Cryo

[lef5501]

I have a question about cryo. We are a small hospital and only use cryo about once a year. Therefore we only stock ten units of O cryo. I know cryo does not need to be ABO compatible, but the Technical Manual says you should try to give compatible if large doses are given. My question is: can we

give 10 uits of O cryo to everyone or should we stock AB cryo. I know at my last facility (large trauma center), we gave AB cryo to patients whose type was unknown. What does everyone else give as far as cryo goes?

[bevydawn]

We only keep 20 units of cryo on our shelf, but they are a mixture of all types. And when cryo is ordered, if we can, we pool 10 of the same type (although it is rarely ever type specific for that particular patient) but that rarely ever happens. And if by some miracle we are able to get 10 of the same type, the patient gets it no matter what type they are or the products are. They have done it that way here since way before I was here and as far as I know they have never had any issues creep up.

[Lcsmrz]

Tough to get AB cryo.

At one small facility, we stocked only Group A cryo, which would be compatible with about 85% of the population. We get patholoigst approval for giving it to the Group B and AB patients.

[Mabel Adams]

We try to stock only group A cryo (15 units) for the reasons stated above. Also, it avoids the "super O's" with the really high titer anti-A,B if we have to give it to a B or AB patient (although I don't know if that is much of a worry in a pool). With the new FDA rules about having a barcoded version of every ABO type in the pool attached to the unit, it is also easier to pool only one type.

[Eagle Eye]

we always have same type in the pool. If we have 5 A's and 5 O's we pool them seperatly. we try to give type which is compatible with plasma but if we do not have in the inventory then we give whatever type is available. Our minimum is 25 for each type so most of the time we are able to provide ABO compatible.

[Mary]

AB would be best, but it is tough to get. Our supplier has started to supply prepooled cryo(5 units). This is a great time saver.

[rcurrie]

Although we try to pool all of the same type, it isn't always possible. Our minumum stock is 80 units, but we try to keep around 150 as we are a level 1 trauma center, 2 hours away from any other source of blood in an emergency. We give type specific FFP, but if it is a trauma patient whose blood type is unknown, we thaw type A plasma in order to conserve our AB plasma. As stated, we are going to be giving compatible plasma 85% of the time, and it is unlikely that the A plasma will harm the B's and AB's that get transfused.

BC

[Karen Olsen]

Everything I read lately talks about this being the next topic to attack since the bacterial testing of platelets has been taken care of. We are not stocked addequately for the most part to be able to give type compatible cryo to our patients. It seems lately that we have been getting mostly type O cryo from our supplier - ugh! I guess we will just have to wait for a mandate from the FDA or AABB.

[donellda]

We usually keep O cryo instock because AB cryo is very hard to get. If we know ahead that a patient is going to use a lot of cryo we may bring in some of his/her own type but in our facility we never know what products are going to be given until it's time to give it. (We deal with a lot of traumas)

[MJDrew]

We basically pool whatever is available, usually keeping it ABO compatible, but it can sometimes be a mix of types. Even in a 10 unit pool, by the time the small amount of plasma is mixed in the patient's total blood volume, it's like spittin' in the ocean! We have 900 beds and a level one trauma center, usually have 200 or so units on hand.

MJ :cool:

[mwlister]

Assuming you are acquiring your cryo from a large Blood Supplier that supplies blood and blood products to multiple institutions I would stock ten units of each type. If not used one to two months prior to expiration I would return them and replace them with longer expiration dates.

Hope this helps, MWL

[bpkelly]

Is your blood supplier making dry button cryos? If so, the volume in those should be so inconsequential that I don't see a problem. The other issue is that cryo is usually a one time thing so no matter what the volume will be small.

[Sandy Jo]

I am Transfusion Service Supervisor in a fairly small hospital and only stock 20 units of cryo. Use it only once or twice a year. We generally stock what our supplier gives us (type O). This also allows us to pool the product together as they are all usually O's. For the number of times we actually use the product, I don't see a point in requesting a specific type as most of the time it just sits in storage until we swap it out with 2-3 months left on it.