I have work in Several Hospitals but none of them required a ASC for plasma. ASC should not be necessary if only plasma is gonna get transfuse. Where this line of thougths is coming from? Does the patient get charge for that unecessary test? Antibodies are in the plasma of the patient and are against red cells antigens. Therefore there is very little risk of a transfusion reaction due to a patient antibody.

If by ASC you mean antibody screen on the recipient, then yes it is necessary. Beacuse there may be a minimal number of non visible rbcs AND because anyhow you routinely perform the antibody screen on recipients as they may need RBCs. Don't break the cycle, don't ask busy technologists to stop and anlayse and waste their time. Better be safe than sorry. And with automation it's great. Keep the work streamlined. You, yourself, said there is very little risk, you did not say "no" risk.

I disagree Liz - - - if you are only transfusing plasma/plts, you only need a type. The minimal amount of red cells/rbc stroma in plasma should not prove any problems - though they may be a source of sensitization.

I know that theoretically you are right, Dave. However, practically I would screen. Do you screen, Dave?

I only screen if the order is for rbc's or a Type & Screen. In the US it can become a reimbursement issue or I may be accused of practicing Medicine without a license. (Not that I am opposed to performing a TS if I think it is appropriate or impending - I just cannot result it or bill for it). For just a plasma or plt order I will only do the ABORh.

I know that theoretically you are right, Dave. However, practically I would screen. Do you screen, Dave?

I don't see any need to perform an antibody screen if only plasma is being transfused. ABO compatibility is the only requirement.

I don't see any need to perform an antibody screen if only plasma is being transfused. ABO compatibility is the only requirement.

This is the protocol we follow.

I agree,ABO compatibility is the only requirement.

oups oups and oups, it is obvious that I am not on the ground. Ok, I asked the supervisor what we do and indeed if we know that the patient is coming in for plasma we only do the ABO Rh. Apparently it is in the SOP that I signed...:surrender:disbelief where is that blushing face?? ok this will have to do: (for past performance).....

I have seen places that require ABS for FFP and PLT. Mostly because of how their computer system handles the samples. If a patient has a BB ID band on or a blood sample in BB. Then some doctors (right or wrong) think that we have a sample in the BB that can be used for a crossmatch, ie ABS has been done.

So to take the guess work out of it (for anyone to collect a BB sample), any blood product must have an ABS.

I only screen if the order is for rbc's or a Type & Screen. In the US it can become a reimbursement issue or I may be accused of practicing Medicine without a license. (Not that I am opposed to performing a TS if I think it is appropriate or impending - I just cannot result it or bill for it). For just a plasma or plt order I will only do the ABORh.

We also will only do the ABO/Rh is only plasma is requested

You can do this IF it is your SOP. Basing my testing patterns on what physicians think is right or wrong is something I endeavor to avoid . . . I tell my staff all the time " The doctors do not run the blood bank or dictate blood bank policy/procedures".

I have seen places that require ABS for FFP and PLT. Mostly because of how their computer system handles the samples. If a patient has a BB ID band on or a blood sample in BB. Then some doctors (right or wrong) think that we have a sample in the BB that can be used for a crossmatch, ie ABS has been done.

So to take the guess work out of it (for anyone to collect a BB sample), any blood product must have an ABS.

We only require an ABO/Rh for plasma or platelets. The testing must be done on the current admission.

Ok, siding with both Liz and David.

Technically, you are correct David, you do not have to perform an Antibody Screen to transfuse FFP.

That being said, I agree with (and have followed at 6 Insitutions) Liz's suggesting one should request a Type and Screen be performed. I agree that these patients often also need RBCs at some point; and I also agree with the workflow (not only in the Blood Bank, but for Nurses and Physicians who place orders; it is difficult enough to get them to order a Type and Screen correctly; let's not confuse them further).

Just my opinion....

Brenda Hutson

Yay!!! Thank you Brenda, you saved me:cool:.

But it is true, although we dont need to Tand S, we do, for the reasons that you mentioned.

At my prior workplace we did not use a BB ID band except for crossmatched products so we avoided some of these issues with bands meaning a T&S has been done. Of course we drew hold specimens which could have caused the same confusion, but seldom did.

We do not require an antibody screen for routine plasma/platelet transfusions. Only requirement is an ABO/Rh.

The issue can take on more significance depending on what your Institutional Policy is on what blood types (date performed) you will accept on a patient for either FFP or Platelets.

For example, we will transfuse Platelets (only) if we have an historical type (at any time). A larger Institution where patients might use several Platelets daily, might differ on that (due to volume).

But for FFP, I am currently changing the requirement to be a blood type performed "on the current admission." So not every 3 days; but at least in same admission. FFP are more frequently given in multiples so a large volume of incompatible plasma becomes more of an issue. So as long as we are requesting a new specimen (i.e first on this admission), for reasons previously mentioned, I prefer to perform a Type and Screen.

Brenda Hutson