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Found 6 results

  1. My hospital recently went live with EPIC’s BPAM module, because of which we had to increase the amount of data being sent across the interface (more OBX segments cross into EPIC for the patient/product matching aspect). The Transfusion Service uses Softbank and we've discovered one the main Soft interfaces into EPIC can only process so many lines of data at one time. How did we discover this? We broke the interface! One massively transfused patient sent across so much data that it crashed. Soft is currently working on a fix for this, but the main workaround they gave is to limit the number of products you can crossmatch/dispense on each order (recommended max =16) and create a new order when that amount is exceeded. For most patients this isn’t a problem, however I am at a loss for what to do with the massive bleeders. In order to be electronically crossmatched the red cell product needs to be on the same order number as the Type and Screen. So when a liver transplant takes a turn for the worse and you transfuse 80 crossmatched red cell units emergently, what do you do? It seems ethically wrong to flip to the uncrossmatched status just because the software doesn't like more than 16 units on one order. Another suggestion was to create "fake" type and screen specimens for each set of 16 units, which also doesn't sit well with me. Does anyone else have Soft and come across this problem? Thanks!!
  2. Howdy everyone! We are a small critical access hospital with 25 beds, and we are looking at implementing a Massive Transfusion Protocol to stabilize a patient as much as possible before they are airlifted to a larger facility. I have had very little luck finding any smaller hospitals that have such a protocol, and would love to hear from anyone regarding input on tailoring a MTP to a facility with limited resources. We do currently have a protocol defining the utilization of O+ units for adult male patients and women over childbearing age. We do not have the ability to provide platelets, rapid fibrinogen testing, TEG/ROTEM, or cryoprecipitate (though as a frozen product, we may decide to add that to the inventory). The addition of Tranexamic Acid, KCENTRA, and PCCs has been discussed, but there doesn't seem to be much information about their use when a patient is going to be airlifted within 1-2 hours. Thoughts? Links? Procedures anyone would like to donate? As a night-shift generalist in a small facility, I am perfectly comfortable admitting that Blood Bank is not my specialty, though I really enjoy the work! Thank you! Leah
  3. Yesterday I attended the first of what I am sure to be many National Whole Blood Summits here in San Antonio. https://strac.org/summit/ If your facility or trauma surgeons are not already pushing it, be prepared. It is coming back. The conferences was excellent. The information and statistics presented was compelling. Low Titre O whole blood is coming (back) and will be the preferred product in traumas and hemorrhagic shock. Get ready!
  4. Is there any regulation that requires Transfusion Services to have a massive transfusion protocol? My hospital system has two facilities- one is a trauma center with a very active MTP that works great. The other hospital is much smaller and in theory does not accept any trauma patients. I found a mini MTP policy at the smaller facility today- it basically states exactly the same thing as the normal Uncrossmatched policy does. The only reason I can think of why this mini policy exists is because some regulating agency says so.
  5. The idea is that whole blood was always the best way to accommodate massively bleeding patients---plasma, RBCs and platelets all in one shot so to speak. And that the common use of component therapy over the years is more due to convenience than otherwise. There have been a few retrospective studies out that seem to suggest that the use of whole blood in these patients leads to better outcomes. On the other hand, maintaining an inventory of WB for the occasional massive transfusion patient seems impractical. Here's one article: http://www.mayoclinic.org/medical-professionals/clinical-updates/trauma/whole-blood-transfusions-reduce-mortality-in-massively-hemorrhaging-patients I am curious if some of our more astute PathLabTalk associates have any opinions on this topic? Thanks, Scott
  6. The idea is that whole blood was always the best way to accommodate massively bleeding patients---plasma, RBCs and platelets all in one shot so to speak. And that the common use of component therapy over the years is more due to convenience than otherwise. There have been a few retrospective studies out that seem to suggest that the use of whole blood in these patients leads to better outcomes. On the other hand, maintaining an inventory of WB for the occasional massive transfusion patient seems impractical. Here's one article: http://www.mayoclinic.org/medical-professionals/clinical-updates/trauma/whole-blood-transfusions-reduce-mortality-in-massively-hemorrhaging-patients I am curious if some of our more astute PathLabTalk associates have any opinions on this topic? Thanks, Scott
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