CICM SAQ 2012.2 Q1
Questions
A 43-year-old woman is transferred to your Intensive Care Unit from a regional hospital following a motor vehicle crash. She is in haemorrhagic shock secondary to abdominal and pelvic trauma and received 3L crystalloid and 8 units O Rh(D) negative blood prior to arrival in your hospital.
a) What are the risks of giving O negative uncrossmatched blood to this patient?
b) Indicate whether crossmatch is needed or not for each of the following blood products:
- Packed red blood cells
- Platelets
- Fresh frozen plasma
- Cryoprecipitate
- Prothrombin concentrate
- Granulocyte concentration
- Intravenous immunoglobulin
Answers
Answer and interpretation
a) What are the risks of giving O negative uncrossmatched blood to this patient?
Risks common to all blood transfusions
- infection, allergy, haemolysis, TRALI, fluid overload, dilutional coagulopathy, etc
Risks specific to O-ve uncrossmatched
- Mixed field group and screen (unclear blood group)
- Prolong group and cross match if specimen not taken before.
Non-ABO, non Rh (D) antigens/antibodies leading to allo-immunisation (sensitization) and delayed haemolytic reactions
b) Indicate whether crossmatch is needed or not for each of the following blood products:
- Packed red blood cells — YES
- Platelets — NO
- Fresh frozen plasma — NO
- Cryoprecipitate — NO
- Prothrombin concentrate — NO
- Granulocyte concentration — YES
- Intravenous immunoglobulin — NO
Examination Library
CICM
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
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