Quick transfusion quiz for busy health professionals

Transfusion Q&A is a database of questions, grouped by topic, designed to test your knowledge of safe transfusion practices and patient blood management. We made it specifically for the time poor (that would be all of us, then).

You can access Transfusion Q&A at qanda.transfusion.com.au. Alternatively you can access individual topics on Transfusion Online Learning on transfusion.com.au.

You choose how you complete a topic: all in one hit as a “quick quiz”; or enrol to get sent questions over time. You choose the device on which you access the education – PC, laptop, mobile phone, or tablet.

If you enrol, the system sends notifications when questions are due to be answered. During enrolment you choose to receive these via email or SMS. You can also choose to customise delivery notifications, indicating how many questions you want to receive with each notification and how often you get the notifications.

But don’t worry if you can’t be bothered with the customisation – we have pre-set a delivery schedule for you.

Every time you answer a question you get feedback on your response and an explanation with links to the relevant information about the topic.

If you want to receive a certificate for CPD purposes, enrol in a topic. You’ll need to get each question correct twice to be awarded a certificate – there are no rewards for random guessing in this game.

If you think you already know your stuff, but just want to confirm this, do a quick quiz. You’ll still get instant feedback on the answers to your questions and a score at the end, but no certificate.

Once you log into Transfusion Q&A, your dashboard will list the topics you are currently enrolled in and those you have completed, with links to your certificate.

 

– Dr Sandy Minck

Intraoperative cell salvage and the ROTEM system – what’s the benefit?

A recent webinar on cell salvage and the ROTEM system hosted by the TPE team at the Blood Service was a great opportunity to come up to speed on new patient blood management techniques.

This joint presentation was given by Peter Frantzis, Head Perfusionist at the Royal Adelaide Hospital and Associate Professor David Roxby, Head of SA Pathology Transfusion Services at Flinders Medical Centre.

Here’s some of the key information from the session:

What is cell salvage?
Intraoperative cell salvage (ICS) is performed as a blood conservation technique and is frequently used in cardiothoracic and vascular surgery as these areas traditionally have high levels of blood usage. It has been gaining more attention lately as transfusion risks have become more fully appreciated, patient blood management (PBM) guidelines have been released and the National Blood Authority of Australia has recently implemented guidelines for intraoperative cell salvage (March 2014).

What happens during the cell salvage process?
During the process, the surgeon aspirates any bleeding into a collection reservoir, the blood is filtered and anticoagulant is added in order to remove debris and prevent clotting. The blood is then centrifuged and washed to produce separated red blood cells (RBC) with a high Hct, suspended in 0.9% normal saline for re-infusion to the patient (autotransfusion).

What are the benefits of cell salvage?
Cell salvage helps to reduce the requirement for allogenic blood transfusion during cardiothoracic and vascular surgery and when combined with improved bypass circuitry/techniques and haemofiltration, patients can even have elevated Hb levels post-surgery. ICS is also very useful for Jehovah witness patients who refuse blood transfusions as a circuit is set up between the patient, heart lung machine and the autotransfusion device providing continuity and ensuring all their red blood cells are returned.

What is the ROTEM system?
The ROTEM (rotational thromboelastometry) system is actually a modified version of thromboelastography [TEG], probably a more familiar term to many of us. The ROTEM system provides real-time measurement of the interactions of coagulation factors, inhibitors and cellular components during the phases of clotting and subsequent lysis over time. The aim of this method is to mimic the sluggish flow of blood in veins.

What are the benefits of ROTEM?
The ROTEM system provides a point of care (POC) test and is proving to be an extremely useful source of information. Clinicians are able to assess their patients before surgery (to determine if coagulopathies are present), during surgery (to determine if coagulopathies are developing) and after surgery (when trying to establish the cause of bleeding). It can also be located in either the operating theatre, transfusion laboratory or networked between these areas. ROTEM results are also available much quicker than traditional coagulation tests like INR, APTT, Fibrinogen and platelet count and enable the treating clinician to discriminate between coagulation related conditions in a more efficient manner.

The benefits of coagulation POC testing have also been highlighted in an article in Anesthesiology, where the randomised clinical trial was terminated 6 months early as initial results demonstrated that haemostatic therapy based on POC testing significantly reduced patient exposure to allogenic blood products and provided significant benefits with respect to clinical outcomes.

Additional information and extra reading
The Blood Service clinical website transfusion.com.au contains excellent information about PBM, blood conservation and the PBM guidelines. In fact, the PBM guidelines: Module 2 Perioperative actually state that ICS is recommended for adult patients undergoing surgery in which substantial blood loss is anticipated and also mentions that TEG and TEG-based POC tests should be considered in adult patients undergoing cardiac surgery.

If you would like more information on these topics, this joint webinar was recorded for educational purposes and can be accessed in Transfusion online learning.

– Tanya Raison, Project Officer, TPE

Welcome to transfusionblog

The Transfusion Practice and Education team at the Australian Red Cross Blood Service has been working for the past five years generating live events, webinars, online learning, apps, Transfusion News, the transfusion website, mytransfusion and more.

We have started this blog to open up conversation about transfusion practice, discussion about education, and to better explain the tools and resources we have created. We can move beyond news stories and event promotion, and talk in more depth about what we do.

We invite you to join the conversation, give us feedback, let us know about the sort of resources you would like to make patient blood management practice easier.
From time to time we would also like to open up the blog as a forum on specific topics, but we welcome discussion and input at all time.

Members of the Transfusion Practice and Education team will contribute to the blog, to showcase their projects, moderate discussions, and outline and background upcoming webinar topics.

We’ll also open up to posts from people in the Blood Service to discuss their roles and increase understanding about the work that takes place here.

You can receive blog alerts using reader on wordpress, or follow @TransfusEd on twitter.

Comments will be moderated for relevance and good manners. The disclaimer for transfusion.com.au applies.