PaulSunV Posted February 13, 2009 Share Posted February 13, 2009 Yes, I got it thanks.Paul Link to comment Share on other sites More sharing options...
John C. Staley Posted February 13, 2009 Author Share Posted February 13, 2009 I'm afraid the problem you face is not the lack of good, reliable data!! But I sure hope it helps. Good luck. Link to comment Share on other sites More sharing options...
PaulSunV Posted February 13, 2009 Share Posted February 13, 2009 (edited) Actually the issue is back on the agenda for next week and we will see how far we can go. Dr. I may be willing to entertain the issue as she talked to someone at the U and they have apparently been using it for about two (2) years and she considers the pathologist at the U to be more conservative than she is. Edited February 13, 2009 by PaulSunV Link to comment Share on other sites More sharing options...
Mabel Adams Posted February 17, 2009 Share Posted February 17, 2009 We use 5-day plasma. We are not a trauma center, but we have the same medical director as a nearby Level 1 trauma center, and they too use 5-day plasma.Overall our use of FFP has been cut dramatically due to technologists monitoring the indication for the transfusion in combination with education of the medical staff by our esteemed blood bank medical director who is also an expert on coaguopathies. Vitamin-K is being recommended for many cases. Our director wrote ain "inhouse" handbook of transfusion guidelines called "Good Transfusion Practice" (aka The Good Book LOL)for all blood products, and it is distributed to each new batch of residents. Generally FFP is not used at my facility unless it's clearly indicated. Incidentally our facility had one TRALI induced sudden death following a FFP transfusion and the FDA highly scrutinized the indication for the FFP infusion of that patient. Is there any chance your Good Book is available online or via email? It sounds like a great resource. Link to comment Share on other sites More sharing options...
bbbirder Posted February 19, 2009 Share Posted February 19, 2009 I would love to see your "good book" also, if you can share.Linda Frederick Link to comment Share on other sites More sharing options...
drsbright Posted February 19, 2009 Share Posted February 19, 2009 Linda: Do you have me mixed up with someone regarding the "good book" !!drsbrightIndianapolis, Indiana Link to comment Share on other sites More sharing options...
PammyDQ Posted February 19, 2009 Share Posted February 19, 2009 Good Transfusion Practice is a hospital print shop published booklet which is 70 pages. I'll talk to Dr. Sweeney when he returns from the Pan-Arabic Trans Med conference in Qatar to see if he doesn't mind sharing his files or perhaps I can mail a booklet. Link to comment Share on other sites More sharing options...
Wendy Posted February 26, 2009 Share Posted February 26, 2009 Could you please share your massive transfusion protocol?Thank youWendy Link to comment Share on other sites More sharing options...
adiescast Posted February 27, 2009 Share Posted February 27, 2009 (edited) OK, I will try to attach it here. The other files are the order for the chart, the list of coolers, and a label we designed to go on the cooler. The "physician orders" mostly consist of instructions for the nurses on things we wanted them to remember.Massive protocol.DOCMBRP cooler list.xlsm10698 MBRP orders 070708.pdfMBRP Cooler labels.xls Edited February 27, 2009 by adiescast Added information Link to comment Share on other sites More sharing options...
brobinson Posted March 4, 2009 Share Posted March 4, 2009 We use 5 day plasma at a level I trauma center. I believe we have discussed this before and except for need of factor V and VIII specifically it has been successful for patients. I'm still fighting the battle to bring the use of 5 day plasma to my facility to reduce the waste of a valuable resource and I need some help.First if anyone has a journal reference or two concerning the factor levels in 5 day plasma and or the efficacy of 5 day plasma I would appreciate knowing where I could find them.Also, I have been asked to provide a list of facilities currently utilizing 5 day plasma, especially level I and level II trauma centers.Any help will be greatly appreciated.Thanks John Link to comment Share on other sites More sharing options...
ccrow Posted March 4, 2009 Share Posted March 4, 2009 John, I used the article in transfusion, convinced the medical director and as of Feb 20 we are using a three day expiration date. :cool: Keep on keeping on..........how is retirement? Link to comment Share on other sites More sharing options...
John C. Staley Posted March 6, 2009 Author Share Posted March 6, 2009 Retirement is GOOD! I check in with my old staff now and then, at least when I'm feeling a little sluggish and need a blood pressure boost. Apparently the 5 day plasma issue is progressing and may even be in place some time in the future, the only problem is most of them don't think they will live long enough to actually see it. Link to comment Share on other sites More sharing options...
rravkin@aol.com Posted February 11, 2010 Share Posted February 11, 2010 John,Three facilities utizing 5 day plasma are The Hospital of the University of Pa, Temple University Hospital, and Christiana Hospital in De. All are Level 1 trauma centers. Link to comment Share on other sites More sharing options...
