jschlosser

Thanks so much Malcom. That makes sense and eases my mind!

Until the next day, when it's back to where you started.

We went live with TAR in January and I'm quite disappointed. The only advantage is the barcode scanning of the patient identification to product. In the lab we have delta checks and other flags that ask us if we need recheck an abnormal value but in TAR nurses can enter a 0 blood pressure or a 500 degree temperature with no checks or alerts. Why isnt there criteria that if a temperature increases by a certain amount TAR alerts the nurse that a transfusion reaction may be happenning or if the oxygen saturation declines think TRALI? Is this something that is possible with TAR and our IT just hasn't included?

BM/PBSC transplant candidate or recipient
 
The nursing staff asks the patient at admission assessment.  If yes, a notification prints in the blood bank.  If ordered by a physician, we clarify the reason.
 
I once had an ER doc order CMVN Irradiated because he "didn't want his patient to get anything".  When I explained the real reason for the product, he changed his mind.

We are a small hospital that didnt have the option of investing in an ISBT label printer so we cant aliquot units for pediatric transfusions. What are our options if we have a trauma involving a child needing blood? Can we hang a unit with the option of stopping the transfusion at the recommended volume for the child's weight and waste the remainder of the unit? Any other suggestions? (Our blood supplier is 4 hours away)

Question--what are you all using for your taget completion of transfusion vitals tag (since everyone seems to have this problem)?  MRPalisades uses <2.0 target.  Years ago, our powers that be decided that our target needs to be 100% completion on the transfusion tag.  Nursing staff can rarely meet that target. 

Interesting enough my hospital had a situation just like this less than a year ago.  We were not informed of the bone marrow transplant but saw that the doctor was an oncologist and when we typed them (previous and we saw they were now an A, we thought we needed to do some digging.  When we finally found out that they had a transplant we gave them O cells as we could not fix the ABO discrepancy even though we had a reason why. 
 
As Shily said, O cells are not rare so we kept as such to not cause any potential effects since no one had ever experienced something like this before.