Perf Tech 3 Test 4

Question 1

Transfusion Risks

Answer 1

• infectious
• febrile reactions (fever, chills)
• uticarial reaction (allergy)
• anaphylactice reactions
• acute hemolytic reaction
• volume overload
• hypothermia
• citrate toxicity
• potassium effects
• TRALI (transfusion related acute lung injury)

Question 2

Techniques

Answer 2

1) auto donation
2) Prebypass autologous normovolemic hemodilution
3) retrograde autologous priming
4) dry venous line
5) mini circuits
6) ultrafiltraion/hemoconcentrator
7) Cell saver
8) re-infusion of shed blood
9) accept lower Hct

Question 3

Auto Donation

Answer 3

patient donates own blood (can done just RBC, platelets, or plasma)

• must have Hct >33%
• contra= MI, CHF, stenosis, ischemia, HTN, angina

Question 4

Prebypass Autologous Normovolemic Hemodilution

Answer 4

take blood from patient and replace with crystalloid

• must have Hct >35%
• spares platelets from bypass, remove 500-1000ml
• place in bag with anticoagulants and given after protamine
• contra- COPD, CHF, CAD, angina, valve issues, clotting issues

Question 5

Retrograde Autologous Priming

Answer 5

uses patients BP to displace prime (200-600ml)

remove from ALF stopcock, manifold, Y’s

Question 6

Dry Venous Line

Answer 6

requires VAVD, venous line emptied before connection to cannula
-only works if patient has enough volume pre-op

Question 7

Mini Circuits

Answer 7

-lowers foreign SA, prime, air, hemodilution, inflammatory,, volume shifts
-no reservoir, HE, ALF
-centrifugal pump acts as BF and venous drainage
Ways to make pump better?
—shorten lines, closer to table, raise reservoir, dry venous line, lower prime

Question 8

Ultrafiltration/Hemoconcentration

Answer 8

removing water, Na, K, bicarb from blood

Zbuff, MUF (afterwards)

Question 9

Cell Saver

Answer 9

separate RBC. but loose plasma proteins, platelets, CF

Question 10

Re-infusion of shed blood

Answer 10

blood into cell saver and delivered right back (without washing)
-only in emergencies and increases free Hgb, defibrination

Question 11

Accept lower Hct

Answer 11

20-25%

-but if low clotting factors, high metabolic needs, respiratory issues= you NEED higher HCT

Question 12

Platelet

Answer 12

150-450 x 10^3/uL of blood
2-3 um
7 day life spans
derived from magakaryocyte in bone marrow

Question 13

3 Phases of Wound Healing

Answer 13

1) Inflammation (day 4-6)- hemostasis, pro-inflammatory cytokines, phago
2) Proliferation (day 6 to 2/3 weeks)- tissue granulation, fibroblasts lay collagen, angiogenesis, epitheliazation (cells migrate), wound edges touch
3) Maturation (21 days to 2 yr)- collagen maturation/stabilization, increase strength, scar tissue, 80% of strength

Question 14

Platelet Growth Factors

Answer 14

1) Platelet Derived GF (PDGF)- collagen
2) Vascular Endothelial GF (VEGF)
3) Transforming GF Beta (TGF-B)
4) Fibroblast GF (FGF)- tissue repair, contraction
5) Epithelial GF (EGF)- keratinocyte migration

Question 15

Platelet Rich Plasma (PRP)

Answer 15

• centrifugation process + thrombin, Ca
• harnesses platelets and GF
• contains 3-7x baseline platelet/GF
• increase healing, lowers infections/pain/swelling/scaring
• apply for chronic/nonhealing wounds, dental, orthopedic, plastic, cardio

Question 16

Harvest Machine Doses

Answer 16

• for 20 mL- pull 3 ACDA, put 1 in white cap, then pull 20ml blood and put in red cap
• for 60 mL- pull 8 ACDA, put 2 in white cap, then pull 60mL blood and put in red cap