BY
Dr
HAYDER M. ABDULNABI
DM, CABS
29/02/1429
TYPES OF BLEEDING
DEPNDING ON THE SOURSE
OF BLEEDING
1- ARTERIAL BRIGHT RED AND
COMES IN JETS WITH THE PULSE
OF THE PATIENT
2- VENOUS DARK RED BLOOD ,
STEADY AND COPIOUS
3- CAPILLARY BRIGHT RED RAPID
OOZE ( ABRASIONS )
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TREATMENT
1- PRESSURE ON THE SITE OF BLEEDING
BY PACKING OR DIGITS OR BALOONS
INFLATED AT THE SITE OF BLEEDING
( ESOPHAGEAL VARICES)
2- REST AND POSITION BY ELEVATION
OF THE INJURED LIMB TO DECREASE
BLOOD RETURN TO THE HEART
3- OPERATIVE PROCEDURES BY USING
HEMOSTATS, CLIPS, DIATHERMY,
LIGATURES, GELATIN SPONGES, AND
ADRENALIN SOACKED GAUZE ( 1: 1000 )
4- BLOOD TRANSFUTION
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INDICATION OF BLOOD
TRANSFUSION
1- ANEMIA-- RECENT STUDY SHOWED
THAT A TRANSFUSION THRESHOLD OF
70G/L WAS AS SAFE AND POSSIBLY
SUPERIOR TO ONE OF 100G/L IN
CRITICAL CARE PATIENTS. A MINIMUM
PREOPERATIVE HAEMOGLOBIN OF
100G/L IS NO LONGER REGARDED AS
ESSENTIAL, AS MANY PATIENTS WITH A
LOWER HAEMOGLOBIN TOLERATE
SURGERY AND SEEM TO RECOVER JUST
AS WELL.
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Autologous transfusion
THERE ARE THREE TYPES OF AUTOLOGOUS
TRANSFUSION:
PREDEPOSIT. THE PATIENT DONATES 25 UNITS OF- 1
BLOOD AT APPROXIMATELY WEEKLY INTERVALS
.BEFORE ELECTIVE SURGERY
PREOPERATIVE HAEMODILUTION. ONE OR TWO- 2
UNITS OF BLOOD ARE REMOVED FROM THE PATIENT
IMMEDIATELY BEFORE SURGERY AND
.RETRANSFUSED TO REPLACE OPERATIVE LOSSES
BLOOD SALVAGE. BLOOD LOST DURING OR AFTER- 3
SURGERY MAY BE COLLECTED AND RETRANSFUSED.
SEVERAL TECHNIQUES OF VARYING LEVELS OF
SOPHISTICATION ARE AVAILABLE. OPERATIVE SITE
MUST BE FREE OF BACTERIA, BOWEL CONTENTS,
.AND TUMOUR CELLS
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Complications of blood
transfusion
1-- Immediate haemolytic transfusion
reactions
This is the most serious complication of blood
transfusion and is usually due to ABO
incompatibility. There is complement activation
by the antigen-antibody reaction, usually due to
IgM antibodies, leading to rigors, lumbar pain,
dyspnoea, hypotension, haemoglobinuria, and
renal failure. At the first suspicion of any serious
transfusion reaction, the transfusion should
always be stopped and the donor units returned
to the blood transfusion laboratory with a new
blood sample from the patient to exclude a
.haemolytic transfusion reaction
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NON-HAEMOLYTIC (FEBRILE)-- 3
TRANSFUSION REACTIONS
FEBRILE REACTIONS ARE A COMMON
COMPLICATION OF BLOOD
TRANSFUSION IN PATIENTS WHO HAVE
PREVIOUSLY BEEN TRANSFUSED OR
PREGNANT. THE USUAL CAUSE IS THE
PRESENCE OF LEUCOCYTE ANTIBODIES
IN THE RECIPIENT ACTING AGAINST
TRANSFUSED LEUCOCYTES, LEADING TO
RELEASE OF PYROGENS. TYPICAL SIGNS
ARE FLUSHING AND TACHYCARDIA,
FEVER (>38C), CHILLS, AND RIGORS.
PARACETAMOL MAY BE USED TO
. REDUCE THE FEVER
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5 TRANSMISSION OF INFECTION
HEPATITIS, HUMAN IMMUNODEFICIENCY VIRUS
OTHER VIRUSES: CYTOMEGALOVIRUS, EPSTEIN
BARR VIRUS, HUMAN T-CELL
LEUKAEMIA/LYMPHOMA VIRUS TYPE 1 (HTLV-1)
PARASITES: MALARIA, TRYPANOSOMIASIS,
TOXOPLASMOSIS SYPHILIS AND TRANSFUSION
OF BLOOD CONTAMINATED WITH BACTERIA
CIRCULATORY FAILURE DUE TO VOLUME-- 6
OVERLOAD.7-- IRON OVERLOAD DUE TO
MULTIPLE TRANSFUSIONS. 8-- MASSIVE
TRANSFUSION OF STORED BLOOD MAY CAUSE
BLEEDING AND ELECTROLYTE CHANGES. 9-THROMBOPHLEBITIS 10-- AIR EMBOLISM
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