Reputation Activity
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Smarty pants got a reaction from Ward_X in Blood Bank usage by Covid19 PatientsJust to clarify... there were several webinars last week with AABB, ASFA and US FDA.
The collection of CCP (COVID Convalescent Plasma) is no different from the collection of ANY plasma. So blood centers can collect it as they would like. It doesn't require anything special if you've been collecting plasma.
Most centers are collecting as much as they can once they get a donor (up to 1L) as a standard "dose" seems to be somewhere in the 300-400 mL range.
It is the TRANSFUSION of the product that requires the IND, and the FDA has promised that they will be approved in 4-8 hours. They need to be submitted and approved on a per-patient basis.
Many blood centers are working now to locate recovered patients and collect plasma. It can then be frozen and a standing inventory in place.
In Australia, if you want to start doing something now... I would start getting an inventory of CCP.
In the US, because of HIPPA (patient privacy) blood centers are having to contact doctors to contact their patients to see if they would be willing to donate and those donors then need to call the blood center. They are testing these "donors" for antibody titers and if it's been <28 days since the onset of symptoms, they are also testing to make sure the virus itself isn't present (so a negative RNA test). Locating these donors and doing the required testing is taking some time. Once found, it's pretty quick and easy process to get the plasma. Then it's a normal process to get it to the hospitals.
It's looking like it's best to transfuse them earlier than later. There is no standard of care... but I would suspect that the best results will be seen if they can be transfused as soon as they're admitted to the hospital (those not admitted may not be sick enough to need this?).
As for billing... your guess is as good as mine.
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Smarty pants got a reaction from AMcCord in Fake blood productsPineapple juice mixed with orange juice (the "pulp" that looks like platelets) makes for an excellent platelet product!
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Smarty pants got a reaction from TreeMoss in Fake blood productsPineapple juice mixed with orange juice (the "pulp" that looks like platelets) makes for an excellent platelet product!
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Smarty pants got a reaction from BloodBanker80 in Volume (Plasma) Reduced PlateletEach manufacturer of platelet bags has validated conditions that must be met for 5 day storage. The AABB/ FDA cannot give you a standard because each bag is slightly different. Talk to your supplier to find out the storage requirements for the bag you are using. (I know Terumo is validated up to a concentration of 2,100,000 and Fenwal has a minimum volume requirement for a range of concentration). If you're outside of that storage recommendation... you probably will need to short-date those products, or at least test the pH prior to issue to ensure a quality product.
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Smarty pants got a reaction from Gnapplec in Neonatal Platelet transfusionsCan you please share with me the current practices of your hospitals for neonatal thrombocytopenic patients?
Are you transfusing antigen negative units? Are you transfusing randoms vs apheresis? Do you collect from the mother for a directed transfusion?
Thanks!
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Smarty pants got a reaction from Yanxia in Use of Whole Blood in Massive TransfusionsWe learn something new from every war. Plastic bags are better than glass bottles. Additive solution prolongs the life of RBCs. It seems that the lessons learned in the current gulf conflict is the valuable use of whole blood in traumas. There are multiple studies, and they're pretty compelling. That said, I don't see much change in maintaining an inventory of WB. I see the change in ordering more FFP along with the pRBCs to treat traumas in order to get the component to be "more like" whole blood. The benefits of freezing the plasma are pretty apparent.
There is also some interesting research being done on platelets stored at 4c. They have a longer shelf-life (the cold slows down their metabolism a bit). And they're already slightly activated, so they work faster when transfused to plug the holes. I think the DoD is actively doing some research on this, and there are a few articles published. Still a lot of work towards the feasibility on how this would be managed, because it is a whole new product with a specific indication. It would need ISBT products, FDA approval... we're still years away.... but it's interesting to read about.
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Smarty pants got a reaction from kate murphy in splitting/ aliquoting a blood unitThe question is how the pedi pack/ transfer pack is attached. Not how it is removed. If it is attached via sterile technique so as to not jeopardize the sterility of the product, it should retain it's original outdate.