John C. Staley Posted February 11, 2010 Author Share Posted February 11, 2010 From what I understand, some time in the past year, 5 day plasma was finally accepted. Not sure if my leaving had anything to do with that!!. Anyway, I would like to see the numbers some day to see if my projected $$$$ savings were any where close. I do appreciate all the support and info I received over the years while trying to get this in place. It may not have occurred during my tenure but at least I can feel good that it actually occurred. Now if only they would consider dropping wD testing!!!! Link to comment Share on other sites More sharing options...
bruner Posted February 16, 2010 Share Posted February 16, 2010 You may have lost a battle, but you won the war! The last group you worked for has switched to 5-day!!!!! I will look for references for you. Thanks for your patience with us for all of the years you worked for the change. Everyone (all 21 hospitals-since we have opened some more since you left) are VERY HAPPY with the change.Hope you are doing well-we miss you. I still haven't retired because I need the health insurance to pay for IVIG every 3 weeks at the tune of $6000. 50 years in healthcare and no retiree health insurance. Go figure. This is the first time I've ever responded, but enjoy and learn from this.bruner (aka fg) Link to comment Share on other sites More sharing options...
JLF Posted February 16, 2010 Share Posted February 16, 2010 We are a Level 1 trauma facility in Atlanta, Georgia. We have been using 5 day plasma for several years. Link to comment Share on other sites More sharing options...
RAROYAL Posted February 17, 2010 Share Posted February 17, 2010 New Hanover Regional Medical Center in Wilmington, NC uses 5 day plasma Link to comment Share on other sites More sharing options...
Dee Posted February 17, 2010 Share Posted February 17, 2010 John - There are a few articles that have been written but I don't have a list. We have been converting to 5 day Plasma for at least four years with no problems. For infants or known patients with a Factor deficiency, we use plasma thawed within the 24 hour time frame. Routine surgeries or other patients needing FFP, we use Thawed Plasma. It has really helped on decreasing product wastage. Link to comment Share on other sites More sharing options...
rlmirand Posted March 8, 2010 Share Posted March 8, 2010 We also waste a lot of unused FFP in our facility and would like to bring the 5 day plasma in house. Would anyone guide me in the process of making this happen? I would really appreciate it. Link to comment Share on other sites More sharing options...
rravkin@aol.com Posted March 8, 2010 Share Posted March 8, 2010 At our facility the Medical Director is very much against the use of five day plasma. I don't know why; in light of the overwhelming amount of info and practice available for it's safe and efficatious use. We can only hope that in the future his veiws will change. Link to comment Share on other sites More sharing options...
kate murphy Posted March 15, 2010 Share Posted March 15, 2010 Before we switched to 5 day plasma, we tested the labile clotting factors, V and VIII, daily post thaw for 5 days. Our internal studies showed that approx 75% of labile factors remain at 5 days post thaw. We determined that for most of our patient population, this was adequate. We do use fresh thawed FFP for neonates and TTP plasma exchanges.If you need to convince med directors or clinicians, do some studies and get some data. I also generated some data on cost savings, as we would not be wasting as many 24 hr plasmas. Some science, some dollars...usually works. Link to comment Share on other sites More sharing options...
Antrita Posted March 15, 2010 Share Posted March 15, 2010 We are a much smaller hospital (140 beds). I didn't have any trouble with the medical staff. ER and OR were very unhappy with the 30 minute delay due to thawing a jumbo plasma when requested. I thought I would see an immediate end to wasted plasma but this wasn't so. I started out with having 1 AB thawed. Since our supplier didn't want me to go thru all their AB plasma I wasn't using it until the 4th day it was thawed if I didn't have a stat. If course, right after we started with the thawed plasma our census dropped. So, I was still wasting plasma. It is better now, but I have to keep a close eye on it, our census and what kind of patient's are in the hosptal. I also went to 3 days on the AB thawed. I also found out that I needed to re-educate some of the techs on what blood type can use what FFP type. It was really discouraging to come to work and find out that the evening before a O pos patient wasn't given the A FFP that was going to expire the next day. Antrita Link to comment Share on other sites More sharing options...
rravkin@aol.com Posted March 16, 2010 Share Posted March 16, 2010 DrSBright,Can you give some level of sumation of this major study? Link to comment Share on other sites More sharing options...
JLF Posted March 19, 2010 Share Posted March 19, 2010 We are level 1 trauma in Atlanta and we have been using 5 day old plasma for more than 6 years. We use both FFP and FP24. Link to comment Share on other sites More sharing options...
Mabel Adams Posted June 24, 2010 Share Posted June 24, 2010 From the Technical Manual it looks like 5 day plasma has good levels of ADAMTS13 so could be used for plasmapheresis. Is anyone doing this and, if so, are there any limitations or were there issues convincing anyone? We are suffering more wastage of thawed frozen plasma due to canceled pheresis procedures or the machine breaking down that I am looking to minimize. Link to comment Share on other sites More sharing options...
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