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Changing FFP (with 24hr exp) to thawed FFP with 5 day exp


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We waste a lot of FFP when its only good for 24 hours after we thaw it. 

I'm looking into putting a procedure in place to change the FFP before the 24 hours are up into thawed FFP with 5 day out date.

 

I was hoping someone has a procedure in place they can send my way for me to copy and use as a guide.  Also, if they can tell me what I need as far as labels and changing ISBT product codes if needed...

 

thanks

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If you have a BB computer system this can be used to control what ISBT product code goes on the thawed plasma.  You BB LIS person would know this information.  

 

Some blood suppliers give you this information, check with them.  If you still have problems feel free to email me at Mary.Mendel@Mercy.Net.

 

Have fun!!!

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Also, if you are handwriting the expiration date and time, you might consider converting directly from frozen FFP to Thawed Plasma.  You will confuse the nurses greatly if you change the expiration date twice, with the last one being LATER than the previous one.  Experience speaking here.  It also save you from having to process the unit twice.

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At the time of thaw, we assign the 5 day outdate (expires at 23:59, which is very nice!) and use the 'THAWED PLASMA' versions of the Product Codes (NOT the 'Thawed NNNN' version!)  I didn't see the sense of putting extra steps in the process (i.e. relabel after 24hrs).  Here are the ISBT128 Codes that we use (we are 100% FP24).  We used Hematrax for labeling ... I don't know where you'd get all these labels if you needed them.

 

We also have the policy that during an emergency (or MD can't wait), we issue whatever is already thawed according to outdate, not ABO Group.  Exception:  We do not issue Group O Plasma to non-Group O (or unknown) patients.  This helps move the inventory as well.

 

E2619PLASMA|CP2D/XX/<=-18C|Frozen<=24hE2720Thawed PLASMA|CP2D/XX/refgE2587PLASMA|CPDA-1/XX/<=-18C|Frozen<=24hE2702Thawed PLASMA|CPDA-1/XX/refgE2555PLASMA|CPD/XX/<=-18C|Frozen <=24hE2684Thawed PLASMA|CPD/XX/refgE7644Apheresis PLASMA|ACD-A/XX/<=-18C|RT<=24h frozen<=24hE2121Thawed Apheresis PLASMA|ACD-A/XX/refgE7646Apheresis PLASMA|ACD-A/XX/<=-18C|RT<=24h frozen<=24h|1st containerE5548Thawed Apheresis PLASMA|ACD-A/XX/refg|1st containerE7648Apheresis PLASMA|ACD-A/XX/<=-18C|RT<=24h frozen<=24h|2nd containerE5549Thawed Apheresis PLASMA|ACD-A/XX/refg|2nd containerE7650Apheresis PLASMA|ACD-A/XX/<=-18C|RT<=24h frozen<=24h|3rd containerE5550Thawed Apheresis PLASMA|ACD-A/XX/refg|3rd containerE7607Apheresis PLASMA|ACD-A/XX/<=-18C|RT<=24h frozen<=24h|4th containerE6393Thawed Apheresis PLASMA|ACD-A/XX/refg|4th container
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We've been converting FFP to TP directly for some time now.  All of our thawed units start with a 5-day outdate.

 

Scott

We also thaw directly to the 5 day product.. ISBT codes are specific to anticoagulant, etc. Your blood supplier should be able to help you match the frozen product to the thawed product. Thawed plasma, unlike thawed FFP, must be relabeled.

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Does anyone have a procedure in place that they can email as far as techs to use when they thaw and relabel plasma to thawed plasma...

Also, our blood supplier wont provide the labels..is there a specific vendor that you purchase a roll of labels from?

thanks

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We ordered our product labels from Shamrock.  The problem we ran into was the occasional "oddball" product that our supplier (ARC) would get from a different region which would have a different preservative formulation and we wouldn't have those labels.  We have such a large number of different labels that it is very difficult to find the correct label, and that's assuming the techs noticed the difference in the original label to begin with.  That is why we decided to switch to Hematrax.  Quite expensive, but much easier and accurate.

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Does anyone have a procedure in place that they can email as far as techs to use when they thaw and relabel plasma to thawed plasma...

Also, our blood supplier wont provide the labels..is there a specific vendor that you purchase a roll of labels from?

thanks

 

Each relabel will depend upon which product is being thawed.  Most distribution centers send several products to their hospitals.  Check with your distribution center as it is very unlikely that a single roll of labels will do this job for you.  Most of these emails refer to computerized systems where the produst label is assigned (or chosen) from a huge list of possible available products that correspond to your original frozen unit and then is printed out by a special label printer.  The 2 systems most likely to work with your computer system, if you have one, are Hematrax and Computype.  If you do not have a Blood Bank computer system, all labeling will depend on your techs picking the correct labels from a stack of several label choices.  UAL, Shamrock and St John's (now PDC Healthcare) have a lot of choices that can be bought in roll form.  Best of luck - the SOP is the smallest part of this job.

