb < 8 g/dL
Hct < 24%
Limit will be higher if pt has comorbidities
◉ How much will 1 unit of PRBCs increase Hgb and Hct in the
average adult?
Answer: Hgb by 1 g/dL
Hct by 2-3%
◉ What is the onset of a hemolytic transfusion reaction signaled by?
Answer: rapidly increasing temp, tachy, HTN OR
Hypotension, oozing surgical field, hematuria
◉ What is possible to occur rapidly with a hemolytic transfusion
reaction?
Answer: Shock, kidney failure, DIC
◉ TRALI symptoms can occur within what time frame?
, Answer: 6 hours
◉ Steps to take when hemolytic transfusion reaction occurs:
Answer: 1.Stop transfusion, call attending, notify blood bank,
support patient hemodynamics
2.Recheck unit against attached paperwork and patient id bracelet
3.Draw blood sample for blood bank(pink), coags(blue), and platelet
count(purple)
4.Insert catheter to check for hemoglobinurea
5.Osmotic diuresis with mannitol and iv fluids
◉ The AABB recommends against warming what?
What do studies show?
Answer: Platelets and cryo
No studies have shown it to be harmful
◉ Is it okay to use a blood filter that has previously filtered blood for
platelets infusion?
Answer: No, this is contraindicated
◉ What size filter do you use for platelet transfusion?
Answer: 170-200 micron filter, anything smaller will filter out the
platelets
