ESSENTIAL LIFE SUPPORTIVE FLUID Blood

Functions Transportation  Delivers O2 from Lungs and nutrients from digestive tract to all body cells  Transports the oxygen as oxyhemoglobin and carbon dioxide as carboxyhemoglobin, carbonic acid, and bicarbonate  Transports metabolic waste from cells to elimination sites (lungs, kidneys)  Transports hormones Regulation  Maintains appropriate body temperature  Maintains normal pH  Maintains adequate fluid volume with NaCl and other salts acting with blood proteins (albumin) to prevent excessive fluid loss Protection  Prevents blood loss through clotting mechanism  Prevents infection through immunity (phagocytosis and antibody production)

Blood Facts/characteristics The average adult has about FIVE liters of blood inside of their body, which makes up 7-8% of their body weight. pH approximately 7.35 – 7.45 Temperature: 38 o C or o F There are about one billion red blood cells in two to three drops of blood. For every 600 red blood cells, there are about 40 platelets and one white cell.

Composition of Blood Plasma: yellowish liquid portion of blood that contains electrolytes, nutrients, vitamins, hormones, clotting factors, and proteins such as antibodies to fight infection. (roughly 55%) Erythrocytes (RBCs): The most abundant cells; produced in the bone marrow and contain a protein called hemoglobin that carries oxygen to all parts of the body (roughly 44%) Leukocytes (WBCs): part of the immune system; destroy pathogens (<1%) Thrombocytes (platelets): clotting factors that are carried in the plasma; clot together in a process called coagulation to seal a wound and prevent a loss of blood. (<1%)

Erythrocytes Hemoglobin is a protein molecule that binds to oxygen.  97% of RBCs made up of this Hemoglobin forms an unstable, reversible bond with oxygen In its oxygen-loaded form, it is called oxyhemoglobin With CO2 attached, carbaminohemoglobin Heme = red, iron (Fe) combined with O2 gives blood its red color Lifespan: Days  Spleen: RBC “graveyard”  Iron recycled, remainder becomes bilirubin (yellow pigment) in liver then excreted as bile into the intestines

Plasma Donation Clotting Factors Immunoglobulin: There are more than 150 primary immune deficiency disorders. These individuals have improperly functioning immune systems and do not respond to traditional antibiotics. Without IVIG, they are exposed to frequent and often serious infections. Albumin: used to treat burns, trauma patients and surgical patients. Hyperimmuneglobulins: used to treat rabies, tetanus, dialysis patients and organ transplant recipients. They are also used to treat pregnant women who have Rh incompatibility

Blood Disorders Anemia: deficiency in the numbers of functional RBCs; symptoms = impaired breathing, fatigue, muscle weakness  Iron deficiency: not enough iron; inability of the body to use iron  Aplastic: failure of the bone marrow to produce RBCs due to poisoning, drugs, radiation  Pernicious: RBCs inadequate due to decreased gastric secretion and vitamin B12 malabsorption; must take B12 shots forever; untreated - certain death  Sickle cell: inherited trait of defective hemoglobin molecule; abnormal sickle shaped RBCs, cells carry less oxygen, break easily, clog vessels; homozygous - severe disease; heterozygous - asymptomatic  Thalassemia: defective synthesis of protein for hemoglobin production; hereditary; several types Polycythemia: too many RBCs and platelets; thickens blood and increases BP; periodic removal of a unit of blood to thin the blood

Blood Composition

Blood Types Antigens: chemical structures imparting specific properties to the surface of the red cell Antibody: protein substance developed in response to foreign body substances Blood Group Systems  Detected on the basis of specific reaction with corresponding antibody as a result of the presence or absence of the blood protein antigens on the RBC surface  Inherited according to Mendelian laws

ABO System Discovered by Landsteiner in 1900 Type A = 41% of population  Has A antigens on RBC surface  Has anti-B antibodies in plasma Type B = 10% of population  Has B antigens on RBC surface  Has anti-A antibodies in plasma Type AB = 4% of population  Has A and B antigens on RBC surface  Has NO antibodies in plasma Type O = 45% of population  Has No antigens on the RBC surface  Has anti-A and anti-B antibodies in plasma Type O is the Universal Donor (can be given to Type A, B, AB, and O) because it has No antigens on the RBC surface Type AB is the Universal Recipient (can receive Type A, B, AB, and O) because it has NO antibodies in the plasma Universal Donor Universal Recipient

Blood Genotypes and Phenotypes 3 alleles, 6 possible phenotypes  AA and AO are both Type A blood  BB and BO are both Type B blood  AB is Type AB blood  OO is Type O blood

Rhesus Factor The presence of the protein, or lack of it, is referred to as the Rh (for Rhesus) factor. If blood does contain the protein, your blood is said to be Rh positive (Rh+).  Genotypes (+/+, +/-) If blood does not contain the protein, your blood is said to be Rh negative (Rh-).  Genotype (-/-)

Rh Incompatibility When Rh- person receives Rh+ blood in a transfusion, person develops antibodies against the Rh+ factor.  This becomes a clinical problem if they receive a second transfusion of Rh+ blood - Rh antibodies will clump with the Rh antigens.  Symptoms of transfusion reaction: chills and fever, rash, itching, shortness of breath, nausea, kidney pain, blood in urine, shock and death Occurs in pregnancy - to prevent this a shot of Rhogam is given shortly after birth to block the development of antibodies.