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1. A few symptomes and syndromes
Adults 1
D eterm ine the volume o f who le blo o d to be E xam p le: haem o glo bin required = 7 g/ d l
transfused : p atient‟s haem o glo bin = 4 g/ d l
V = (haem o glo bin required minus p atient‟s p atient‟s weight = 6 0 k g
haem o glo bin) multiplied by 6 multiplied by V o lum e in m l = (7 – 4 ) x 6 x 6 0 = 1 0 8 0 m l
p atient‟s weight
D eterm ine the transfusion rate: E xam p le: 1 0 8 0 m l to be ad m inistered o ver
(1 m l o f who le blo o d = 1 5 d ro p s) 3 ho urs
1 0 8 0 (m l) ÷ 1 8 0 (m inutes) = 6 m l/ m inute
6 (m l) x 1 5 (d ro p s) = 9 0 d ro p s/ m inute
Children
Newbo rns and child ren und er 1 y ear: E xam p le: a m alno urished child weighing 2 5 k g
1 5 m l/ k g o ver 3 to 4 ho urs 1 0 (m l) x 2 5 (k g) = 2 5 0 m l o ver 3 ho urs
C hild ren o ver 1 y ear:
2 0 m l/ k g o ver 3 to 4 ho urs 2 5 0 (m l) ÷ 1 8 0 (m inutes) = 1 .4 m l/ m inute
M alno urished child ren: 1 .4 (m l) x 1 5 (d ro p s) = 2 1 d ro p s/ m inute
1 0 m l/ k g o ver 3 ho urs
M o nito r vital signs (p ulse, blo o d p ressure, resp irato ry rate, tem p erature) and watch
fo r clinical signs o f transfusio n reactio ns.
I n so m e cases, p articularly in child ren suffering fro m severe m alaria, anaem ia m ay
cause h eart failure w h ich m ay be d eco m p ensated by transfusio n. I f signs o f
h y p ervo laem ia are seen: furosemide slo w, d irect I V : 1 m g/ k g w ith o ut exceed ing
2 0 m g/ k g.
– If p resent, treat any p ulm o nary o r p arasitic infectio n (m alaria).
Prevention
– Iro n o r fo lic acid d eficiency :
• d rug sup p lem ents in p regnant wo m an:
elemental iron (6 5 m g) + folic acid (4 0 0 µg) P O : 6 0 m g o nce d aily = 1 tab/ d ay
• Nutritio nal sup p lem ents if the basic d iet is insufficient
– F o r p atients with sick le cell d isease: lo ng term treatm ent with folic acid P O : 5
m g/ d ay .
– E arly treatm ent o f m alaria, helm inthic infectio ns etc.
39
Adults 1
D eterm ine the volume o f who le blo o d to be E xam p le: haem o glo bin required = 7 g/ d l
transfused : p atient‟s haem o glo bin = 4 g/ d l
V = (haem o glo bin required minus p atient‟s p atient‟s weight = 6 0 k g
haem o glo bin) multiplied by 6 multiplied by V o lum e in m l = (7 – 4 ) x 6 x 6 0 = 1 0 8 0 m l
p atient‟s weight
D eterm ine the transfusion rate: E xam p le: 1 0 8 0 m l to be ad m inistered o ver
(1 m l o f who le blo o d = 1 5 d ro p s) 3 ho urs
1 0 8 0 (m l) ÷ 1 8 0 (m inutes) = 6 m l/ m inute
6 (m l) x 1 5 (d ro p s) = 9 0 d ro p s/ m inute
Children
Newbo rns and child ren und er 1 y ear: E xam p le: a m alno urished child weighing 2 5 k g
1 5 m l/ k g o ver 3 to 4 ho urs 1 0 (m l) x 2 5 (k g) = 2 5 0 m l o ver 3 ho urs
C hild ren o ver 1 y ear:
2 0 m l/ k g o ver 3 to 4 ho urs 2 5 0 (m l) ÷ 1 8 0 (m inutes) = 1 .4 m l/ m inute
M alno urished child ren: 1 .4 (m l) x 1 5 (d ro p s) = 2 1 d ro p s/ m inute
1 0 m l/ k g o ver 3 ho urs
M o nito r vital signs (p ulse, blo o d p ressure, resp irato ry rate, tem p erature) and watch
fo r clinical signs o f transfusio n reactio ns.
I n so m e cases, p articularly in child ren suffering fro m severe m alaria, anaem ia m ay
cause h eart failure w h ich m ay be d eco m p ensated by transfusio n. I f signs o f
h y p ervo laem ia are seen: furosemide slo w, d irect I V : 1 m g/ k g w ith o ut exceed ing
2 0 m g/ k g.
– If p resent, treat any p ulm o nary o r p arasitic infectio n (m alaria).
Prevention
– Iro n o r fo lic acid d eficiency :
• d rug sup p lem ents in p regnant wo m an:
elemental iron (6 5 m g) + folic acid (4 0 0 µg) P O : 6 0 m g o nce d aily = 1 tab/ d ay
• Nutritio nal sup p lem ents if the basic d iet is insufficient
– F o r p atients with sick le cell d isease: lo ng term treatm ent with folic acid P O : 5
m g/ d ay .
– E arly treatm ent o f m alaria, helm inthic infectio ns etc.
39
