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

In chronic anaemia the patient In chronic anaemia the patient should be transfused to:should be transfused to:

Maintain the Hb above 10.0

Maintain the Hb just above the concentration which is not associated

with symptoms of anaemia

Maintain the Hb above 12.0

Maintain the Hb above 9.0