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Factor Assay Testing for Trauma Patients
Hi Everyone, I need some advice again for trauma. We currently do not do any factor assays in house. We currently provide PT, aPTT, Ddimer, and Fibrinogen. Do you perform any factor assays for trauma patients with hemophilia A, B, or vWF? Do you offer any factor assays for trauma patients? I’m not sure if factor assays are needed or if this is overkill. How do you handle these type of patients? Thank you
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Neonatal Syringe Transfusions
When a syringe aliquot is created it goes through a filter. When the product is being given on the floor does it have to go through an additional filter in the blood administration tubing or can it go though tubing without a filter? Thanks
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What in your MTP?
We are currently using the HemoRoam which as a seperatre refrigerated compartment from the room temperature compartment. In the 2nd MTP Pack the patient will get 6 RBCs, 6 Plasma, Plt, and one dose of cryo. Unfortunately we have found that when the cryo is in the platelet compartment it cools down the platelt too much. How does everyone take up their cryo? How do you monitor how quickly they transfuse the cryo since it is only good for 4 hours? Thank you
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Cardiac surgery and what it means for our blood bank?
Hello Everyone, We are in the process of bringing cardiac surgery next year. I have never worked in a hospital that performed cardiac surgery. What are some of the things that we should be thinking about for our blood bank? I understand the volume of products we have in house will have to increase. I'm thinking we will need a TEG or Rotem. Which one is the question? Should I also be concerned about brining cell saver in house? Ours is currently contracted out. Any tips would be greatly appreciated since I will most likely be involved in build process. Thank you in adavance!
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BLOOD DRAW DURING TRANSFUSION
We will draw blood is the patient is receiving a transfusion. We put a comment on the results stating the patient was being transfused at the time of draw. We will draw a patient 15 minutes after transfusion. Here is the reference we used for our policy. Elizalde, J.I., Clemente, J., Marin, J.L.,Panes, J., Aragon, B., Mas, A., Pique, J.M., Teres, J. "Early changes in hemoglobin and Hematocrit levels after packed red cell transfusion in patients with acute anemia." Transfusion Practice. Volume 37. (1997): 573.
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Bags for transporting blood products at issue/dispense
Yes, we use biohazard bags that seal.
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Level 1 trauma center Massive Transfusion protocol
Hello, We also have Softbank/Epic. We issue everything in softbank. In EPIC the first 2 units of the MTP are completely entered in BPAM like a regular transfusion. After the first 2 units are completely documented the nursing staff will just enter in a total volume for products transfused. All patients are registered in epic as a trauma.
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Rh Pos or Rh Neg?
At our facility if the patient has an Anti-D of 2+ or less we consider the patient Rh Negative and issue RhIg. The sample is then sent to the reference lab to determine if the patient is a weak D or partial D by molecular testing.
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Scanning Emergency released blood into EPIC
In order for scan in emergency release blood products at our location they have to place an order. After the order is placed we can issue the units in our seperate blood bank LIS system. After the units are released in the blood bank LIS and the transfuse order is released in EPIC they can scan in the units. The process is the same for the RN as scanning in regular units.
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Best Practice Alerts for Transfusion Reactions
Good Morning, I am working on creating some best practice alerts that will appear for patients that have a past history of transfusion reactions. This will appear when providers order additional blood products for these patients. Would anyone be willing to share any that they are currently using? Thank you.
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D Molecular Testing
If we get a 2+ on a pregnant patient or woman in child bearing years we confirm the 2+ in tube. If the patient is still a 2+ we interpret the patient as Rh Negative and send the patient out for molecular testing.
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DTT-Treatment of Screening Cells (Daratumumab/Darzalex)
I have never done DTT treated cells so bare with me. I have been looking at the Dithothreitol 0.2M that Hemo bioscience offers. Whe you get the product is it in powder or liquid form? How much is in the bottel? If its a liquid to do thaw it and aliquot it out into smaller volumes? When you treat the cells to you mix 1 ml of DTT with 25 mL of reagent cells?
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Pediatric Transfer Bags
I will have to check if we can get pediatric plasma units from our supplier. I didn't think of that.
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Pediatric Transfer Bags
CariieM we did decide that once the patient is 50 kg we will use the adult pediatric MTP policy. Kate Murphy, I was thinking we would take up whole units for the first red blood cell and plasma. Why they are runing them up another blood banker would split units based on the weight. I'm thinking you might be right in issueing full units since it will maybe only be done 1 a year. At your facility do the Dr. just take the amount they need from one unit then discard the rest?
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Pediatric Transfer Bags
We do get one baby unit a week that has the transfer packs docked to the unit. I wanted to have transfer packs in house that we could sterile dock ourself since we have a welder if needed.