What do "you" do??

[Brenda K Hutson]

I am just trying to get a feel for the different policies out there regarding this issue:

What is your Policy with regard to establishing (or reconfirming) a patient's ABO Type for subsequent FFP Transfusions? Some possible choices:

1. Just need to have "a type" on record; doesn't matter how long ago it was done.

2. Type them once per admission and then they can have FFP for the rest of that admission? So

would need new type each admission if FFP requested?

3. Re-confirm their ABO Type every "?" period of time?

Thanks,

Brenda Hutson, CLS(ASCP)SBB

[nmpoupard]

I've worked at adult and children's hospitals and the policies were different. At the adult hospital we required that the patient be typed once per admission. At the children's hospital we accept historical blood types for platelet, plasma and cryo transfusions.

[AMcCord]

We require a type once per admission for FFP and platelets.

[JOANBALONE]

Hi Brenda,

We require an ABO/Rh once per admission for inpatients. Our outpatient policy is once every 2 months.

JB

[Malcolm Needs ☆]

When I was working in the hospital environment, we required a type per admission.

[RR1]

At my hospital we accept historical type for Platelet, FFP and Cryo issues.

[swede]

We require one type per admission for FFP. Cryo and platelets require a historical type.

[Marilyn Plett]

I would vote for an ABO once per each admission, partly because patients have been known to "share" insurance identities!

[Steven Jeff]

Historical type for platelets, FFP and cryo is acceptable at my hospital

Steve

[Eagle Eye]

once per admission for FFP and platelets....Hem Onc patient we give platelet base on historical type but require type every week.

[Bill]

We accept historical data for platelets & FFP. We do not stock Cryo.

[Yanxia]

We type the speciman every time when require plasma or platelet transfusion except the patient is difficult to draw blood.

Because we have encountered some cases the doctor write the type wrong.

[tbostock]

At my previous hospital: Typed each admission for plasma, for platelets and cryo just had to have a blood type on file.

At my current hospital: for plasma, cryo, and platelets, we have to have at least two previous types from two admissions within the past 12 months on file.

I like the first scenario better, since giving type specific blood is really more critical with plasma. And there are patients who use fake ID, insurances, etc (see other post above).

[PaulSunV]

A type and screen is required for each hospital stay at each of the two hospitals where I currently work.

[adiescast]

We use a historical type for plasma, platelets, and cryo. I would prefer to have a current sample and we are looking into what it would take to change the policy (since you have to have a doctor's order for the test and we would like the patient's doctor to order it).

[Brenda K Hutson]

We use a historical type for plasma, platelets, and cryo. I would prefer to have a current sample and we are looking into what it would take to change the policy (since you have to have a doctor's order for the test and we would like the patient's doctor to order it).

Currently, for new patients, we call the floor and ask them to Order a Type and Screen (and they do). While an Antibody Screen is not necessary for FFP, we have generally thought that if they are using FFP, there may be a chance they will use RBCs also; so why not have the Screen done as long as we have a specimen. However, I think we will probably change that since I would not think we can justify charging for the Screen under those conditions.

Brenda

[jcdayaz]

We use historical type only for FFP. We have adopted the practice of transfusing non type specific platelets and/or cryo ( in most circumstances...not always....depends on the frequency of transfusion need). We still require a Type/Screen specimen prior to transfusion of these products if we have no history on the patient. We think it best to get a pretransfusion sample to get a "baseline"...ie..prior to anything foreign being introduced.

[PammyDQ]

We use the "once per admission" guideline for all plasma products, however our "regular" HemOnc & Transplant patients are exempt. They are usually typed multiple times due to frequent RBC transfusions as well.

Brenda, when we have a new patient and they're requesting FFP etc, we only require an ABORh to be done, but since they're receiving these products because they MIGHT bleed, we usually suggest a TS to be ordered just incase. As long as the MD orders it, I don't see how it can actually be questioned. We can release the product prior to the completion of the screen though.

[MAGNUM]

For FFP, Platelets, and Cryo, we accept a historical type to assign the unit, but do require a current Type and Screen to be on file.

[Brenda K Hutson]

For FFP, Platelets, and Cryo, we accept a historical type to assign the unit, but do require a current Type and Screen to be on file.

If you require a "current" Type and Screen to be on file, then it doesn't sound like you "accept" a historical type??

Brenda

[KarenJ]

We use historical type if there are at least 2 separate types on file. if we don't have history we ask for a type & screen.

[vam3401]

We require an ABO/Rh per admission.

[tms8313]

If a patient at our hospital has a blood type, type and screen, or type and crossmatch performed for transfusion of any blood products they must be issued a Transfusion Service armband.

For plasma or platelet transfusions, as long as the patient is wearing this armband, they can receive the products since a blood type was confirmed. They may wear this armband for the entire admission. If the armband gets removed for any reason, then the patient must have a blood type reconfirmed again and the patient is given a new armband.

Patients are retested every 72 hours if red cells are given and a new armband is issued each time.

[trisram]

Each time FFP is needed, if a type&screen is not done within the last 3 days, FFP won't be issued. Once the type&screen is performed and the screen is negative, that is when we issue the FFP. If the screen is positive, we won't issue until the Ab ID is done.

I've never been in a situation where there was no time to do a type&screen just to issue FFP. Usually, in emergency situations, blood is issued.

Edited January 18, 2010 by trisram

[jcdayaz]

I would vote for an ABO once per each admission, partly because patients have been known to "share" insurance identities!

I agree with your statement here. I have been involved in two instances of a patient trying to use someone else's insurance info. Guess what? Different blood types!!! SCARY THOUGHT!!!

It seems in the last 10 years or so hospitals have started doing a MUCH better job at requiring proper ID on a patient. However, I would not think in an emergent situation proper care could be refused due to lack of ID. So your suggestion, in my opinion, is a GOOD one!!!