What is the policy at your facility for pre-transfusion testing when only plasma products or platelets are given? Do you require a specimen at each encounter/admission or will you allow a historical ABO to be used?

Historical.

A historical works at my facility as well. 

I would prefer a specimen/admission but I can live with a historical type.

Current

Let me play the devils advocate when it comes to using the historical type. What happens if the patient is not really the patient that the original ABO was performed on? What about the times when the ID number is bought and used by multiple people especially where there is a large community of people who are not necessarily legal to be here?

For these reasons and a few more, we require a current type.

49 minutes ago, MAGNUM said:

Let me play the devils advocate when it comes to using the historical type. What happens if the patient is not really the patient that the original ABO was performed on? What about the times when the ID number is bought and used by multiple people especially where there is a large community of people who are not necessarily legal to be here?

 

Great point.  I worked at a large facility.  We had multiple users of Medicare IDs.  Noticed when the "same" person came for prenatal work - but had different blood types.  We knew they were sharing cards.

We require one blood type per registration for all of the reasons stated above.  We also have encountered a few patients with identical first and last names and similar dates of birth that kept getting merged together.  We caught it each time because of their different blood types.

If I remember correctly, we required a new type with each new admission for plasma.  Most of the time a type and screen was ordered just in case.....  

Edited October 22, 20204 yr by John C. Staley
forgot my coffee cup!!!

For inpatient transfusion, we need a Type&Screen that was performed at least once for the duration of the admission.  Does not need to be current.  

For outpatient transfusion, we use historical Type&Screen with ABO verified on two separate draws.  We use the bloodloc system so, as long as the patient has this code on their driver license/ID that matches our LIS, it is valid for transfusion until they lose it.  Otherwise, a new T&S is needed.

 

On 10/21/2020 at 9:11 AM, MAGNUM said:

Let me play the devils advocate when it comes to using the historical type. What happens if the patient is not really the patient that the original ABO was performed on? What about the times when the ID number is bought and used by multiple people especially where there is a large community of people who are not necessarily legal to be here?

For these reasons and a few more, we require a current type.

Let me play devils advocate to your devils advocate. 

What ABO platelet would you give out if all you had was an incompatible platelet?

Historical for platelets and current admission for plasma.

For plasma we require a current blood type(same admission).

If platelets or cryoprecipitate a historic type is acceptable 

All Blood Products: We require a current BB sample, tested, etc.

Plasma, Platelets, Cryo: No time limitation as long as the patient is still wearing the matching BB Band. 

Plasma: If there is no current sample tested, it is given 'Uncrossmatched'.  If I'm interpreting the 'rules' correctly, that's what we have to do for plasma.

Platelets: We stock Group A Platelets so that is what they get.  We obtain Group compatible if we have to order platelets for a specific patient or a neonate.  Shortest outdate is used first.

Cryo:  There is no consideration for ABO Group ... shortest outdate is used first.  

On 10/25/2020 at 7:52 AM, Cliff said:

What ABO platelet would you give out if all you had was an incompatible platelet?

that's all i ever have are ABO incompatible plts (usually). 

 

Encounter or every 3 days.

This is also so a valid BB band will work with nursing transfusion software.

On 10/27/2020 at 9:29 AM, David Saikin said:

that's all i ever have are ABO incompatible plts (usually). 

 

 

We try to give compatible, but unless they have a restriction for a certain ABO type, we give incompatible.  If needed, we wash.

17 minutes ago, Cliff said:

We try to give compatible, but unless they have a restriction for a certain ABO type, we give incompatible.  If needed, we wash.

Ummmmmmmm, how do you wash plasma Cliff?

4 hours ago, Malcolm Needs said:

Ummmmmmmm, how do you wash plasma Cliff?

 

Lookit wiseguy, I was responding to a comment about platelets. 

We have had docs request plasma when patients had severe reactions in the past and washed product restrictions.  No, we have not figured out how to wash plasma yet.