Issuing FFP/Platelets on Historical Type

[cmiller]

I would like to get feedback on policy for issuing FFP and Platelets.

Do you issue to a patient if an ABO/Rh are on file or do you require a type be performed on a current sample?

Do you require a Blood Bank ID Band to be used?

I know according to AABB that using historical types is acceptable for these components, but I was just curious if others went "above and beyond" to ensure patient safety.

Thanks!

[janet]

We do a type on each admission for plasma only.....platelets we generally give what-ever is expiring (we are 10 hours from our blood suplier).

[Seveets]

For Platelets we order just a "BAND" so that the patient is wearing a separate Blood Bank bracelet.

The ordering labels are brought to us and we look up to see if the patient has a blood type on file.

If so, then the phlebotomist just needs to verify patient id and put a bracelet on them.

If no blood type then we add "TYPE" to the order and have the patient drawn.

For Plasma we are still doing a "TYPE and BAND" so that the patient is drawn and the blood type is done (again) even if there is a history.

I'm not sure why the difference (other than the oncologist was tired of having his patients redrawn everytime they got platelets).

[Eagle Eye]

For plasma we require type done on each hospital admission. no band required.

For platelet, same as plasma (exception : oncology patient---require type done every 10 days). No band required.

For red cell---new specimen every 72 hrs and band required.

[John C. Staley]

We require a "current" type and screen for plasma and platelets. For in-patients current is defined as: during this hospital stay. For out-patient series patients current is: within the past 30 days. I'm not sure how that was derived but that is our current policy.

We do not use a blood bank specific arm band and I will fight the use of one with every resource at my disposal. Out-patients have the armband in their chart. When they come in the nurse IDs the patient, puts the armband on and then goes through all the usual pre-transfusion steps. That armband is the same one used to ID the sample when the patient was drawn. Not a perfect system but it seems to work.

[kim]

At our hospital we do not require a new type for either plasma or platelets. As long as the patient has a historical type in the computer we release the products. When I started working here I thought it was a tad bit odd because what if the patient really was not who they said they were and how do you work up a transfusion reaction without a new sample. I still think its a good idea to draw a new spec!

[bbbirder]

While I know that a new specimen is technically not required, we have found that for inpatients, we like to get a new specimen for FFP. We have had too many times when a patient getting FFP now needs red cells (STAT! or so they say). I would not want to be without a fresh specimen that I can use for RBC XMing.

For oncology inpatients, we will stretch the 3 days if they are just getting PLTs. For oncology outpatients, we will let them keep their BB ID band and use it for 2 weeks if they are just getting PLTs.

Linda Frederick

[jhaig]

Any infusion of platelets or plasma gets a new specimen drawn and a blood bank band (one band per admission). Even if there is a previous history on file, how do I know for sure that the correct patient was drawn previously? And how do I know for sure that the current specimen was drawn from the right patient as well? I want to know that the current specimen has been tested to verify the ABO/Rh. I'm just careful about patient ID and I don't think cutting a corner is this case is worth the potential adverse outcome.

It takes a couple of minutes to recheck an ABO/Rh. To me, the extra couple minutes is worth it to be sure you've got the right patient. Going 'above and beyond' helps me sleep better at night.