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Platelets for CABG


Jessica A

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We do not routinely stock apheresis platelets because we only give 10-15 per month.  We perform a variable number of CABG procedures in our cardiovascular OR.  Our current physicians require 2 platelets on hold in case they are needed but they rarely get used by the patient.  If we are lucky we can use the same 2 platelets for multiple CABG procedures in a week or use them on our other inpatients but mostly they get discarded.  We are at least an hour from our blood supplier so by the time we place a STAT order it usually takes 2-3 to get the product.

My question is for other facilities that don't stock platelets but do perform CABGs.  How many units of apheresis platelets do your surgeons want on hold?  Do you end up discarding them?  I'm wondering if I can convince my surgeons to only request 1 and if they need to use it, we can order another on a STAT run. 

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I want to implement Verax but I'm waiting until we change computer systems in 2019 because our current system does not work for us at all.  That will help a lot.  I've only been at my hospital for about 6 months and we are not currently inspected by the FDA but I'm still trying to get us cleaned up to my standards before I invite them in.  The closest hospitals don't have any sort of critical care or cancer center so they will rarely need a platelet.  I have requested that they call us before the blood supplier since the are even farther from the blood center than we are.  The one hospital that we could pawn them off on wasn't interested when I suggested it.  We discard an average of 50-60 per year.  As a former platelet donor, I would be devastated to know that the units I spent hours donating every few weeks were thrown out.

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Can you set up a routine rotation plan with your blood supplier? I can't believe that they have so much product on hand that they can afford to waste that many units of platelets. We are 150 miles from our supplier and rotate platelets Mon-Fri. In the previous year we rotated Mon, Wed and Fri for several months and that worked well, too. We may outdate the 1 unit we carry through the weekend, but that's it except for unusual circumstances.

Edited by AMcCord
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