Introduction and Safety
1-6
20077/021 US XTRA Operator’s Manual
23. The following substances that are not considered in the American Association of Blood Banks
publication,
4
should be added to the list:
Potentially harmful substance Effects
Recommended action in order of
priority
Amniotic fluid Soluble component contains proteolytic
enzymes which could activate clotting.
Squamous cells could cause pulmonary
emboli
1. Do not aspirate into system
Fecal contamination Sepsis 1. Do not aspirate into system
2. Aspiration may be necessary in
emergency cases
Tumor cells Potential risk of metastasis 1. Do not aspirate into system
2. Aspiration may be necessary in
emergency cases
3. Irradiation of salvaged blood is always
recommended
Clotting Adjuncts
•Topical thrombin
•Fibrin Glue
Monofilament collagen
May activate clotting 1. Do not aspirate into system
2. Irrigate wound before resuming
salvage
Microfibrillar Collagen (e.g. Avitene) Causes platelet activation Do not aspirate into system
Betadine Reduces hemoglobin; seems to be a
reversible effect. May cause hemolysis;
may cause allergic reaction if patient is
sensitive to iodine
1. Do not aspirate into system
2. Irrigate wound before resuming
salvage
3. Thoroughly wash salvaged blood
Methylmethacrylate (fresh bone cement
only)
Toxicity; heat produced hemolysis 1. Do not aspirate into system
2. Irrigate wound before resuming
salvage
Gastric Fluids Contains proteolytic enzymes; could
activate clotting
1. Do not aspirate into system
2. Irrigate wound before resuming
salvage
3. Thoroughly wash salvaged blood
Antibiotics not licensed for intravenous use May be delivered in higher dose than
normal concentrations; potential serious
reactions (e.g. hypotension, shock).
1. Do not aspirate into system
2. Irrigate wound before resuming
salvage
Epinephrine May be delivered in higher than normal
concentrations. Studies show that the
catecholamines not removed. May
cause severe hypertension
1. Do not aspirate into system
2. Irrigate wound before resuming
salvage
Table 1-3 Suction/Collection Wand Substance Warnings
4
Guidelines for blood recovery and reinfusion in surgery and trauma. Bethesda, MD; American
Association of Blood Banks, 1997: 19-22
Potentially harmful substance Effects
Recommended action in order of
priority
Smoke produced on the operative site by
electrosurgical instrumentation
Carbonized particles may be aspirated
from the field and directed inside the
filter of the reservoir.
The smoke aspirated could produce a
brownish color on the vacuum line
connected to the reservoir
Keep away the aspirator from the
operative site during the use of
electrosurgical instrumentation.
Use evacuation systems to capture and
filter surgical smoke to remove odor,
particulates, and other potentially
hazardous by-products of electro
surgery procedures
Ceramic and metal debris released by
prosthetics materials
Effect of darkened tissue or clots (blue/
green/black) surrounding prosthesis
unknown to systemic circulation
Do not aspirate into system
Table 1-4 Addendum to Suction/Collection Wand Substance Warnings
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