blood transfusions The injection of blood from a healthy person into the circulation of a child whose blood is deficient in quality or quantity. Several different components of blood can be transfused into a child, but red blood cells are the most common type of blood product transfusion.
There are several reasons why a child may require a blood transfusion, including a sudden loss of blood; low hemoglobin count before, during, or after surgery; severe heart or lung disease; bone marrow failure or anemia.
Most of the body's blood cells are produced in the bone marrow, the spongy material in the center of the bones. Blood is made of plasma that carries red and white blood cells and platelets. Red blood cells carry oxygen from the lungs to other body organs and carry carbon dioxide back to the lungs. Bleeding after an accident, surgery, or disease may lower the red blood cell count. White blood cells fight infections by destroying bacteria, viruses, and other germs. White blood cell transfusions are rarely given and are usually reserved for children with a low white cell count and severe infection that does not respond to antibiotic therapy.
platelets help control bleeding by plugging blood vessels damaged by injury or surgery. platelet count might be low because of bone marrow disorders, increased destruction of platelets, or medications. platelets may be transfused before a surgical procedure that could trigger bleeding in a child with a low platelet count.
plasma carries blood cells throughout the body and contains proteins, vitamins, and minerals, some of which help the blood to clot. plasma or fresh frozen plasma can be transfused in children who have a severe deficiency of certain clotting components of the blood.
The blood used at most hospitals is from volunteer donors who are not paid for giving blood or blood products. Each blood donor must answer medical history questions and be given a limited physical examination before being accepted as a donor. All donated blood is tested for hepatitis, syphilis, and antibodies to immunodeficiency viruses including the aids virus. These tests decrease the chances of transfusion-related infections.
Blood is collected and stored in sterile bags which are used once and then thrown away. Before blood is given to a child, it is cross-matched with the child's own blood to make sure it is compatible. The blood is given through a needle in the vein.
Because of concerns over possible contaminants in blood, some patients prefer to use blood donated from people they know. A directed (or designated) blood donation is one in which a person donates blood that is reserved at the time of donation for the transfusion of a specific patient at a later date. The donor is usually a family member or a close friend who has been chosen by the patient's family. There is no proof that directed donors are safer than volunteer donors, and not all directed donor blood will be compatible with the patient's blood.
Most transfusions do not cause any problems, but mild side effects may include symptoms of an allergic reaction such as headache, fever, itching, increased breathing effort, or rash. This type of reaction can usually be treated with medication if the child needs more transfusions in the future. Serious reactions are rare. The most common serious side effect is serum hepatitis, an infection of the liver.
boil An inflamed pus-filled section of skin (usually an infected hair follicle) found often on the back of the neck or moist areas such as the armpits and groin. A very large boil is called a carbuncle.
Boils are usually caused by infection with the bacterium Staphylococcus aureus, which invades the body through a break in the skin, where it infects a blocked oil gland or hair follicle. When the body's immune system sends in white blood cells to kill the germs, the resulting inflammation produces pus.
A boil begins with a red, painful lump that swells as it fills with pus, until it becomes rounded with a yellowish tip. It may either continue to grow until it erupts, drains, and fades away, or it can be reabsorbed by the body. Recurrent boils may occur in people with known or unrecognized diabetes mel-litus or other diseases involving lowered body resistance.
Bursting a boil might spread the infection. Instead, apply a hot compress for 20 minutes every two hours to relieve discomfort and hasten drainage and healing. After treating a boil, wash hands thoroughly before cooking to guard against staph infection getting into food.
It may take up to a week for the boil to break on its own. To further reduce chance of infection, showers, not baths should be taken. If the boil is large and painful, a physician may prescribe an antibiotic or open the boil with a sterile needle to drain the pus. Occasionally, large boils must be lanced with a surgical knife; this is usually done using a local anesthetic.
More seriously, bacteria from a boil may find its way into the blood, causing blood poisoning; for this reason, doctors advise against squeezing boils that appear around the lips or nose, since the infection can be carried to the brain. (Other danger areas include the groin, armpit, and breast of a nursing woman.) Signs of a spreading infection include generalized symptoms of fever and chills, swelling lymph nodes, or red lines radiating from the boil.
Some experts note that boils are usually infected cysts and recommend leaving cysts untouched, or having them lanced by a physician. For patients prone to boils, some experts recommend washing the skin with an antiseptic soap.
Keep skin around a boil clean while drainage is occurring and take showers to lessen the chance of spreading the infection.
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