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The BB supervisor sent a certified packet to the physician on record. We included a letter documenting the transfusion, a copy of the current FDA requirements for notification, and a form for them to complete and return by a certain date with the notification information. The Medical Director’s name and phone number were in the letter as the contact person for the physician. The Medical Director was copied on this info in case he was called. If the completed form were not returned, the Medical Director called the physician. Every phone call, etc, was documented. There were problems, as mentioned above. We had hospitalists who only treated the patients in the hospital who might not work there anymore or did not feel responsible for follow-up. What if the patient went to rehab and never went home? If we could not reach an end point, we sent to risk management for resolution.

Precisely! Our current conundrum is a snarky Ortho attending who is insinuating that our blood supplier and my blood bank gave the patient "contaminated blood" and he shouldn't have to be the person to notify the patient. Snarkiest of the snark, and its clear there is little understanding of the risks of transfusion. My medical director wants to involve our Patient Safety and Quality folks or Risk/Legal, since this is an FDA requirement, and I think we'll have to take that route, if for nothing more than educating the physicians.

We do not routinely transfuse neonates (have not done one here in 30 or so years). We would give the freshest O= we have; irradiated if we have one. We are 3 hrs from our blood supplier. Chances are the infant will be transfused before we could receive appropriate products.

If the unit if leukoreduced, as all red cell transfusions should be, there is no need for CMV negative in my view.

There are several layers to this question. First, you will need a fresh O negative, CMV-, irradiated prbc available rather quickly. We are not small but we only transfuse neonates about 3-4 times/year yet we receive a fresh unit every Monday to use for emergency transfusions. If it is non emergent (say for iatrogenic anemia), then we order from our supplier a fresh unit with satellite bags sterile docked so we can continue to use that unit for future transfusions on that baby. The goal here is to limit donor exposure. You may not need to worry about that if you do not have a high level NICU. Are you aliquoting the unit into syringes? You will need a procedure and supplies for that. You need to meet with your Neonatologist and work out your logistics. Those are just a few things to think about. I assume you already have policies and procedures in place for this.