ABO&Rh for Plasma Products

[Mary]

We require that a patient have a record of 2 ABO&Rhs on file before we issue plasma products unless it is an emergency in which case we issue Group AB.

If a patient does not have previous records, we draw a sample and armband the patient with a Blood Bank armband and perform an ABO&Rh.

The problem comes in when we issue units for a patient that had previous records, but is not wearing an armband. This confuses the nurses.

What does everyone out there do?

[Seveets]

We have a Type and Band; whenever FFP is needed.

Our Oncologist specialist was upset about type and band order for his patients that require a lot of platelets, so for that product a Band gets order (but the phlebotomist must first check with the blood bank to confirm that we have a known blood type) -- this works ok, except when red cells get added on and we run around trying to find a non-existent speciment tube.

[John C. Staley]

We are ultra conservative when it comes to issuing blood products. We have to have a current type and screen (current defined as this hospital stay) at least started with the ABO/Rh completed prior to issue of any plasma products.

[Jane]

We do the same thing you do Mary. It does occasionally confuse the nurses but we also put on our blood bank form that an armband is only required for blood. There aren't too many questions but we do get one now and then.

[Eagle Eye]

We also require current type and screen (atleast once each hospital stay) before issuing FFP. At least ABO/Rh completed prior to issue of FFP. We do have typenex band system, we require new specimen every 72 hrs. If antibody screening is pending and there is an emergency, we release type specific with emergency release sigend by the physician ( checked off as type specific before the completion of test).

[Mary]

Why do you do an antibody screen if only plasma products are ordered?

[Eagle Eye]

That is a good question. We get a order for type and screen. We rarely get an order where we have patient coming in frequently just for plasma, where we should do only ABO-RH. May be I need to look at the STAT.. how many time patient comes in just for plasma products.

Thanks

[CABMT]

We require a Typenex band for red cell products as well as plasma, but not for platelets. We do not require a current antibody screen for plasma alone.

[ANORRIS]

How do you handle transfusing FFP if the unit of FFP has an antibody? Do you ignore and transfuse? Do you only use caution on kidd?

[khalidm3]

How do you handle transfusing FFP if the unit of FFP has an antibody? Do you ignore and transfuse? Do you only use caution on kidd?

We don't use any blood product having antibody screen positive. We test our donors by pool cells for ABS.

[Mabel Adams]

Where I used to work we didn't use our band system for anything but RBCs. We would give out FFP based on historic type (only one required). As I was leaving that job we changed to requiring a type on the current visit due to some concern about people borrowing another's medical ID.

At my new job, we use a band for any blood product but they don't have to draw a sample for it if we don't need to type for plts or FFP. We require 2 historic types or one type on the current visit for FFP and Plts. I can't see any reason for making a doctor sign for universal donor plasma since there isn't any increased risk to it like there is for uncrossmatched blood. Unless that signature is serving as the doctor's order because you are doing it outside the usual computer orders. Antibody screen has no bearing on FFP transfusion except that a fair percentage of patients that need plasma end up needing blood as well. Still, I can't see a medical justification for the Ab screen until the doctor orders blood or a type and screen. I'd be surprised if CMS would think they should pay for it, but I suppose under DRGs they may not always know.

[tbostock]

We need a vaild Type and Screen (this admission) for all blood product orders. Our take is much like Mabel's, if a patient needs FFP or platelets, they have the potential to also require red cells. For type specific red cells to be issued, we require two separately drawn blood types to be performed (one can be historical).

[sgrovenger]

We also require a valid Type and Screen, because we cannot issue a blood product in our system without having an ABORH and Antibody screen result unless we are using the emergency release procedure. We had an instance where a tech wanted to just issue a platelet, so he put in a negative antibody screen result without actually testing it. Then, low and behold, that patient needed blood, and it looked like, in the system, we had already done the antibody screen. After that, we changed our policy to require a current Type and Screen sample for plasma components, even platelets!

[nmartin]

At our facility, we require all patients receiving a transfusion, regardless of the product to be wearing a Blood Bank armband. This removes all confusion from the transfusionists. If the patient needs to be armbanded with a new BB armband , then we have a policy to always have at least one ABORh type done, associated with that armband number if giving platelets, FFP or CRYO. If the patient continues to wear that same BB armband, we give the platelets, FFP and CRYO without any further typing.

[Mabel Adams]

If you require testing each time, what do you do for OP transfusions that come in for plts once a week? Still draw and test every time?

[cthherbal]

Where I work, the outpatient bands for platelets are good for 30 days. Provided they are wearing their Blood Bank armband, they can go home and return for platelets within the 30 day timeframe.

[nmartin]

The outpatients wear their BB armbands for a few weeks. When they come to have their CBC's done the MD also orders a "Hold for BB" which is an EDTA and the patient gets a BB band put on if they do not already have one.

[tcoyle]

We do not use the armbands nor require a current type or screen for plasma/platelet transfusions. We can transfuse from a historic type and in an emergency we can issue type A plasma. We also never transfuse plasma with an antibody.