Protocols - Hemorio

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COMMUNICATION FORM OF CRYOPRECIPITATE USAGE Name of the Health Service: Address: Technical Responsible: Subject’s Name: Folder: 168 Diagnosis: Case summary: Physician who has prescribed the component: Stamp and Signature Transfusion Date
TRANSFUSIONAL INDICATIONS AT THE HEMATOLOGICAL DISEASES 1 – FALCIFORM DISEASE The de-leukocytated blood must be transfused prophylactically. In these subjects, you must not transfuse red blood cells with a falcemic trace (presence of Hemoglobin S), nor with others abnormal hemoglobin (C, D, etc.). SIMPLE TRANSFUSION AT THE ACUITY: Transfuse whenever the hematocrit has fallen more than 20% below the base level of the subject, or whenever there are signs of hemodynamics decompensation induced by anemia. Transfuse phenotyped red blood cells to the antigens Rh and Kell (Rh1, Rh2, Rh3, Rh4, K1). If the subject is under a chronic transfusion regimen, respect it, unless it is extremely difficult, the antigens Jka and Jkb. The simple transfusion aims at increasing the capacity of entrainment of oxygen, not reducing significantly the concentration of Hb S. The increase of hematocrit above 35%, with no decrease of the percentage of Hb S, may lead to an increase of the blood viscosity, providing a negative effect of the transfusion on the pathology. CHANGE TRANSFUSION MODALITIES a - ERYTHRACYTAPHERESIS (CHANGE OF RED BLOOD CELLS) – It is performed in automatic processes of continuous or discontinuous flow. It offers a number of advantages on the simple transfusions for the control of certain complications of the Falciform Disease. The most important is that we can adjust fast and simultaneously the hematocrit and the level of hemoglobin S, allowing the reversal of severe situations, eliminating the risk of changes at the blood viscosity and in the blood volume, and discontinuing tissue damages before they become irreversible. Indicated in the cases of ischemic CVA and severe Acute Thoracic Syndrome. b – MANUAL PARTIAL EXSANGUINE TRANSFUSION (PARTIAL CHANGE OF BLOOD). There is a removal of blood from the subject, followed by red blood cells transfusions. The plasma of the subject may be returned or not. It has as a purpose: 1 – Remove the red blood cells with hemoglobin S, thus reducing the global tenor of this abnormal hemoglobin. 2 – Keep the levels of Hb S around 30-50% The main indication for the regime of Partial Exsanguine Transfusion is the prevention of the recurrence of cerebrovascular accident (CVA). The regime is started with a change transfusion (exsanguine or erythracytapheresis). It is important to monitor the subject in order to detect not only complications such as hyperviscosity, but also the occurrence of hemolytic reactions and alloimmunization. These latter complications may make unfeasible the continuation at the change transfusion program. It is performed manually, and one or two venous accesses may be used. We may be based on the following formula: 169
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PROTOCOLS INSTITUTE OF HAEMATOLOGY
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COORDINATION AND REVISION Clarisse
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SUMMARY: PART I - CLINICAL PROTOCOL
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1.INICIAL CLINICAL EVALUATION SICKL
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TREATMENTO AND IN ADULTS AT ANY AGE
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SPLENECTOMY - INDICATIONS: (1) CHIL
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OUTPATIENT TREATMENT: It is based o
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ASPIRIN AND NSAID PARACETAMOL OPIOI
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CONDUCTION: - Hospitalization - Com
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ONE, TWO-DIMENSIONAL DOPPLER ECHOCA
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Hemianopsia Homonymous deficit of v
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TREATMENT OF CONVULSIVE EPISODES -
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INITIAL ATTENDANCE TO PREGNANT WOME
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- It may occurs acute thoracic synd
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3 Diet with potassium restriction 4
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MICROALBUMINURIA Screening Patients
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RECURRENCE OF PRIAPISM: - Pain Trea
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SPECIAL CARES DEFERASIROX - The use
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TREATAMENT: DRUG Hydroxiurea (hard
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MAJOR AND INTERMIDIATE THALASSEMIA
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HEREDIRATY SPHEROCYTOSIS CLINICAL E
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G6PD DEFICIENCY INITIAL EVALUATION
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LABS EXAMS TO DIAGNOSE APLASTIC ANE
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SELFIMMUNE HEMOLYTIC ANEMIA CONCEPT
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2. Splenectomy: Vaccinate 14 days b
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IMMUNE THROMBOCYTOPENIC PURPURA LAB
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THROMBOTIC THROMBOCYTOPENIC PURPURA
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HEMORRHAGIC SYNDROME INTRODUCTION H
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MULTIDISCIPLINARY FOLLOW-UP OF HEMO
