In this episode of End of Shift, Eric and Joe continue their discussion with Dr. Shannon Jackson, talking about blood types and donation as well as sickle cell disorders.
Most hospitals carry: pRBC, FFP, platelets and cryo. The Canadian Blood Services knows where all the products are, and the central transfusion registry in BC circulates products to areas of need and does so with minimal wastage.
FFP is made from plasma which is separated from donor blood and frozen to minus 35°C to preserve it. Cryoprecipitate (cryo) is made from FFP which is frozen and repeatedly thawed in a laboratory to produce a source of concentrated clotting factors including Factor VIII, Factor XIII, von Willebrand factor and fibrinogen.
FFP can reverse the effect of warfarin because it contains substantial levels of vitamin K dependent clotting factors (II, VII, IX, X and protein C/S). FFP is indicated when a patient has MULTIPLE factor deficiencies and is BLEEDING.
Cryoprecipitate is indicated for the treatment of acquired fibrinogen deficiency or dysfibrinogenaemia, due to critical bleeding, an invasive procedure, trauma or disseminated intravascular coagulation (DIC). It’s not ideal for specific factor replacement.
If you have no factor available, you can use FFP/cryo.
ONCE AGAIN, you can call 604-682-2344 (St. Paul’s Hospital) to reach a hematologist 24/7.
DONATE DONATE DONATE!
There is never too much blood – donated blood can also be used for non-clinical research. You can donate every 8 weeks! There are very few exclusions to donating.
Go to Canadian Blood Services – www.blood.ca – to book your donation.
Dr. Shannon Jackson is a clinical hematologist and the medical director of the Provincial Adult Bleeding Disorder program based out of St. Paul’s Hospital in Vancouver.
Related Clinical Resource:
Treatment of Persons with Inherited Bleeding Disorders (PwIBD) in the Emergency Room
End of Shift Podcast Hosts
The End of Shift Podcast is hosted by ECBC members Eric Angus and Joe Haegert.
Eric Angus
Eric Angus is an emergency physician and trauma team leader at Lions Gate Hospital. He is married with 15-year-old twins. His non-medical interests include origami, meditation, mountain biking, skiing, rock climbing, just generally being outside, and drinking wine. He has a diploma in mountain medicine and volunteers for ski patrol and the North Shore Rescue team. He is an ATLS instructor. He dabbles in stoicism and Buddhist philosophies.
Joe Haegert
Joe Haegert practices emergency and trauma medicine at the Royal Columbian Hospital in New Westminster, British Columbia. He is a talented teacher, engaging speaker, and devoted clinician. He lives in South Surrey with his wife Sandy and managed to raise three children without much incident. Known for his unflagging enthusiasm, Joe enjoys all aspects of the outdoors and recently has taken to turning wooden burls into all manner of bowls and tables.
Disclaimer: The views and opinions expressed in this podcast are those of the authors and do not necessarily reflect the official policy or position of ECBC.
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