Quick question...

 

What is everyone's policy on ABORH testing for outpatients receiving platelets?  Right now we do an ABORH on patients for every out patient encounter.  Sometimes that gets very redundant if they come in say every day for 4 days.  I haven't really found in the standards what is optimal for this situation.  We have since changed it to every 3 days, but I think our pathologist was confusing the whole antibody formation time frame.  

 

Thoughts? 

 

 

 

 

Right.  No need to worry about atypical antibodies for platelets (and you are not doing a AB screen anyway!)  But I do think you want to verify the patient's ABO/Rh for each separate visit.  It could just be one of those "lab must have a policy for..." regulations--which would leave it up to the pathologist.

 

Scott

_{Once every 12 months.}     

We will allow a patent to use the same blood bank armband number and specimen for outpatient platelets/plasma as long as they stay under the same encounter number. So our outpatient cancer center gives patients a financial encounter as recurring that lasts for a month. As long as the patient doesn't receive any red cell transfusions, and hasn't in the last 3 months, and keeps their armband on we will just do one blood type at the beginning. If they receive red cells then we're at 3 days or if they get officially discharged in the system and a new encounter started we will redo the blood type.

We will allow a patent to use the same blood bank armband number and specimen for outpatient platelets/plasma as long as they stay under the same encounter number. So our outpatient cancer center gives patients a financial encounter as recurring that lasts for a month. As long as the patient doesn't receive any red cell transfusions, and hasn't in the last 3 months, and keeps their armband on we will just do one blood type at the beginning. If they receive red cells then we're at 3 days or if they get officially discharged in the system and a new encounter started we will redo the blood type.

This is what we do except our recurring visits are for six months.

Edited April 24, 201411 yr by AMcCord

^{Right.  No need to worry about atypical antibodies for platelets (and you are not doing a AB screen anyway!)  But I do think you want to verify the patient's ABO/Rh for each separate visit.  It could just be one of those "lab must have a policy for..." regulations--which would leave it up to the pathologist.}

 

^Scott

 

 

 

^{I agree with Scott, only because phlebotomist  are human and mistakes can be made. I know that confirming ABO/Rh is more important in RBC transfusions, I just think confirming blood type should be a standard across the board.}

When we collect pre-transfusion blood the patient is banded with a unique BB ID number. As long as the patient has this uniquely numbered armband and we have a type from a specimen with that number we will transfuse plasma products, either FFP of platelets.

We don't always have the luxury of giving only plasma-compatible platelet units.  That makes it hard to see the increased risk of a mistype in a platelet only transfusion. One good thing would be that  being sure of the patient type would help in properly interpreting the situation when a high titer O donor causes a hemolytic transfusion reaction. Fortunately I have never seen one of those.

 

We currently have a policy of requiring 2 historic types or one for the current visit.  I am looking for a new approach that makes sense--more for plasma but will look at platelets too.

 

In our new EMR, OP visits can stay open for many months as long as they are used at least every 45 days.  That would save us from admissions errors.

We often issue non-specific group & type plateletphereses to our patients if we do not have group & type specific plateletphereses on hand.  Therefore...(here comes the gasp).......we do not repeat the ABO/Rh testing on the patient before issuing platelets.

 

We have also, fortunately, not encountered a hemolytic transfusion reaction due to a high titer Group O donor.

 

Donna

We often issue non-specific group & type plateletphereses to our patients if we do not have group & type specific plateletphereses on hand.  Therefore...(here comes the gasp).......we do not repeat the ABO/Rh testing on the patient before issuing platelets.

 

We have also, fortunately, not encountered a hemolytic transfusion reaction due to a high titer Group O donor.

 

Donna

I am not gasping.  

Me neither. All our patients get type A platelets because that's what we stock. If a physician wants type specific platelets, we order them and it takes a day to get them.

We do the same as Donna, because we do give type compatible to kids under 12. A lot of our platelet users are heme-onc kids so we may not be able to provide adults with their own type. The only hemolytic reaction I have seen to plts was in another time and place and it was a 5 year old.

We would give type specific to kids, though we don't have many pediatric cases who need platelets.

We often issue non-specific group & type plateletphereses to our patients if we do not have group & type specific plateletphereses on hand.  Therefore...(here comes the gasp).......we do not repeat the ABO/Rh testing on the patient before issuing platelets.

 

We have also, fortunately, not encountered a hemolytic transfusion reaction due to a high titer Group O donor.

 

Donna

 

Same for us.  We do require 2 ABO/Rh types in history if not typing a current sample.