Clinical use of blood, blood products and replacement fluid Obstetric care may require blood transfusions. It is important to use blood, blood products and replacement fluids appropriately and to be aware of the principles designed to assist health workers in deciding when (and when not) to transfuse.
Full Answer
What is the clinical use of blood?
GENEVA 1 Introduction The Clinical Use of Blood forms part of a series of learning materials developed by WHO/BTS in support of its global strategy for blood safety.
What is the clinical use of blood Handbook?
The Clinical Use of Blood The Clinical Use of Blood Handbook World Health Organization Blood Transfusion Safety GENEVA 1 Introduction The Clinical Use of Blood forms part of a series of learning materials developed by WHO/BTS in support of its global strategy for blood safety.
Why is the availability and appropriate use of blood products important?
Thus, the availability and appropriate use of the various blood products allows not only optimal transfusion therapy for each patient, but also fuller utilization of national blood resources. MeSH terms
When can the prescribing clinician override the blood ordering schedule?
Each hospital transfusion committee should agree a procedure for the prescribing clinician to override the blood ordering schedule when it is probable that the patient will need more blood than is stipulated: for example, if the procedure is likely to be more complex than usual or if the patient has a coagulation defect.
What do hospitals use blood for?
Blood transfusions are given to patients in a wide range of circumstances, including serious injuries (such as in a car crash) surgeries, child birth, anemia, blood disorders, cancer treatments, and many others.
What set is used for blood transfusion?
Y-type sets can be primed with blood or Normal Saline. Usually, a new set is used for each component transfused. If 2 units are to be given consecutively and they are ABO compatible with one another, one set may be used for both as long as they are infused within 4 hours.
Can blood be used as medicine?
In high-income countries, blood products are most commonly used to support advanced medical and surgical procedures, including treatments of cancer and haematological diseases, trauma resuscitation, cardiovascular surgery and transplantation.
What is blood component therapy?
Transfusion of one or more of the components of whole blood. The blood components may have been taken from the patient previously (autologous transfusion) or donated by someone else (homologous transfusion). Except in the case of acute hemorrhage, the transfusion of whole blood is rarely needed.
What is BT set?
Romsons Blood Administration Set (BT Set) is a standard non-vented set with mounded drip chamber and build-in spike.
What is BT set in medical?
- Specially designed for transfusion of blood and blood components. - Specially designed roller clamp for better flow control & precise adjustment of infusion rate.
When do we use blood products?
They are generally given to patients who have severe reactions to plasma (eg, severe allergies, paroxysmal nocturnal hemoglobinuria, IgA immunization). In IgA-immunized patients, blood collected from IgA-deficient donors may be preferable for transfusion.
Why is bloodletting considered as therapeutic phlebotomy?
Therapeutic phlebotomy has several physiological mechanisms. For example, bone marrow stem cells are stimulated by bloodletting to generate new red blood cells (RBCs), which requires the transport of iron (in the ferritin form) from the body's stores to create hemoglobin (Hb).
Why did doctors use bloodletting?
In 18th-century Europe, surgeons continued to use bloodletting as a treatment for fever, hypertension (high blood pressure), inflammation of the lungs, and pulmonary edema (excess fluid in the lungs). Some physicians had even wider uses for this allegedly therapeutic method.
What is blood processing?
Blood banking is the process that takes place in the lab to make sure that donated blood, or blood products, are safe before they are used in blood transfusions and other medical procedures. Blood banking includes typing the blood for transfusion and testing for infectious diseases.
Why would you need a blood transfusion?
Blood transfusions are used for patients who have experienced serious injuries from car crashes or natural disasters. Individuals with an illness that causes anemia, such as leukemia or kidney disease, will often be the recipients of blood transfusions.
What are the 4 main components of blood and their functions?
What are the components of blood?Red blood cells (RBCs) carry oxygen to the body. Each RBC lives for about 4 months. ... White blood cells (WBCs) are part of the body's immune system. WBCs help fight infections and diseases. ... Platelets are cells that help with clotting. ... Plasma is the liquid portion of blood.
What should the clinician record when transfusing blood?
The clinician should record the reason for transfusion and investigate any adverse effects. PRESCRIBING BLOOD. Prescribing decisions should be based on national guidelines on the clinical use of blood, taking the woman’s needs into account.
Why is it important to use blood products?
It is important to use blood, blood products and replacement fluids appropriately and to be aware of the principles designed to assist health workers in deciding when (and when not) to transfuse. The appropriate use of blood products is defined as the transfusion of safe blood products to treat a condition leading to significant morbidity ...
What are the principles of transfusion?
Decisions about prescribing a transfusion should be based on national guidelines on the clinical use of blood, taking the woman’s needs into account. Blood loss should be minimized to reduce the woman’s need for transfusion.
How long after transfusion do you send blood samples?
After the initial investigation of the transfusion reaction, send the following to the blood bank for laboratory investigations: - blood samples at 12 hours and 24 hours after the start of the reaction: - 1 clotted; - 1 anticoagulated (EDTA/sequestrene) taken from the vein opposite the infusion site;
What is the risk of red blood cells?
The transfusion of red cell products carries a risk of incompatible transfusion and serious haemolytic transfusion reactions. Blood products can transmit infectious agents—including HIV, hepatitis B, hepatitis C, syphilis, malaria and Chagas disease—to the recipient.
How does blood transfusion help?
Used correctly, blood transfusion can save lives and improve health. As with any therapeutic intervention it may, however, result in acute or delayed complications and it carries the risk of transmission of infectious agents. It is also expensive and uses scarce resources.
What conditions require blood transfusion?
