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Medicines management
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Kirsty Andrews, Martina O’Brien
Whole blood is now rarely given to because there are alternative products that can be used that are less difficult and costly to collect but are just as effective. So, packed cells, plasma and platelets are given where there is a specific need (e.g. a person with low platelets after chemotherapy), but if the individual has lost blood and is still medically stable, intravenous fluids may provide sufficient replacement while their body manufactures more blood cells.
Management of the Sick Child
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
This is shock in the context of external or internal haemorrhage identified clinically. Bleeding can result from trauma, gastrointestinal bleeding, splenic rupture (secondary to sickle cell disease, malaria or trauma), dengue haemorrhagic fever or other haemorrhagic fevers. Haemoglobin may initially be normal, as it takes time to fall to reflect blood loss. Stop any visible bleeding via tourniquet, pressure bandage or surgical haemostasis before and during assessment of ABCDE.4,6 As always in ABCDE approach, provide oxygen, support airways/ventilation as needed, ensure vascular access and monitor vital signs. Order O-negative blood, or type-specific if facilities allow. Give bolus 20 ml/kg Ringer’s lactate IV/IO and repeat up to three times until blood is available. Transfuse 20 ml/kg whole blood as fast as possible and repeat as needed. Keep the patient warm, insert an NG tube and prepare for transfer once stable.
Damage Control Resuscitation
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Replacing lost blood with whole blood has been advocated – this is hard to deliver except in well-resourced trauma systems. Whole blood in RLE can be circumvented to an extent with a donor panel but this requires both measures to assure blood safety, minimise risk, and access the donation equipment and laboratory facilities to test compatibilities.
Preparation and exchange transfusion effect of a double polymerization human umbilical cord haemoglobin of red blood cell substitute
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2023
Wentao Zhou, Shen Li, Shasha Hao, Xintong Xie, Honghui Zhang, Jiaxin Liu, Hong Wang, Chengmin Yang
A transfusion-related event occurs every 2 s in the United States (US), approximately 300 million units of red blood cells (RBCs) are used clinically each year, and this trend is also increasing significantly [1]. Study has pointed out that only about 3% of age-eligible people donate blood, resulting in a blood donation rate and blood amount that fall short of current needs [2]. Nearly 35% of prehospital deaths in trauma is haemorrhage, and haemorrhagic shock (HS) accounts for about 20% of military casualties are on arrival to field hospitals and an additional 5% require urgent transfusion [3,4]. A review [5] reported that nearly 90% of potentially survivable battlefield deaths was haemorrhage, and if better haemorrhage control include field-ready blood, blood components, or blood substitutes the lives should could be saved. However, there are certain risks and limitations associated with transfusion of whole blood (WB) or RBCs. So the high and fast-growing demand for the substitute of WB or RBCs at the sites of need is necessary.
Snakebite-associated thrombotic microangiopathy: a spotlight on pharmaceutical interventions
Published in Expert Review of Clinical Pharmacology, 2023
Tina Noutsos, Geoffrey K Isbister
Like antivenom, FFP is also a WHO essential medicine and has specialized clinical governance requirements around all steps of its transfusion-related processes – from blood donation, manufacture, and administration [66]. Blood products such as FFP require effective and efficient governance, regulatory oversight, and procurement systems for collection and processing, testing for transmissible diseases, storage, and transport, which all contribute to its significant cost. These special requirements can clearly pose more of a challenge in low to low-middle income countries where snakebite is most common. However, even the most resource-limited countries typically undertake whole blood donation, fractionation into separate components including plasma, and supply to hospitals [69]. WHO surveys show that low income countries, including tropical and subtropical countries where snakebite is most common, typically have higher ratios of whole blood donations versus apheresis donations, less relative contributions from voluntary non-remunerated donors versus family or paid donors, less processing into components including FFP (50% donations in low income versus 96% high income countries), and lower capacity for 100% coverage of screening of blood donors for transmissible diseases [70].
Targeted drug delivery via folate decorated nanocarriers based on linear polymer for treatment of breast cancer
Published in Pharmaceutical Development and Technology, 2022
Mostafa Zamani, Mozhgan Aghajanzadeh, Ali Sharafi, Kobra Rostamizadeh, Hossein Danafar
Whole blood was collected in blood collection tubes. Blood was centrifuged (4500 rpm, 6 min) to separate red blood cells (RBCs). Then, RBCs were suspended in PBS. RBCs suspension (1 ml) was mixed by PBS (negative control), distilled water (positive control), CUR-loaded FA-PEG-PCL, and CUR-loaded mPEG-PCL separately in different tubes. The tubes were shaken for 4 h at 37 °C. Then, the tubes were centrifuged (12 000 rpm, 10 min), and the absorbance of the supernatants of the centrifuged tubes which contained lysed RBCs were determined at 540 nm by UV–Vis spectrophotometer (Spectro UV–Vis Auto UV-2602). The hemolysis percent of the prepared samples were determined through the comparison of the absorbance of the prepared samples with the absorbance of the positive and negative controls.