2nd day in paed ; blood transfusion....

Assalammualaikum wbt.....

hari ni second day ummi kt paed postg...suka sgt utk ummi kongsi dgn sahabat2 pembaca setia blog ummi tntg sikit2 ilmu perubatan ni...anyhow, klw ad yg xfhm...blhla bertanya pd ummi ya...

ok, hr ni pg2 lg ummi dh kene present case, takutla jgk sbb hari kedua dh present case kt specialist, anyhiw, ummi got same finding as the specialist because the mo n ho did not report about the crepitation...then, ummi go to interview an ambigous pt (aka khunsa) which got CAH (congenital adrenal hyperplasia), play DA with tom n short case respiratory with aii ye...

then, we got student round at 11 am till 1pm...out for lunch n solat....

at 2pm--go to observe and assist blood transfusion and consent taking...

here we go...1st ummi nk cite about blood transfusion...

all 3 of my pt had beta thalassemia major and having a regular monthly blood transfusion...so, the step is...

first--set line la kn, baby branula got 2 color--yellow and pink; pink is bigger than yellow...it is a small thing, so we need to 'sambung' dgn t-jx wire b4 smbg dgn blood line...

then, check the blood, the consent paper and the pt form...make sure the name, ic no, blood no, type of blood is same and make sure that the pt line is not bump....

actually, the blood had been filtered twice b4 masuk badan pt...filtered mean all the leukocyte had been removed from the blood, so then, blood transfusion reaction will be less and it also can reduce the CMV ix becuse usually CMV is carried out by leukocyte aka white blood cell...

then, waktu nk mskkn blood 2 dr line ke bdn pt, make sure no bubbles...because it can be air emboli...n many cx can arrised from the emboli...

em, before that kita kene tau bape byk titisan darah per minit yg akn msk ke dlm bdn pt...

so, cara nk kira dia amount of blood req by dr/ time in minit then darab 20 (infusion filtered pny rate)...so, dptla kadar titisan drh per mnt...so, double checkla...kira manually...but ad jgk faktor2 lain yg mempengaruhi such as ketinggian tmpt gantung darah, kelebaran line etc...

n klw kanak2 plk,,,maksimum darah atau fluid blh msk dlm bdn adalah 20ml/kg/day....so kiralah...n biasanya dr akn infuse blood in 4 hours....

ok, enough with the blood transfusion....c u soon dear...

salam sayang,

ummuhumaira'