As I have inherited the processes in Bloodbank, our standard of practice includes the same criteria for platelet transfusion as rbc transfusion... we perform a new type & screen every 72 hours. In my opinion, this is over-kill. However, in order to change my procedure, I need documentation. Can anyone point me in the right direction to pinpoint the exact location in the AABB Technical Manual that specifically states the requirements for pre-transfusion testing when the patient is only getting platelets? Also, any input on what everyone else is doing would be ever so helpful. Same thing for FFP... Thanks.

Hi Rachel. On page 410-411 of the 15th edition of the AABB Technical Manual it states "When only plasma and platelets or Cryoprecipitated AHFare being infused, historical testing information in the patient's record may be used." We make sure that the patient has had a type and screen done on the current admission for platelets, FFP and cryo.

Thanks for your post. The main problem I'm running into is with reoccuring out-patients... Some come twice weekly, thus allowing us to "stretch" the use of the same band for a week, but some only come once a week. On those, we are performing a type & screen every week. I have heard of some facilities who only use historical data, but how do you determine how long that "historical data" should be used???

We used to use historical data for all plasma based products but after a couple of incorrect admissions we have changed to requiring a blood type on the current admission. For outpatient transfusions, we require a blood type each time the patient presents to the hospital. If we have a historical blood type, we just do the front type as a "blood type verification". We do not require require an antibody screen unless the patient is also receiving RBC's.

For platelet transfusion we only require a historical type. It doesn't matter if it was yesterday or 20 years ago. For FFP we require a type from the current admission.

Do you still use historical types for patients receiving platelets or plasma? The 15th edition of the Technical Manual is referenced...but I am unable to find the same wording in the current edition. Am I overlooking it or has this changed?

We routinely use patient's historical testing information for platelet, plasma, and cryo transfusions.

I over-kill. Definitely. New sample every 72 hours. etc.. The thing is we have many techs (dedicated to BB but many) so if the Blood group is archived and the patient needs RBCs suddenly ... then what? If its an evening shift why give them more worries to order a new sample. What if I only do a forward.. what should I enter it as? and if RBCs are later needed and I dont have an AbSc.. why burden the next shift......etc..etc. So I do over-kill and I am at peace :meditate:and happy :cuddle:and I go home with less worries .

Has anyone ever used this emoticon: hahahhaha how embarrassing!!!

I have never used that particular emoticon Liz, but I think I know on whom it was based. I see him every morning in the mirror!!!!!!!!!!!!

hahahahaha Malcolm nooo!:disbelief

About my post I wrote only "a forward.". hmm no I meant only "a type and not an AbSc".

"If we have a historical blood type, we just do the front type as a "blood type verification". We do not require require an antibody screen unless the patient is also receiving RBC's."

As a side question, how does a "front type" and a historical record ensure that the correct patient has been drawn ? I would think that you would have better than a 1 in 3 chance that any two people are the same ABO/Rh (in US, majority are A or O pos).

I ask because I have seen the use of "history" in cases here as patient ID validation, and I really don't understand how it can be relied upon. Maybe used in conjuction with electronic crossmatch procedures (we don't do that here either)?

If there is some question as to a patient's ID (like when they remove thier BB armband), we redraw and repeat both the screen and the ABO/Rh before transfusion.

So what happens when this patient that "only" needs platelets, or cryo, or FFP suddenly needs a unit of packed cells? I "over-kill" in that I at least require a Type and Screen, that way we are covered.

We make sure that the patient has had a type and screen done on the current admission for platelets, FFP and cryo.

Same here. I want to verify patient plasma status (antibody wise) prior to infusing plasma products. But 1 T&S an admit only for non-rbc.

We recently had this conversation in our lab after reading the proposed changes to 28th edition of standards. I've copied below.

6.23 Pretransfusion Testing of Patient Blood

Pretransfusion testing for allogeneic transfusion shall include ABO group, and Rh type. For Whole Blood, Red Blood Cell and Granulocyte components, pretransfusion testing for unexepected antibodies to redcell antigens shall be performed.

This standard was edited for clarity.

Currently we accept historical type for plt transfusions only (consider the fact that we don't require type specific in adults anyway). However, the change in wording of the new standards makes it seem like we will need to start requiring a pretranfusion sample for ABO Rh type.

We require only an historical type (with recheck performed on the same sample) in order to issue type-specific plasma or platelets.

As I have inherited the processes in Bloodbank, our standard of practice includes the same criteria for platelet transfusion as rbc transfusion... we perform a new type & screen every 72 hours. In my opinion, this is over-kill. However, in order to change my procedure, I need documentation. Can anyone point me in the right direction to pinpoint the exact location in the AABB Technical Manual that specifically states the requirements for pre-transfusion testing when the patient is only getting platelets? Also, any input on what everyone else is doing would be ever so helpful. Same thing for FFP... Thanks.

We use historical type as long as there is documentation of at least 2 ABO-Rh testing on file. Otherwise, we would get a new sample and retype them.