Unit 2 - Transfusion Therapy

Indicative Content
In this Unit you will learn about:

• Transfusion in Surgery and Critical Care
  
• Transfusion in Medical Patients
  
• Obstetric Transfusion
  
• Transfusion in Children
  
• Transfusion in Transplantation Medicine

Learning Outcomes
You will be expected to:

1.  Describe, explain, categorise the following with respect to transfusion in surgery, and evaluate and recommend management strategies for 

a.   Pre-operative assessment including anaemia and coagulation         
      problems

b.   Cell salvage and blood sparing surgery

c.   Acute bleeding 

d.   Post-operative transfusion thresholds

e.   Cardiac surgery and bypass  

2.   Describe, explain, categorise the routine and/ or restrictive use of red cell/ platelets/ plasma with respect to transfusion in critically ill patients. Evaluate and explain transfusion triggers and threshold; recommend management strategies 

3.   Describe and explain the following with regard to major haemorrhage for a range of different patient groups 

a.   The physiology of shock and trauma induced coagulopathy

b.   The acute management of major haemorrhage including
      pharmacological treatments and transfusion management

c.   The use of near patient testing in major haemorrhage 

d.   Emergency transfusion outside the hospital setting and selection of
      appropriate blood components 

4.   Evaluate and recommend transfusion management strategies for a range of inherited haemoglobinopathies.

5.   Determine and explain the problems associated with chronic transfusion such as iron overload in haematological diseases

6.   Describe, evaluate and recommend strategies for transfusion management of patients with warm and cold auto-immune haemolytic anaemia, autoimmune thrombocytopenic purpura (AITP) bleeding, thrombotic thrombocytopenic purpura (TTP), haemolytic uremic syndrome (HUS), microangiopathic haemolytic anaemia (MAHA)

7.   Describe, explain, categorise the use of blood components in cancer (oncology and leukaemia) patients with respect to red cells, platelets, granulocytes. Evaluate specific transfusion triggers/ thresholds and beneficial effects of transfusion. Recommend management strategies including recommendations for resolving transfusion-associated problems/ adverse effects of transfusion and alternatives to transfusion

8.   Outline, describe, explain, and categorise anaemias and haematological disease occurring in pregnancy (including HELLP, TTP, and SCD). Describe, evaluate and recommend strategies for their management

9.   Determine, describe, explain and investigate the features and cause of, and problems associated with, obstetric massive transfusion, antepartum haemorrhage and postpartum haemorrhage. Outline, explain and evaluate treatment options including use of blood components 

10.  Outline, describe and explain the causes and effect of haemolytic disease of the fetus/ newborn (HDFN). Describe, evaluate and recommend strategies for clinical management of women with clinically significant red cell antibodies in pregnancy, and of the affected fetus/neonate including intrauterine and exchange transfusion

11. Determine, describe and explain the design, operation and performance of anti-D Ig prophylaxis for the prevention of immune anti-D formation in D negative females

12. Describe, categorise and explain the particular management and administration of blood component transfusion in children including neonatal transfusion and differing stages of prematurity

13. Explain and categorise the principles and practice of transfusion support in haemopoietic stem cell and solid organ transplantation patients including pre-, peri-/ ‘during’, post-treatment management and guidelines 

Back to CTP Student Guide

Unit 3 - Transfusion Management and Organisational Practice