hemorrhagic and hemolytic anemia

what is hemorrhagic anemia?

related to deficiency in total circulating blood volume

what is acute hemorrhagic anemia?

moderate to large volume in a short time period

• surgery

• trauma

• acute GI bleed

what is chronic hemorrhagic anemia?

small to moderate volume over a long time period

• menorrhagia

• chronic GI bleed

what are the stages of hemorrhagic shock?

mild (<20% blood volume)

moderate (20-40% blood volume)

severe (>40% blood volume)

s/s of mild hemorrhagic shock

cool extremities

palor

diaphoresis

increased capillary refill time

anxiety

s/s of moderate hemorrhagic shock

tachycardia

tachypnea

oliguria

orthostatic hypotension

confusion or lethargy

s/s severe hemorrhagic shock

severe tachycardia

severe hypotension

hemodynamic instability

obtunded or comatose

general s/s of hemorrhagic anemia

low RBC level (normocytic, normochromic)

low Hgb/Hct levels

monitor vital signs closely for changes from baseline

mental changes can be an early sign!

management of hemorrhagic anemia

treat underlying cause

transfusion of blood products

what is a type and screen?

determined blood type and checks for antibodies that contribute to transfusion reactions

what is the universal donor?

O-

what is the universal recipient?

AB+

what should you monitor for during a blood transfusion?

s/s of transfusion reaction

what should you do if a reaction is suspected?

STOP the transfusion, keep IV open with normal saline, notify provider

s/s of transfusion reaction

urticaria

pruritus

fever/chills

respiratory distress/dyspnea

hypotension

hematuria

what is hemolytic anemia?

RBCs are destroyed faster than they are replaced

• acute vs chronic

contributing factors to hemolytic anemia

mechanical

chemical

autoimmune response

organ dysfunction

common causes of hemolytic anemia

implanted devices

• mechanical heart valves

• cardiopulmonary bypass machines

substances

• snake venom

• hypotonic infusion

• chemicals (arsenic)

• heavy metals (lead)

• infection (malaria)

immune response

• transfusion reaction to incompatible blood type

• hemolytic disease of the newborn

hypersplenism

• long-term or excessive ETOH ingestion

• SLE

• RA

s/s of hemolytic anemia

low RBC level

low Hgb/Hct levels

elevated reticulocyte count

jaundice

dark or bloody urine

splenomegaly

management of hemolytic anemia

treat underlying cause

transfusion of blood products

only when critically necessary