safe blood transfusion cffffffftftfffttftdr

Fffffftgggftft f fvfvg gbjuihbhibuhbhb bubble by gym gym by hg guy got us g he gu by gybgu gu gu

1. Competency-based Medical Bachelor Program “CBMBP”

2. Safe blood transfusion By Dr. Mohammed Hosny Fouda Ass.prof , of clinical pathology

3. Blood Products

4. Any therapeutic substance prepared from human blood: Whole blood Blood components Red Cell Concentrate and suspension Platelet Concentrate Plasma FFP Cryoprecipitate Cryosupernatent

5. Plasma Derivatives Human plasma proteins prepared from plasma under Pharmaceutical Manufacturing Conditions Albumin Coagulation factors concentrates Immunoglobulins

6. Principles of Clinical Transfusion Practices Avoid blood transfusion Transfusion is only one part of the patient’s management. Prevention and early diagnosis and treatment of Anemia & underlying condition Use of alternative to transfusion eg . IV fluids Good anesthetic and surgical management to minimized blood loss.

7. Prescribing should be based on national guidelines on the clinical use of blood taking individual patient needs into account. Hb level should not be the sole deciding Factor Clinical evaluation is important The clinician should record the reason for transfusion clearly. A trained person should monitor the transfused patient and if any adverse effects occur respond immediately.

8. Triggers of Component Transfusion The lowest thresholds for transfusion of components are: Hb level of 6-7g/dl. Clinical judgment FFP threshold: PT & PTT 1.5 times the upper limit of the normal range. Platelet threshold of: 10 000/µl- 20 000/µl for prophylactic transfusion 20 000/µl for BMA and Biopsy 50 000/µl for surgery, massive transfusion, Liver cirrhosis. 100 000/µl for surgery to brain or eye.

9. Blood Transfusion -Guidance and Regulations WHO recommendations

10. safe and adequate blood supply also clinical transfusion process Appropriate use of blood Collection samples, patient ID compatibility testing Administration of blood Adverse event reporting Hospital transfusion committee

11. Safety in blood transfusion Measures to protect donor : Should be voluntary Age from 17 – 60 years Weight above 50Kg Hemoglobin >13 g/ dL for men, >12 g/ dL for women Minimum donation interval of 12 weeks (16 weeks advised) with 3 donation per year maximum

12. 6- Exclusion of : Pregnant and lactating women Cardiovascular disease including hypertension Respiratory disorders Insulin dependent diabetes Chronic renal diseases Certain careers as drivers (bus ,plane , train) as delayed fainting is dangerous

13. Measures to protect recipient: Donor selection Microbiological tests of donations Immunoheamatological testing of donations Lecuodepletion of cellular products Monitoring and testing of bacterial contamination  

14. Microbiological tests of donation Must be done: HIV 1 and 2 Hepatitis B and C viruses Syphilis screening Should be done CMV May be done West Nile virus

15. Immunoheamatological testing of donations Blood grouping for donor and recipient Cross matching (pre transfusion testing)

16. Hazards and complications of blood transfusions Early: Hemolytic reaction: immediate or delayed Reactions caused by infected blood Allergic reactions to white cells, platelets or proteins Pyrogenic reactions (to plasma proteins or caused by HLA antibodies)

17. Circulatory over load Bacterial contamination Air embolism Thrombophilibitis Post transfusion purpura

18. Late: Transmission of infections Iron overload Transfusion-associated graft-versus-host disease

19. Hemolytic reaction: immediate or delayed Signs & Symptoms of a Transfusion Reaction Mild Reaction: Fever Urticaria Rash Pruritis

20. Severe Reaction: Pyrexia, rigors Hypotension Loin/Back Pain Increasing anxiety Pain at infusion site Respiratory Distress Dark urine Severe Tachycardia Unexpected bleeding (DIC)