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A motorcycle accident
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Aggressive fluid resuscitation to correct tissue hypoperfusion within 24 hours of injury is associated with improved clinical outcomes. Initial volume expanders of choice are crystalloids, but there is no evidence to suggest that colloid expanders are any better or worse in this function. Blood and blood products may also be used in patients with severe blood loss.
Medicines management
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Kirsty Andrews, Martina O’Brien
Blood cells are fragile, so bags need careful handling, and some such as platelets are therefore never put through a pump which would crush them further. They are all infused through filtered giving sets, and blood products must also be used within 30 min of removal from the designated blood fridges they are kept in, otherwise the cells start to become damaged (Robinson et al. 2017).
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
IV fluid therapy may be: Crystalloid fluids: solutions containing molecules that pass freely through the semipermeable membranes of the body fluid compartments, for example, 0.9% saline, 5% dextrose and Hartmann’s solution.Colloid fluids: these contain large protein molecules that tend to remain in the circulation longer. Vascular fluid loss can be replaced with smaller volumes than if crystalloids are used. Colloids tend to be more expensive and do have a higher incidence of adverse effects than crystalloids.Blood and blood products: these include whole blood, packed red cells, fresh frozen plasma (FFP) and human albumin solution. These should be used to replace the loss of specific fluids, and not for general fluid resuscitation. Caution should be exercised, due to their high potential for causing adverse reactions and their expense.
Delayed blood transfusion is associated with mortality following radical cystectomy
Published in Scandinavian Journal of Urology, 2020
Wei Shen Tan, Ye Wang, Quoc-Dien Trinh, Mark A. Preston, John D. Kelly, David Hrouda, Adam S. Kibel, Ross E. Krasnow, Jen-Jane Liu, Benjamin I. Chung, Steven L. Chang, Matthew Mossanen
Transfusion of blood products were defined as transfusion of any blood products according to hospital charge description. Blood products were classified as packed red blood cells (PBRC), whole blood, fresh frozen plasma (FFP), platelets and cryoprecipitate. Early transfusion was defined as transfusion on the day of surgery and delayed transfusion defined as any transfusion from day one postoperative during the index admission. The following baseline patient variables were extracted: age (categorized by quartiles: ≤62 years, 63–69 years, 70–77 years, ≥77 years), sex (male, female), race (white, non-white), marital status (married, unmarried), insurance status (Medicare, Medicaid, private, other/unknown), and Charlson Comorbidity Index [CCI] (0, 1, ≥2). Clavian-dindo classification was defined using ICD-9 codes with major complications defined as grade III–V complications.
Blood product administration during high risk neuroblastoma therapy
Published in Pediatric Hematology and Oncology, 2020
Allison Silverstein, Kiranmye Reddy, Valeria Smith, Jennifer H. Foster, Heidi V. Russell, Sarah B. Whittle
These results show that as therapy has intensified over time, so too have exposures to blood products. Blood product transfusions carry several medical and non-medical risks. Increases in transfusion requirements likely lead to additional or longer clinic visits, hospitalizations, and emergency room visits, all of which contribute to the burden of diagnosis to a family including time away from work, school and home, and costs to both the family and medical system. Medical risks of transfusion include acute risks such as transfusion reactions, viral and bacterial infections, and chronic risks including immune injury and modulation and transfusional iron overload.9,17–19 While little is known regarding long-term effects from platelet transfusions, repeated red blood cell transfusions are known to cause iron overload.9,18
Assessing guideline adherence in patients with non-variceal upper gastrointestinal bleeding receiving antiplatelet and anticoagulant therapy
Published in Scandinavian Journal of Gastroenterology, 2019
Carolin Vogt, Gabriel Allo, Martin Buerger, Philipp Kasper, Seung-Hun Chon, Johannes Gillessen, Tobias Goeser, Christoph Schramm
High risk endoscopic stigmata were defined as Forrest Ia, Ib, IIa and IIb lesions, low risk endoscopic stigmata as Forrest IIc and Forrest III lesions [14]. Low and medium thromboembolic risk was defined as deep vein thrombosis or pulmonary embolism beyond 3 months, CHA2DS2-VASc-score <6 points, and biological heart valve replacement. High thromboembolic risk was defined as deep vein thrombosis or pulmonary embolism within 3 months, atrial fibrillation and stroke within 3 months, mitral valve replacement, use of older aortic valve device, two or more heart valve replacements, CHA2DS2-VASc-score of ≥6 points, heart valve replacement and thromboembolism, or severe thrombophilia (homozygous factor V mutation, antiphospholipid syndrome, protein c, protein s and antithrombin deficiency). Major bleeding was defined as the need for packed red blood cells, drop in haemoglobin level of ≥2 g/dL or absolute haemoglobin level <8 g/dL. Comorbidities were assessed using the Charlson comorbidity index (CCI). Specialty of treating physicians was grouped into internal medicine and other specialties. Follow-up period was defined as time period between index endoscopy and hospital discharge or death. Blood products included platelet concentrates, fresh frozen plasma, and single or combination of coagulation factors.