Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Transfusion of Blood and Blood Components


Related Terms

  • Autologous Transfusion
  • Blood Component Therapy

Specialists

  • Anesthesiologist
  • Emergency Medicine Physician
  • General Surgeon
  • Hematologist
  • Immunologist
  • Internal Medicine Physician
  • Oncologist
  • Pathologist

Comorbid Conditions

Factors Influencing Duration

Blood transfusions are not disabling unless a transfusion reaction occurs. An adverse reaction to the blood transfusion may occur up to ten days after the transfusion. The disease or injury that necessitated the transfusion will be what determines the disability duration.

Medical Codes

ICD-9-CM:
99.02 - Transfusion of Previously Collected Autologous Blood; Blood Component

Overview

A blood transfusion is the injection (infusion) of compatible blood (whole blood) or blood components (red blood cells, packed red blood cells, white blood cells, gamma globulin, plasma, albumin, platelets, cryoprecipitate, clotting factors) directly into the bloodstream.

The various components of the blood serve a variety of different purposes. Red blood cells are necessary for carrying oxygen to tissues. Packed red blood cells is whole blood in which excess fluid volume (plasma) has been removed. White blood cells and gamma globulin are necessary for fighting infection. Plasma is the liquid in which all blood components are suspended. Albumin is a protein that helps to maintain the blood volume. Platelets, cryoprecipitate, and other clotting factors are necessary for blood clotting.

Blood given in a transfusion may be the individual's own blood (an autologous transfusion) or it may be from a donor. An exchange transfusion is a type of transfusion in which the individual's entire blood volume is slowly and carefully replaced (exchanged) with donor blood. Before a transfusion can be given, the blood is subjected to as many as 15 tests to ensure compatibility of the donor and recipient (McCullough 1871). The most important test is cross matching to ensure compatibility of blood types. The most important of these cross matchings involve blood group proteins ABO (blood types A, B, AB, O) and the Rhesus (Rh) blood types (Rh negative or positive). If an incompatible blood type is transfused, it may result in blood cell destruction. Generally, only blood of the same blood type may be given. Cross matching involves taking a sample of the recipient's blood, identifying the blood group, and matching it with a suitable donor's blood. Cross matching may take up to an hour. In an emergency situation when there is no time for cross matching, O Rh-negative blood ("universal donor blood"), plasma protein solution, or an artificial plasma substitute may be given to the individual until tested blood becomes available. Blood is usually transfused into an arm vein. Each unit (approximately 1 pint) of blood is given over a period of 1 to 4 hours. In an emergency, the blood can be delivered within minutes. The amount of blood given depends upon the condition for which it is required. Usually, when a transfusion is needed, more than 1 unit is given.

Blood products may be given during hospitalization, as an outpatient, or at home by a home health nurse.

Source: Medical Disability Advisor



Reason for Procedure

Blood transfusions are performed in order to replace blood lost due to severe bleeding (hemorrhage) after an accident or during an operation. Transfusions are also given to treat chronic anemia that has not responded to medication, other blood disorders (hemophilia, leukemia), or internal bleeding (gastrointestinal bleeding).

In an exchange transfusion, nearly all of the recipient's blood is replaced by donor blood. Babies born with a hemolytic disease (Rh incompatibility) causing abnormally high levels of bilirubin in their blood can suffer brain damage if their blood is not replaced by donor blood. In sickle cell anemia, damaged red blood cells are removed and replaced with healthy donor cells. Transfusion of platelets, cryoprecipitate, and other blood clotting factors are given to individuals to restore the body's normal coagulating ability (such as in hemophilia). Platelet transfusions can also be given to individuals with certain forms of leukemia when there is an abnormal decrease in platelets (thrombocytopenia). White blood cells may be given (rarely) to replace an abnormally low level of white blood cells. Fresh frozen plasma may be given to help restore normal coagulation ability. Gamma globulin (immune globulin) may be given to help prevent development of certain infections (e.g., hepatitis B). Depending on the purpose and formulation, gamma globulin may be given as an injection into a muscle (intramuscular, IM) or into a vein (intravenous, IV).