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  • 5 months later...

We also thaw all plasma straight to 5 day thawed plasma. Thankfully my previous boss did this years ago so I didn't have to go thru the process of explaining to the heart doctors the difference between thawed FFP and thawed plasma. Everyone gets thawed plasma except for neonates. Neonates get 24 hour expiration plasma. We have very few neonates that get any type of blood products much less plasma.

 

We have an ISBT printer that prints the correct everything on the label. There was a ton of validation that had to be done for every type of anticoagulant that might show up before the printer went into service.

 

It is cost effective to use thawed plasma because we waste very little. We keep two type A and one type B thawed at all times for possible trauma. Our computer is set so we can give type A to a patient of unknown blood type during a trauma.We rotate the thawed plasma thru surgery and thaw more as needed. Surgery is happy because they can get plasma in a hurry when they need it. They don't have to wait for us to thaw what they need. If a physician changes their mind about giving plasma after we got the order to thaw, we have 5 days to find another patient to give it to. We are happy to not waste.

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If you are buying preprinted lables be sure to check on whether your supplier sends apheresis plasma units that are divided units--same product code but VA0 and VB0 at the end.  This works different than platelets or RBCs collected by apheresis.

 

We still thaw plasma for traumas as 24 hour and convert it later to 5 fay plasma if not used because the process is way faster in our computer because we don't relabel thawed FFP (24 hr).  We also get unused plasma in from our small sites who lack ISBT label printers so make only 24 hr exp. plasma.  We like to keep it complicated, right?  :)  Mostly, we make 5 day thawed plasma from the start.  We just have a few exceptions.

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  • 4 months later...

Mabel,

We used to see this when plasma was thawed but just barely beyond the "slushy" point so that the unit was still very cold when it came out of the waterbath..  You will have cryoprecipitate forming in the refrigerator.  It is sort of like the process where you make cryoprecipitate by thawing the FFP in the cold.

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We label using a digitrax printer as well.  Love it!

We have consulted with iccbba.org for help in choosing the correct thawed code when we have had a question.  If you don't find the answer to a specific question, the people at ICCBBA will help you out over the telephone or email.

 

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On April 6, 2016 at 7:09 PM, Mabel Adams said:

Does anyone have problems with clots or other white stuff that shows up in thawed plasma units after a day or so in the fridge? We're trying to figure out if it is a problem at our supplier or something that happens more with thawed plasma. 

Stick it back in the thaw bath.  If it resuspends it is fibrinogen.  If it doesn't, then it's activated fibrin.

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We moved to 5 day thawed plasma couple of years ago. Our computer system has an option to modify the product to 5 day Plasma on adult FFP and 24hrs on Pedi FFP. When we do a 5 day modification, ISBT printer prints a modified label with appropriate information and we relabel the product. Our wastage is close to Zero ever since we moved to 5 day plasma. We always have two "A" FFP for emergency purposes.

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Yes, we do, but only for massive transfusion. The AABB Circular of Information states the following:

Quote

 

Indications

Liquid Plasma is indicated for the initial treatment of patients who are undergoing massive transfusion because of life-threatening trauma/hemorrhages and who have clinically significant coagulation deficiencies.

Contraindications

See Fresh Frozen Plasma. Do not use Liquid Plasma as the treatment for coagulation factor deficiencies where other products are available with higher factor concentrations.

 

In an extreme case we would use it for emergency release if we needed, but we keep two thawed AB plasmas for that use (and in the case of pediatric traumas).

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We keep 4 A liquid plasma in rotation.  We got that approved with the Trauma Committee for emergency release as well as Massive Transfusion Protocol, citing several studies.  It's easier to keep on hand than AB liquid plasma.  Doctors can't order it, we just substitute it as necessary.  When the expiration date is close, we will use it on in or out patients as compatible units.

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On 5/18/2015 at 5:21 AM, BankerGirl said:

Also, if you are handwriting the expiration date and time, you might consider converting directly from frozen FFP to Thawed Plasma.  You will confuse the nurses greatly if you change the expiration date twice, with the last one being LATER than the previous one.  Experience speaking here.  It also save you from having to process the unit twice.

When I worked in a major trauma hospital a few years back (early 2000s!), we simply started out converting the FFP to thawed plasma at the outset, to prevent issues with forgetting to relabel, confusion over dates, etc, as stated above, in our busy transfusion service.  If I were directing the transfusion service there now, I would definitely have made the switch from AB to A as well.

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