SportsFan

We are a level 1 trauma center for pediatrics. What are others doing for this population? Using an age cut-off or weight or using AB plasma as emergency release? For adults, we are using A plasma as recommmended by ARC. Thanks for any input.

We were told that they don't have anyone to spare. Also they would have to train mutliple people on multiple shifts on how to pick up products as well as where the blood bank is. We will have the same issues and more because we have to train people on multiple locations!! As far as staff, they said we should petition the hsopital for more staffing so we can be runners.

Recently at my hospital, it has been suggested that the blood bank staff should be the runners for all massive transfusions. My gut reaction is no. We currently do not do this and this was not done at my previous institution. I talked to some colleagues at other hospitals and the majority except one said they do not run. I am hoping to hear what others do and use this as evidence for or against this idea of the blood bank staff running blood. The idea of us running worries me especially if the situation arises where there is more than one bleeding patient. Thanks for any experiences that you share! .

DAT for anemia is understable but unless every patient is coming in with that diagnosis, I think you may be onto something. I would track the DATs she orders and let the data do the talking. Present it to the medical director with your concern and he/she can talk to the hematologist to find out what the reasoning is. Many hospitals are looking at utilization including lab tests.

There was a recent paper in Transfusion May 2013 which discussed antibody of undetermined specificity. There was also an accompanying editorial. May be useful and help answer your question.

Thank you Goodchild. Dansket- here is what I found on the CAP checklist which Goodchild mentioned in the above post. TRM.41350 Phase II Is a compatibility label or tag securely attached to each unit before issuance, and does it remain attached until completion of the transfusion? NOTE: A label or tag must be securely attached to every unit before issuance and remain attached until the transfusion is completed. The label must include appropriate patient and donor identifiers and blood groups, crossmatching testing results, and interpretations.

When labeling blood components with recipient's information, what is required to be on the tag/label? We have one tag which we say must remain attached to the unit and another tag which is removed at the time of the bedside clerical check. The tag which is removed has the patient name, MRN, DOB, blood type of patient, blood type of unit, unit number, date and time of issue, also has listed if unit is Hemoglobin S negative or CMV negative, and results of crossmatch. On the tag which remains attached to the unit, the patient's name and mrn are listed as well as blood type of patient and unit. I am trying to find (unsuccessfully) what is required to be on the tag which remains on the unit. I looked in the technical manual and the CFR but am having trouble understanding what should be on the tag that remains. Any input or suggestions where to find this information would be much appreciated. Thanks!

I am trying to get to the bottom of why some prefer pooled platelets and why we don't just go to 100% apheresis platelets as I know our supplier would like us to do. One thing I have learned is that there has been a thinking/theory here that if someone is refractory to platelet transfusions and we can't get HLA matched or HLA matched has not worked, you should give pooled platelets. The idea is that maybe there will be some bump in plt count. As far as the pooling from the apheresis units, I have no idea how that got started. I believe the sampling is in a closed system so the apheresis units are still good for the remainder of their shelf life but I need to confirm. The apheresis units are given as a regular unit and I was told it is because an apheresis unit is equivalent to 5-6 WBD plt units. So taking 1 unit off still qualifies it as equivalent to 5 units of WBD plts. From a QA standpoint, I have to investigate what is or is not being done. But I can't find this situation anywhere to figure out what needs to be done in way of plt count or bacterial testing. From the responses so far, it appears no one else does this. Thank you for all your responses!

That was mine as well but I am newer to this field and maybe I am missing something.

At my new hospital, we transfuse mainly apheresis platelets but have a few hematologists who prefer pooled platelets. I recently found out that if we don't have any pooled platelets in house and there is a request for pooled platelets, we prepare our own pooled platelet by taking "one unit equivalent" from 6 apheresis units and pooling those 6 "one unit equivalents" together to make a pooled platelet. I have never heard of doing this before. I can't find anything in the technical manual that talks about this. The new pooled unit is not bacterial tested. The reasoning I was given was that the apheresis units were tested so the pooled unit is fine. Does anyone else do this? This practice concerns me and I would prefer we don't do this but I need evidence or support to show that we shouldn't be doing this. Thanks.

1. University hospital with ~560 beds. Average number of samples per month is 2,400 and avg. # of RBCs transfused per month is 2,000. 2. STAT is 60 minutes and often from OR, ER, or L&D. 3. Logged in to blood bank to verify results. Most come directly to the blood bank and we spin it. 4. Neo or sometimes the Echo 5. Yes, monthly by our lab QA manager. Both STAT and regular type and screens are monitored. TAT starts when the specimen is logged into the blood bank system not when it arrives so a sample could be in the blood bank but not logged in (happens more with non-STATs for batching purposes).

This is a two part question regarding what you are doing with type and screens and the order for the T&S. 1) Does your blood bank have extended hold T&S (example 28 day hold)? And for how many days/weeks? If so, is the extended hold only for your pre-op patients? 2) If you use EMR for ordering T&S, do you have hard stops in place? For example, must they answer yes/no/unknown for has the patient been transfused in the last 3 months? Or is the question there and a requirement but no hard stop? Or no question at all? Background is we are looking at changing the EMR order because often this question is not answered. This is causing pre-op samples to become a 3 day sample instead of a extended hold. We have to do a lot of calling/e-mailing to let them know and it's a waste of tech time. I should say that in our current epic order this is not a question but rather a statement which if true one needs to click to highlight (also very confusing and needs to be changed). Since we are looking at changing the order and the length of our extended samples, I was wondering what other places are doing. Thanks!

We are in the same situation. We just bought coleman coolers on wheels too! Right now, we are trying to figure out how many cool packs to put in and how many whole blood units will fit. If I may ask Deb, what did you end up going with? Thanks!

For those of you collecting PAS platelets, how often are you collecting concurrent plasma? We are looking at getting the Trimas but currently use Amicus. On Terumo's website, it says: Plasma replaced by PAS can be collected as an additional plasma product for transfusion, while still classifying the donors for plateletpheresis for deferral purposesWhen we started collecting PAS platelets, Fenwal had no recommendation on what to collect. But we are revisiting this issue and I would like to see what others are doing. Thanks!!

We use 4 blood volumes and may adjust down from that depending on absolute CD34 count.