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LYOPHILIZED CONCENTRATES: They are
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TABLE 2: REPLACEMENT THERAPY TO PER
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CONDUCTION IN CONFIRMED INTRACRANIA
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Severe CET with neurological change
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PHARMACOKINETICS OF CLOTTING FACTOR
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INHIBITORS CLASSIFICATION The inhib
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- Extended surgeries require increa
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CLINICAL DIAGNOSIS: According to In
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DDAVP TEST The “test dose” must
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TREATMENT OF BLEEDING SITUATIONS SI
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TABLE 6 - REPLACEMENT THERAPY IN LE
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• Primary prophylaxis: controvers
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CLINICAL AND LABORATORIAL FOLLOW-UP
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MYELODISPLASIC SYNDROME LABORATORIA
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If EPO < 500 mU/ml : EPO (8000U 3x/
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ACUTE MYELOID LEUKEMIA LABORATORIAL
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LMA LMA M3 - non-M3 LMA Protocol LM
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Key: Volunteer to aggressive treatm
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Acute Promyelocytic Leukemia Transf
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BMP LMA IN CHILDREN AND TEENAGERS
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Ara-c dose reduction by age: Age in
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ATRA RECOMMENDATION: ATRA is starte
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- venous hydration - leukapheresis
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POLYCYTHEMIA VERA LABORATORIAL TEST
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TREATMENT - 2nd LINE - Indicated fo
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ACUTE LYMPHOID LEUKEMIA LABORATORIA
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RE-INDUCTION Phase I (weeks 1-4) -
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Cycles 2, 4, 6, 8 - Methotrexate 20
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PHASE 2 Infusion CPM in 1 hour 1000
Page 118 and 119: CURATIVE RADIOTHERAPY of CNS < 1 ye
Page 120 and 121: CHRONIC LYMPHOCYTIC LEUKEMIA LABORA
Page 122 and 123: fludarabine 25 mg/m VENOUS 2 D1-D3
Page 124 and 125: TRICHOLEUKEMIA LABORATORIAL TESTS -
Page 126 and 127: - age >45 years old - leukocytosis
Page 128 and 129: - Leukemia / T-Cell Lymphoma in Adu
Page 130 and 131: INDICATIONS FOR THE TREATMENT: Symp
Page 132 and 133: 1 st line Chemotherapy R- CHOP (21
Page 134 and 135: CODOX- M/IVAC Cycles 1 and 3 Cyclop
Page 136 and 137: BLOCK A DEXA VO/IV 10 mg /m2 in 3 d
Page 138 and 139: - Surgical treatment is only indica
Page 140 and 141: LEUKEMIA / T-CELLS LYMPHOMA OF THE
Page 142 and 143: HN2 or PUVA (similar to the located
Page 144 and 145: MULTIPLE MYELOMA LABORATORIAL TESTS
Page 146 and 147: RESPONSE CRITERIA Full Response Abs
Page 148 and 149: WALDENSTRON MACROGLOBULINEMIA LABOR
Page 150 and 151: − If HLA-identical related donor
Page 152 and 153: TREATMENT PROTOCOL - ACUTE MYELOID
Page 154 and 155: TREATMENT PROTOCOL - MULTIPLE MYELO
Page 156 and 157: Post-autologous transplantation pro
Page 158 and 159: PART II - TRANSFUSIONAL PROTOCOLS A
Page 160 and 161: PRESERVATION AND CONSERVATION: The
Page 162 and 163: TRANSFUSION OF RED BLOOD CELLS, PLA
Page 164 and 165: FORMAL CONTRAINDICATIONS TO THE PLA
Page 166 and 167: 1 - TRANSFUSION OF FROZEN FRESH PLA
Page 170 and 171: Volume to be = changed (*) VOLEMIA
Page 172 and 173: HEMOTHERAPIC PROTOCOL TO FALCIFORM
Page 174 and 175: 5 - TRANSFUSIONAL CONDUCT AT THE SE
Page 176 and 177: CML - Subjects with symptoms relate
Page 178 and 179: - Aplastic anemia bearers - HIV pos
Page 180 and 181: Severe reaction: anaphylactic shock
Page 182 and 183: - Heart monitoring - Prescribe Furo
Page 184 and 185: CARES AT THE PLATELETS CONCENTRATE
Page 186 and 187: ATTACHMENT I - HEMATOLOGICAL CLINIC
Page 188 and 189: INFECTIOUS SPLENO MEGALIES IMMUNO L
Page 190 and 191: INVESTIGATION OF HEMORRHAGIC SYNDRO
Page 192 and 193: INVESTIGATION OF POLYGLOBULIAS: POL
Page 194 and 195: ATTACHMENT III - HEMATOLOGY SPECIAL
Page 196 and 197: IMMUNOPHENOTYPE PROFILE OF THE ACUT
Page 198 and 199: ATTACHMENT IV - PAIN APPROACH ROUTI
Page 200 and 201: If it is prescribed for more than 1
Page 202 and 203: HOW TO PRESCRIBE OPIOID: SPECIAL CA
Page 204 and 205: SPECIFICITIES OF EACH OPIATE (cont
Page 206 and 207: METHADONE Intravenous (*) Oral path
Page 208 and 209: Psychic Dependence or “addiction
Page 210 and 211: CROSS TOLERANCE - The subject must
Page 212 and 213: ATTACHMENT V - CHEMOTHERAPY SUBJECT
Page 214 and 215: ATTACHMENT VII - IRON CHELATION GEN
Page 216 and 217: 10. G N N - DFP DFP-100 mg/kg/day d
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ATTACHMENT VIII - SEDATION IN CHILD
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224 NOTES _________________________
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224 NOTES _________________________
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Expresso Gráfica e Editora Ltda-me
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