Share Posted January 18, 2009 Share Posted January 18, 2009 I am trying to change our incompatible plasma policy. Our former Medical Director wanted us to tally all incompatible plasma. So if an AB patient gets several doses of non- AB platelets or cryo & even A red cells -we tally up all the incompatible plasma. The A red cells are considered to have 50 mls of incompatible plasma. If we transfuse over 750 mls we have to contact a pathologist. So when we have a trauma or open heart that is a AB or B we have to haul out the calculator & oftentimes call a path. If we transfuse > 750 ml in a week then we have to obtain volume-reduced pheresis for a month! Our blood supplier only has a limited amount of platelets. I want to concentrate more on providing the oncology patients and infants with type specific platelets.Tallying the type O plasma seems more reasonable. We also do a 1:25 Initial Spin anti-A & anti-B titer on the O pheresis and never transfuse a O pheresis with high titer to an A, B or AB patient. Does anyone else tally the plasma in red cells and cryo?What are other facilities doing to address incompatible plasma? Link to comment Share on other sites More sharing options...
Eagle Eye Posted January 19, 2009 Share Posted January 19, 2009 we do not tally incompatible plasma in RBC, SDP & cryo(we try to give ABO ocmpatible cryo eg. B patient can get B or AB).We do not give ABO incomatible SDP which has anti and/or anti-B titer of 64 or higher. (eg it patient is A and if we need to give B SDP, we make sure that anti-A titer is <64). Link to comment Share on other sites More sharing options...
Share Posted January 20, 2009 Author Share Posted January 20, 2009 So you titer a B SDP? I would think it would only be necessary to titer O SDP because it is my understanding that the O SDP is the only one ever implicated in a hemolytic TRXN. Link to comment Share on other sites More sharing options...
Eagle Eye Posted January 20, 2009 Share Posted January 20, 2009 Yes you are right but sometime you have to think about techs. who are working on the bench. To make their life simple and for consistency any time we have incompatible plasma we do titer. We also have a flag in our computer system so at the time of by passing flag they need to enter a reason for relase of incompatible plasma. Link to comment Share on other sites More sharing options...
geekay Posted January 21, 2009 Share Posted January 21, 2009 When the patients safety is concerned, it makes sense when we do the titre of O plasma....but for B plasma titration, only in selected cases/ patients only, it helps...and makes sense too... with wishes and regards, engeekay2003 Link to comment Share on other sites More sharing options...
bbbirder Posted January 28, 2009 Share Posted January 28, 2009 WOW! I would think only doing this for the O's would be important.I am looking for a good way to track O plasma (from Platelets) given to non-O's. Does anyone have a good way to do this that is not just hit or miss? Something in their comptuer?Thanks,Linda Frederick Link to comment Share on other sites More sharing options...
Eagle Eye Posted January 29, 2009 Share Posted January 29, 2009 I do nto know what computer system you have but in cerner classic you can write CCL to get a report of all those patient who receives non-O plasma(only patient whoes type is not O).Check with your LIS manager or call your support and you should be able to get a report. Link to comment Share on other sites More sharing options...
Share Posted January 29, 2009 Author Share Posted January 29, 2009 At my hospital we keep track with an attached sheet of paper stabled to a patient record card. We haven't gotten rid of patient record cards yet. I have found in the literature that only type O platelets have caused hemolytic transfusion reactions. There have been 25 documented cases in 30 years of HTR from O plts transfused to non-O patients and 6 deaths reported to the FDA in the past 10 yrs. according to Mark Fung, MD in the Arch Path Lab Med, Vol. 131, June 2007. It is not frequently reported, but there may be a lot of under-reporting. It is a concern & I certainly do not want it to happen where I work and I want to be compliant with the regs. Unfortunately you need a policy for incompatible plasma and I want a reasonable policy--but none of the regulating agencies tell you what the standard of care is?? Link to comment Share on other sites More sharing options...
Mabel Adams Posted February 8, 2009 Share Posted February 8, 2009 Wonder how those risks compare to the number of patients that die every year due to drug errors. Not that we BBers want to take increased risks, but it gives some perspective. Link to comment Share on other sites More sharing options...
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