I was taught that hemoglobiin should be tested 4 hours after transfusion, Platelets and FFP should be tested 15 minutes to 3 hours post transfusion.We are not currently checking (for the most part) with in any established time-frame.

Do you have any established guidelines for rechecks?

Is this necessary? I can not locate current information on the subject.

Is it up to the physicians?

How do you know if the patient has had a "bump" if you do not check the platelet count?

How would you know if additional transfusion(s) were needed?

Thank you. Jonilynn

Here, its up to the physicians.

 

 

 

Scott

We have an automatic nursing order that comes with the 'transfuse platelets' order for 'Draw 10 min post-transfusion PLT count' that should be drawn within 10-60 minutes. Our blood management program also recommends single unit orders with checking lab values in between for RBCs but this is up to the physician's discretion.

I've never seen formal studies as to "when" a post-tx hct should be done. Did read an article years ago that said results were valid after 5 min in the non-bleeding pt but . . . seems kind of soon.   Plts - 30 minutes post (up to one hr), esp if looking for refractoriness (?). 

See attached for support that 15 minutes is adequate for red cells.

For platelets, if we are accessing for refractoriness, we have them do a post-tx platelet count at 30 minutes to look for a bump.

Early changes in hemoglobin after RBC transfusion.pdf

Thank you for that article Terri! I haven't seen it.

Edited January 29, 201510 yr by goodchild

Thank you for that article Terri! I haven't seen it.

Found it when a physician was challenging our 1-hour post rule. I discovered that is mostly folklore with no supporting study until this one. And it makes sense if you think about how many times the heart beats in a minute. It shouldn't take hours for the body to equilibrate because the body is always trying to keep itself in a hemostatic state.

Thank you all for your posts. I found an article from ARC:ractice Guidelines for Blood Transfusion: A Compilation from Recent Peer-Reviewed Literature.

 

RBC 15 minutes to 1 hour

PLTS 10 minutes to 1 hour and

FFP immediately prior and post transfusion.

 

T&T would like hospital wide consistency and with the push for Patient Blood Management, this would be a great time to incoporate.