labail

at our institution we err on the side of caution and as soon as we know that the recipient has received an ABO mismatched bone marrow transplant, we start transfusing them the appropriate RBC type that is compatible with both, as well as FFP/plasma. we also do type and screens on the inhouse patients every 3 days and watch for the conversion of blood types. once fully converted, we change the patient's permanent blood type to the new transplanted blood type and make a notation that the patient used to be ____, received a bmt on ____, watch blood types carefully. on these patients, we also disallow electronic crossmatching.

We are a 400 bed hospital level 1 Trauma Hospital and occasionally have patients that require "massive transfusions" We have a massive transfusion protocol that seems to be working BUT.... The nursing staff now wants us to send all blood products (RBCs, FFP, cryo, and platelets) together in some type of transportation "system". We of course put RBCs in a cooler 1-6 and send the FFP, cryo and platelets seperately. My question is.... DOES ANYONE HAVE ANY IDEA AS TO HOW I CAN CREATE A TRANSPORTATION "SYSTEM" THAT SOMEHOW WOULD HAVE ALL PRODUCTS, KEPT AT DIFFERENT TEMPS. IN ONE CARRIER. My thought was to have plastic carrier bags to attach to the outside of the cooler for the platelets and cryo... Any creative ideas would be welcome.

Not sure we should be doing it, but after much urging of our anesthesiologists, we have started doing cold screens again on patients scheduled for heart surgery. We do tube screening at room temperature and at 4 degrees and incubate for 30 minutes. If that screen is positive, we then do a more complete study. We test patient's plasma at 4 degrees, 12 degrees, Room temp, 30 degrees and 37 degrees, with an incubation of 60 minutes. We report out the strength of reaction seen at the different temperatures. Apparently, they have used the information to adjust the core temperature they take the patient to with better outcomes. Lou Porter, MBA, MT(ASCP), SBB