When you remove it, you just need to ensure that it is a "permanent seal" not just a clamp with can accidentally open. Those grommets are generally considered a "permanent seal".
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Smarty pants got a reaction from dragonlady97213 in splitting/ aliquoting a blood unitThe question is how the pedi pack/ transfer pack is attached. Not how it is removed. If it is attached via sterile technique so as to not jeopardize the sterility of the product, it should retain it's original outdate.
When you remove it, you just need to ensure that it is a "permanent seal" not just a clamp with can accidentally open. Those grommets are generally considered a "permanent seal".
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Smarty pants got a reaction from John C. Staley in splitting/ aliquoting a blood unitThe question is how the pedi pack/ transfer pack is attached. Not how it is removed. If it is attached via sterile technique so as to not jeopardize the sterility of the product, it should retain it's original outdate.
When you remove it, you just need to ensure that it is a "permanent seal" not just a clamp with can accidentally open. Those grommets are generally considered a "permanent seal".
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Smarty pants got a reaction from exlimey in Blood Product Check on Nursing UnitIn my experience, one of the reviewers needs to be licensed (RN, MD...) the 2nd person does not. They're reviewing to make sure the paperwork matches the recipient, anyone can do that. The person to hang the unit and start the transfusion needs to ensure that the blood type is compatible and matches.... I struggle to find a single nurse who really understands that (unforrunately).
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Smarty pants got a reaction from BBR in TSCD-II welderTerumo also makes a T-Seal... which might meet your need, it can be linked together (multiple devices with a single power source) to do a full line of segments in a single action which is quite handy if you're looking to do that too.
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Smarty pants got a reaction from spavlis in Donor Adverse EventsOnly moderate or severe AEs require MD review. All minor events are reviewed by nursing staff to ensure that they're properly categorized and were appropriately managed. (Moderate/ Severe are categorized as LOC, additional medical intervention (call 911)...)
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Smarty pants got a reaction from mollyredone in Iron Management in Blood DonorsAuntie-D ... just to clarify. There is a minimum Hgb to allow donation, there is also criteria required by each device to ensure that a donor's hgb does not drop below a specified level (Trima is configurable down to 10g/dL. Haemonetics is somewhere around 10.3). The "anemic" designation that MJDrew is talking about isn't always the Hgb level, but the donor's ferritin level. The problem here is not necessarily the cost to test the ferritin, but what to do with the information once you get it. My blood center initiated ferritin testing on all apheresis donors (assuming increased frequency would have larger depletions - although we do NOT collect apheresis RBC products at all). In the first month we deferred between 30-40% of our donors for low ferritin levels (all donors had 12.5 hgb or higher prior to donation, and only lost RBCs in samples and kit residuals. More than 8 weeks (often more than years!) since their last WB donation). If we continued deferring donors with ferritin levels outside the "normal" range, there would not be enough products to meet our patient needs. Ever again. Of note, again, we were NOT COLLECTING RBCs from this donors.
So, if we want to continue meeting our patient needs, we need to be more selective in who we defer. FDA/ AABB have no suggestions on what that number is, and talking to other centers who are testing donor ferritin levels, there is a wide range of numbers used to create this deferral. One blood center only is concerned about ferritin levels in women of child bearing years. Their argument being, that (as the FDA/ AABB report) we DO NOT know the impact of low ferritin on our donors, and it seems that a large population walks around daily with low ferritin levels (and normal hgb levels) there IS data that lower iron stores can impact a developing fetus. To me, that seems like a good place to start. As with all decisions regarding blood donors, while our first approach is always to first do no harm, there is also a balance between an unknonwn risk, and meeting patient needs. As I understand it, what the FDA/ AABB is asking for is some help in trying to determine what is a sane and logical point to start deferring donors that is not going to defer 30-40% of a normal, healthy population and create a health crisis in this country of epic proportions.
(p.s. I've seen a donor with a hgb of 16, and crazy low ferritin levels. It's a fascinating measurement that defies logic).