Ensis01

I am a little confused; as the process to manufacture PR platelets has the same effect as irradiation what do you want to warn your techs of?

My experience is that the BB reports out the antibody identification. Never the reactivity! If a titer is ordered the only thing reported is the titer or “too weak to titer”. As the rise in titer is the most relevant result, consistency in method and technique is very important, both within your hospital system and the reference lab you use. Physicians are interested in your results not the process. Keep that simple. If they have questions your Medical Director can enlighten them.

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Agreed to all the above; as you say you have implemented a policy that prioritizes clinical benefit over inventory control and waste reduction, which the hospital (physicians, Med Techs and bean counters) follow. My experience, however, is disciplinary action taken over product wastage. So unless a hospital implements a policy similar to the one you outline, which the Med Techs can follow, giving only ABO specific platelets will be problematic.

Hi Neil, I have been following your RBC and platelet transfusion observations, and your resulting evolution of policies with interest and I agree with ABO matching platelets (also my observations). I guess however I am one of these that see too many problems for implementation, even gradual. Yes the Med Techs select the platelet, but mostly it has to be the shortest date first to minimize waste (a major concern/factor every where I have worked). A policy to only give ABO identical to a patient (one, all, or a percentage) will result in occasions where the ABO matched platelet can not be obtai

It makes sense to have a K neg policy while the patient is on anti-CD38 therapy, i.e. K neg units are given because DTT meant Kell antibodies could not be ruled out. Once anti-CD38 therapy is finished and if the patient never had anti-K and you can rule it out I see no reason to keep giving K neg units.

My deepest condolences for your loss.

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Agree with Malcolm and OkayestSBB. The process I would suggest is to only investigate then call Ch/Rg once the following criteria are met: there should be reactivity on phenosimilar cells, which should titer out to your HTLA defined policy. Reactivity should be negative with Ficin treated cells and positive with 0.2M DTT treated cells. Then neutralize with plasma (and saline controls). Hope that helps.

I agree with the consensus. I would however check each and every card against Meditech to ensure nothing extra is on the card, once checked (updated) make a note in Meditech and discard the card. Also keep the unused cards as they are fantastic for use during down time events and can be discarded once Meditech is updated.

At my previous hospital we would accept and use a historical ABO from another lab but only if it came from within our hospital system.

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If you provide blood for the outpatient surgery center it makes no sense to have two separate procedures for emergency releasing blood otherwise you would need two procedures for EVERY process that you do at both sites, and that would really suck

Finish the unit.

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