David Saikin

Most rbcs in the USA are leukoreduced and AS rbcs. The residual plasma in these units is very minimal. I cannot remember ever washing rbcs for neonate/preemie transfusion, starting in 1972. (before AS or leukoreduced rbcs)

since your institution considers blood/components "medication" do you get paid what a pharmacist gets paid? If u are using 2 or more lines for transfusion how would u know which product causes a reaction? Rhetorical questions.

The AABB Tech Manual states that only 0.9% saline may be added when transfusing blood or blood components. I do not see a problem running plasma and rbcs together - see my comment above.

While I appreciate this sentiment, my reality for apheresed plts is that I only receive group A or O - depending on what is there and pending outdates at the supplier. As a small institution (24 beds) I do not have the capability for washing plts (though I have in the past at larger, tertiary care places). Aside from myself - all the techs are generalists who would rather not do BB if they had a choice ( though for the most part they do excellently). I guess the larger institutions get dibs on the ABO identical plts - not so for us little guys whose usage is random and rare.

I know large institutions that use an immediate spin titer of 51 or less. Whether this is a titer or dilution I cannot say. The medical director there told me that it is a titer.

Immediate spin xm; we try not to draw a 2nd sample. We use BloodLocs (which are considered barrier protection).

years ago all we had was warm saline or ether. We used warm saline on cord bloods with +DATs.

Have you contacted your vendor? They might be able to provide a starting point.

We use AS-1 red cells w CPD as the anticoagulant.

We have had docs that have wanted to and done the intraoperative collection/reinfusion. We set up guidelines: we will not accept the blood into the blood bank. It has to be reinfused within 6 hours of collection or discarded. Treated like shed blood. This was only done for a short time. The MD became seriously ill - none of the other docs cared to use this process.

Excellent Choice!

I tried to send you a message with my procedure. Send me one and I'll forward it to you.

See my answers in between your questions.

There is no standard that requires a transfusion to be started within a certain time frame from release. the only timing that is critical is that the unit needs to be complete within 4 hours of release.

We use them; no plans to stop