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management diagnosis hematology reactions differential thresholds allergy blood bruising causes gibleed hypersensitivity pathophysiology product treatment types anemia anticoagulation aplastic cancer
Indications for Transfusion Packed RBCs • Hgb <7 g/dL or hematocrit <21% in a patient with uncompromised
hemoglobinopathy Platelets ... Prophylactically for platelet ... not transfuse platelets ... Platelet transfusions ... Management #RBCs #Platelets
Thresholds for Transfusion of Platelets in Adults Major surgery or invasive procedure, no active bleeding - ≤
Thresholds for Transfusion ... of Platelets in ... 100 (rarely) Stable ... #Management #Platelets ... #Transfusion #Plateletpheresis
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 Blood Product Transfusions One Pager Summary Type and screen - determines blood type and detects in recipient
donor (apheresis) platelets ... , due to anti-platelet ... common following platelet ... coagulopathy & ↑bleeding ... contamination: Platelets
Bleeding and Bruising - Differential Diagnosis Algorithm • Vascular System Defect - Congenital vs Acquired •
Bleeding and Bruising ... Differential Diagnosis Algorithm ... vs Acquired • Platelet ... vs Acquired #Bleeding ... Differential #Diagnosis #Algorithm
Thromboelastography (trademarked as TEG) • Graphical representation of the fibrin polymerization process • Point-of-care anti-coagulation monitoring
determining if transfusion ... algorithms and ... reduce number of transfusions ... amplitude • If ↓ → platelet ... deficiency → give platelets
Blood Transfusion Reactions Immune Mediated: • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
, due to anti-platelet ... Injury (TRALI): Leading ... common following platelet ... coagulopathy & ↑bleeding ... contamination: Platelets
Approach to Leukocytosis - Differential Diagnosis Algorithm Features of hematologic malignancy: • Symptoms: B-symptoms, bruising/bleeding, fatigue/weakness, immunosuppression
Differential Diagnosis Algorithm ... B-symptoms, bruising/bleeding ... anemia, ↑ MCV, ↑/↓ platelets ... Differential #Diagnosis #Algorithm
Causes of Bleeding / Bruising - Differential Diagnosis Algorithm Thrombocytopenia - Quantitative Defect • Decreased Production •
Causes of Bleeding ... Differential Diagnosis Algorithm ... Sequestration Disordered Platelet ... Coagulation #Bleeding ... Differential #Diagnosis #Algorithm
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
Findings: • Bleeding ... incompatible blood transfusion ... Findings in DIC: • Platelet ... Thrombocytopenia - Platelet ... hydration • RBC transfusion
Aplastic Anemia - Illness Script Signs and symptoms: • Recurrent infections from neutropenia • Mucosal bleeding from
neutropenia • Mucosal bleeding ... from low platelets ... Supportive care (transfusions
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