Source: Medical Disability Advisor



How Procedure is Performed

Written consent for a transfusion may be needed. Before the transfusion can be given, access into a vein must be established. A small hollow, plastic tube (catheter) is inserted through the skin directly into a vein (an intravenous catheter, IV catheter). The intravenous catheter is then connected to an intravenous infusion system consisting of tubing and a plastic bag containing a fluid solution that will be dripped into the vein. The solution that is initially hung is usually a plain solution (saline) that is similar to the fluid in the veins. A sample of the individual's blood must be carefully typed and cross-matched (usually done in the blood bank, a part of the laboratory that specializes in identification and preparation of blood components) to assure compatibility. When the blood to be transfused is ready, the blood to be given is carefully checked by two nurses to assure that it is the correct type and product. A special filter and blood tubing are attached to the blood bag (needed for infusion of many, but not all blood products), and the tubing is then inserted into a port on the intravenous tubing. The infusion can then be given. It is allowed to drip in slowly at first and the vital signs are monitored for signs of an infusion reaction. After several minutes, if no reaction occurs, the rate of infusion can be increased. When completed, the blood tubing and bag are removed from the intravenous line and discarded.

Source: Medical Disability Advisor



Prognosis

The predicted outcome for transfusion of whole blood or packed red blood cells is the return to normal levels. The predicted outcome of infusion of white blood cells and gamma globulin is adequate response to infection or prevention of infection. The predicted outcome of infusion of platelets, cryoprecipitate and other clotting factors is adequate clotting ability.

Source: Medical Disability Advisor



Complications

Many complications may occur with blood transfusions. One complication that may occur is a reaction to an incompatible blood type (transfusion reaction, ABO incompatibility, hemolytic reaction). Symptoms include chest pain, trouble breathing, fever and chills, and low blood pressure. Life-threatening shock may occur if the transfusion is not stopped and emergency treatment given. Another complication that may occur with transfusion is an allergic reaction to donor blood. This may occur due to an allergic reaction to medications in the donor blood, or to the presence of particles that cause allergic reaction (antigens). This type of reaction may result in anaphylaxis with symptoms such as chills, swelling of the face and larynx, itching and hives, wheezing, nausea and vomiting. Anaphylaxis can result in death unless emergency treatment is initiated. Another complication that can occur is infusion of blood that contains bacteria (usually bacteria such as Pseudomonas or Staphylococcus). This type of reaction may cause fever and chills, vomiting, abdominal cramping and diarrhea, and low blood pressure. Infection with viruses such as hepatitis and HIV is another complication that may occur, although in developed countries blood is always thoroughly tested for these viruses before it is given as a transfusion. The risk of viral infection from transfusion is much greater in third world countries in which this pre-transfusion testing is not performed.

Individuals with impaired heart function (such as heart failure) may not be able to tolerate the fluid volume needed for transfusions and may develop symptoms of fluid volume overload or heart failure. Individuals receiving rapid transfusion of large volumes of blood may be at risk for a severe drop in temperature (hypothermia) because of the low temperature of the blood.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

The type of work performed by the individual and the reason for the transfusion will dictate any restrictions or accommodations. If a significant reaction occurred, hospitalization and treatment may require extra time off from work. If no complications occur, there should be no need for work restrictions or accommodations specifically related to the transfusion procedure.

Individuals with chronic disease needing recurring transfusion may return to sedentary jobs the next day. Individuals needing first time transfusions for acute injury or disease are unlikely to return to work for at least a week.

Source: Medical Disability Advisor



References

Cited

McCullough, Jeffrey. "Blood Procurement and Screening." Williams Hematology. 6th ed. New York: McGraw-Hill, 2001. 1871-1877.

Source: Medical Disability Advisor






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