Conditions that may require blood transfusion include: postpartum haemorrhage leading to shock; loss of a large volume of blood at operative delivery; severe anaemia, especially in later pregnancy or if accompanied by cardiac failure. Note: For anaemia in early pregnancy, treat the cause of anaemia and provide haematinics.
What is the threshold for RBC transfusion?
Upon entering an order for RBC transfusion, the intern received an interruptive BPA, which stated that “Strong evidence suggests that in hemodynamically stable, non-bleeding patients, an Hb threshold of 7 g/dL (or 8 g/dL in acute coronary syndromes after cardiac surgery) can decrease transfusion requirements and avoid adverse outcomes.” There was an option to remove the transfusion order or proceed with the order if clinically indicated. The intern reviewed the case with his senior resident, which prompted a discussion of the evidence that a restrictive transfusion strategy (transfusion when Hb level is <7 g/dL) significantly improved outcomes in patients with acute upper GI bleeding when compared with a liberal strategy (transfusion when Hb level is <9 g/dL). 17 The intern removed the transfusion order. The patient remained hemodynamically stable and did not require any further RBC transfusions.
What is restrictive transfusion?
Restrictive transfusion practice is a key element of PBM, incorporating the principle of giving RBC transfusions only when the potential benefits are deemed to outweigh potential risks, along with a goal of minimizing the use of RBC units. 2 Improving blood safety and promoting restrictive blood transfusion practices first gained impetus in the 1980s in response to the recognition that hepatitis C virus and HIV were transmitted by blood transfusion. 4 Since then, despite substantial advances in safety with respect to infections transmitted by transfusion, evidence has accumulated to indicate that RBC transfusion continues to be associated with other short- and long-term adverse patient outcomes. Institutional experience and national databases indicate that a restrictive RBC transfusion approach and other measures to minimize the use of RBC transfusion, such as detection and management of preoperative anemia, 2 began to have an impact as best practices when RBC transfusions began to decline annually in the United States starting in 2010. 4
What blood pressure was hematemesis?
A 64-year-old woman presented to the emergency department with hematemesis. On presentation, she had a systolic blood pressure of 70 mm Hg and heart rate of 140 beats per minute (bpm). Her hemoglobin (Hb) concentration was 6 g/dL. She received 2 L of crystalloid fluids and was transfused with 3 units of packed red blood cells (RBCs). Emergent upper endoscopy revealed a bleeding gastric peptic ulcer that was clipped. She was transferred to the intensive care unit where she was evaluated by the on-call medicine intern. She denied any current chest pain, shortness of breath, lightheadedness, dizziness, or hematemesis. Her blood pressure was now 130/80 mm Hg and her heart rate was 80 bpm. Her Hb was 8.1 g/dL. Unaware of evidence suggesting that a restrictive transfusion strategy would be appropriate in the setting of acute upper gastrointestinal bleeding, the admitting intern ordered a transfusion of 1 unit of packed RBCs. How can clinical decision support (CDS) reduce such inappropriate transfusions?
Abstract
Blood pressure measurement in clinical care settings seldom follows the protocol recommended by national guidelines, potentially leading to overestimates or underestimates of blood pressure control.
Introduction
High blood pressure is a cause of major illness and death in the United States. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) established guidelines for the accurate measurement of blood pressure to aid in diagnosis and clinical management (1,2).
Methods
Data for this analysis were collected in conjunction with the Evaluating Community Peer Advisors and Diabetes Outcomes in Rural Alabama (ENCOURAGE) study, a group-randomized pragmatic trial of the effect of community peer advisors on diabetes outcomes. The details of recruitment and data collection are provided elsewhere (6,7).
Results
The study sample had 227 participants with diabetes ( Table 1 ). Their mean age was 59 years; 86% were black and 74% were women. Thirty percent of participants were using 3 or more medications for their blood pressure, and 17% were not taking any medications for blood pressure.
Discussion
In this study of 227 community-dwelling adults with diabetes, we found that blood pressure measured following typical approaches used in physician offices resulted in higher blood pressure assessments for most patients compared with measures obtained using the same equipment but closely following JNC-7 recommendations.
Acknowledgments
This work was funded by the American Academy of Family Physicians Foundation Peers for Progress program and the University of Alabama at Birmingham School of Medicine. Dr Safford was also supported through a midcareer faculty development award from the National Heart, Lung, and Blood Institute of the NIH (K24HL111154).
Tables
Table 1. Characteristics of the Study Sample of Community-Dwelling Adults With Diabetes (n = 227), Overall and by Difference in Systolic Blood Pressure a, Alabama, 2010–2011
What is clinical diagnosis?
Clinical diagnosis is the process of using assessment data to determine if the pattern of symptoms the person presents with is consistent with the diagnostic criteria for a specific mental disorder outlined in an established classification system such as the DSM-5 or I CD-10 (both will be described shortly). Any diagnosis should have clinical utility, meaning it aids the mental health professional in determining prognosis, the treatment plan, and possible outcomes of treatment (APA, 2013). Receiving a diagnosis does not necessarily mean the person requires treatment. This decision is made based upon how severe the symptoms are, level of distress caused by the symptoms, symptom salience such as expressing suicidal ideation, risks and benefits of treatment, disability, and other factors (APA, 2013). Likewise, a patient may not meet the full criteria for a diagnosis but require treatment nonetheless.
What is the purpose of a CT scan?
Finally, computed tomography or the CT scan involves taking X-rays of the brain at different angles and is used to diagnose brain damage caused by head injuries or brain tumors. 3.1.3.5. Physical examination.
Does receiving a diagnosis mean you need treatment?
Receiving a diagnosis does not necessarily mean the person requires treatment. This decision is made based upon how severe the symptoms are, level of distress caused by the symptoms, symptom salience such as expressing suicidal ideation, risks and benefits of treatment, disability, and other factors (APA, 2013).