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!

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).

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).

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.

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.

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!

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

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.