Carrie Easley

If at all possible, define a pre-admission process so that a T&S can be drawn prior to the day of surgery. No one is happy when they find-out that the patient on the table has an antibody that will significantly delay packed cell availability. I would also "make friends" with your Perfusion team. Ours are the TEG experts in the OR, and help to guide the component utilization. We still reserve two platelets for a CAGB, but rarely transfuse these patients.

Just FYI... RadSure can now be stored @ RT.

The code is P9044. It's about 25% more than frozen plasma from our supplier.

We are a level II trauma center that averages 4-5 MTP's per month. We have an order set built in our hospital information system that includes baseline labs, hourly labs, TXA bolus/infusion, and eight rounds of blood components (48 packed cells, 48 plasma, 8 plateletpheresis, and 70 units cryo). The components cross to our BB LIS (SoftBank). We issue rounds until told to stop by patient care staff. We either select/issue or emergency issue based on how much of our compatibility testing is completed. Although we use the Epic blood product administration module (BPAM) for most transfusions, it's currently too clunky for MTP. We issue paper transfusion records generated by SoftBank for the RN's to document on. These are returned to the Blood Bank so that we know what was given & when. Any missing documentation is included in the comprehensive review that takes place after each event.

We have a similar policy. We only request the second draw if they order packed cells w/ historical type, though. Our high-risk deliveries also get a type and screen. My issue is when we need to turn the ABRH specimen into a full T&S (adding the ABSN to the existing order). We have not found a way for Epic to automatically add-on to a BB specimen like they can in other areas. We also have a BB Hold tube, but the issue is the same...if they order testing, we have to manually go in to Beaker & add collection info. Has anyone found a true add-on method that interfaces f/ Epic to Soft?

New question Does anyone have a good workflow for adding an antibody screen onto an existing ABRH? We frequently run into this in our L&D (ex. Mom comes in planning for a vaginal delivery, so they order an ABRH. She turns into a C-section, so they want a full T&S). Since Epic sees Softbank as a reference lab, we can't get the add-on without the banker manipulating in Patient>Orders>Modify. I'd appreciate any insight! ~Carrie

They are just 400 mL transfer bags made by Charter Medical. Item # T3104

Same here...straight to K-B if no infant Rh available.

Me We use Epic/Beaker with SoftBank.

Chhibber V et al. Is group A plasma suitable as the first option for emergency release transfusion? Transfusion 2014;54:1751-5. Cooling L. Going from A to B: The safety of incompatible group A plasma for emergency release in trauma and massive transfusion patients. Transfusion 2014;54:1695-1697. Isaak EJ, et al. Challenging dogma-Group A donors as universal plasma in massive transfusion protocols. Immunohematology 2011;27:61-65 (NOTE: Free pdf download of full issue). Mehr CR, Gupta R, von Recklinghausen FM, et al. Balancing risk and benefit: maintenance of a thawed group A plasma inventory for trauma patients requiring massive transfusion. J Trauma Acute Care Surg 2013;74:1425-31. Zielinski MD et al. Emergency use of prethawed group A plasma in trauma patients. J Trauma Acute Care Surg 2013;74:69-75 Some of these are several years old. A quick search will literally provide dozens of articles. It was well publicized @ AABB 2018 and the Blood Bank Guy has a podcast from August 2017 that provides more info.

Just got the book today (as well as the positive DAT work-up counterpart)! Looking forward to incorporating these case studies into new employee training.

We use type A liquid plasma (never frozen) for traumas and massive transfusions until type-specific/compatible can be thawed.

Congrats!!! I think many of us have our own version of Malcom in our mind 🤓

An amazing honor and well-deserved. The knowledge you share spans continents and grows exponentially!!!

That’s awesome Mabel! Is this workflow just in OpTime, or can it be used in other settings?