ADVERSE EFFECT OF TRANSFUSION — Transcript

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1. 0:05assalamualaikum and good day students
2. 0:08this is the lecture on adverse effects
3. 0:11of transition so
4. 0:13first i start with a real-life situation
5. 0:16in which a mother had a complication
6. 0:20after
7. 0:21given a wrong blood this is a very real
8. 0:24history happened in our country
9. 0:26in which a mother which has a black
10. 0:29group o was given a blood group b
11. 0:33so the point that i want to highlight
12. 0:36here is
13. 0:37the complications of blood transfusion
14. 0:40is very real and we at the healthcare
15. 0:43professional be it doctors or nurses
16. 0:46need to aware that this complication can
17. 0:49happen and we need to do anything to
18. 0:52prevent this kind of complication
19. 0:55all right so for the lecture proper
20. 0:58i will introduce you to the definition
21. 1:01of transmission duration as we know
22. 1:03blood transfusion is an irreversible
23. 1:06event in which we need to weigh the
24. 1:10benefits against the risk of a
25. 1:13particular blood transfusion to the
26. 1:14recipients the transfusion reaction is
27. 1:17defined as any unfavorable transfusion
28. 1:20related event
29. 1:21occurring in a patient during or after
30. 1:24transition
31. 1:25of blood or blood component when you
32. 1:28read many books you will see there are
33. 1:30many classifications occur
34. 1:33some of the books will classify the
35. 1:35translation reaction
36. 1:37based on the underlying mechanism of how
37. 1:40does that happen
38. 1:42some of the book will classify it based
39. 1:45on the course
40. 1:46of
41. 1:47the complication and some of the book
42. 1:50will classify it based on the timing of
43. 1:52the complication
44. 1:54many of the books classify this as
45. 1:57hemolytic complication against
46. 1:59non-hemolytic complications infectious
47. 2:02against non-infectious complications
48. 2:04immune against non-immune complications
49. 2:07or acute against delayed complication
50. 2:10these complications of blood transfusion
51. 2:12are mostly mild with overall incidence
52. 2:15of one to two percent
53. 2:17but however we have fatalities
54. 2:20around one in one hundred thousand to
55. 2:22five hundred thousand patient transfuse
56. 2:25and majority of deaths were because of
57. 2:28preventable errors and half of the
58. 2:31deaths are due to incompatibilities
59. 2:34in which
60. 2:35patient was given wrong blood and this
61. 2:38can occur in 1 in 6 000 to 30 000
62. 2:42patients
63. 2:44what are the common errors that can
64. 2:46happen and also leading to complication
65. 2:49of the solution
66. 2:51the first one is
67. 2:52patient
68. 2:53misidentification this is most important
69. 2:56when you we want to
70. 2:58identify a patient
71. 3:00for blood sample before we want to
72. 3:02transfer the patient and also
73. 3:05identification of the patient when we
74. 3:07want to transfuse a patient with a blood
75. 3:10component the second one will be the
76. 3:12sample error the subsequent reason is
77. 3:14wrong sample was issued in which there
78. 3:17are a sample mix up in a ward for
79. 3:21example if there are more than one
80. 3:23patients that need transfusion
81. 3:25so we want to take blood for
82. 3:27pre-transmission testing but there will
83. 3:29be a risk of
84. 3:31mixing of blood from different patients
85. 3:33if we take the blood sample together at
86. 3:37the same time other errors can happen is
87. 3:40transcription errors in which
88. 3:42we probably
89. 3:44label or wrongly fill in the blood
90. 3:47request form
91. 3:49administration area as i have mentioned
92. 3:51in which we have transfused
93. 3:54wrong patient to a particular blood
94. 3:57the subsequent one is the
95. 3:59technical and also the storage error
96. 4:03okay
97. 4:04let's discuss about the causes of the
98. 4:07complication
99. 4:08in here i have divided it into a
100. 4:12non-immune and immune complication and
101. 4:14also acute and delayed complication
102. 4:17acute complication usually when the
103. 4:20complication happens within the 24 hours
104. 4:23of transmission
105. 4:25in which delayed after 24 hours up to
106. 4:29months after the transition
107. 4:33the non-immune complication in which
108. 4:35there are not a direct immune mechanism
109. 4:39involved in that complication whereas in
110. 4:42immune complication there are direct
111. 4:44immune mechanisms that cause the
112. 4:46complication
113. 4:48so the acute non-immune complication
114. 4:50will be for example
115. 4:53bacterial contamination
116. 4:55hypothermia
117. 4:57hypocalcemia which is usually
118. 5:00occur in infants
119. 5:02air embolism and also volume overload
120. 5:07for immune complication in acute phase
121. 5:10of transfusion is fibril non-hemolytic
122. 5:13transfusion reaction
123. 5:15acute hemolytic transfusion reaction
124. 5:18allergic reaction anaphylactic reaction
125. 5:21and transfusion related acute lung
126. 5:23injury which sometimes we call as trilli
127. 5:26the delayed non-immune complication will
128. 5:28be all the infectious complications such
129. 5:31as hiv infection hepatitis b and c
130. 5:35cmv or
131. 5:36cytomegalovirus other virus such as
132. 5:39bipolar virus b19 infection
133. 5:42hypothetis a malaria chagas disease and
134. 5:46also the iron overload
135. 5:48the immune complication is delayed in
136. 5:51molecular transformation reaction
137. 5:53post transfusion popula or what we call
138. 5:56as ptp
139. 5:57transformation associated graph versus
140. 5:59host disease or thg phd and also immune
141. 6:02modulation
142. 6:04some of the common ones will be
143. 6:05discussed in this lecture but the less
144. 6:08if you want to know more you need to
145. 6:10read about it
146. 6:13okay what are the possible signs and
147. 6:15symptoms of a blood or blood component
148. 6:17transmission reaction this is very
149. 6:20important for you especially the nurses
150. 6:22because you are the first liner
151. 6:24that usually be there
152. 6:27at the bedside of the patient most of
153. 6:29the time okay
154. 6:31so you need to be aware that these are
155. 6:34the possible signs symptoms of a
156. 6:37translation reaction
157. 6:39okay we have the pyrexia which is fever
158. 6:42righteous
159. 6:43hemoglobinuria nausea vomiting
160. 6:46breastlessness and coughing restlessness
161. 6:49agitation and confusion
162. 6:52flushing pain in at the chest abnormal
163. 6:54muscle bone or loin arty carrier in
164. 6:58which the patient will complain of the
165. 6:59rash which is an itchy rash
166. 7:02diarrhea headache abnormal bleeding
167. 7:05collapse or sometimes the patient
168. 7:07generally feeling unwell so when a
169. 7:10patient undergoing a blood transfusion
170. 7:12and they are complaining that they are
171. 7:14not feeling very well so you must take
172. 7:17that complaint very seriously
173. 7:20it might indicate the earlier signs and
174. 7:22symptoms of a blood transfusion reaction
175. 7:26okay