Best Practices in Neonatal Transfusions

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Best Practices in Neonatal Transfusions

  1. 1. Company LOGO BEST PRACTICES IN NEONATALTRANSFUSIONS BEST PRACTICES IN NEONATALTRANSFUSIONS Jacque Tagliere, MT(ASCP)SBB
  2. 2. Neonatal TransfusionNeonatal Transfusion Component ConsiderationsComponent Considerations Neonatal AliquotsNeonatal Aliquots Transfusion ConsiderationsTransfusion Considerations Component ChoicesComponent Choices
  3. 3. • Red Blood Cells • Fresh Frozen Plasma • Platelets Component ChoicesComponent Choices
  4. 4. • Iatrogenic transfusion – 35 days – 42 days • CPDA-1 • Additives – AS-1 and AS-5 Have Mannitol – AS-3 Lacks Mannitol • Potassium – Surgery or exchanges – Irradiation Red Blood CellsRed Blood Cells
  5. 5. • ALL ROUTINE TESTING REQUIRED • ADDITIONAL TESTING – CLINICALLY SIGNIFICANT ANTIBODY, USE ANTIGEN NEGATIVE UNITS – HEMOGLOBIN S NEGATIVE • EXCHANGE OR MASSIVE TRANSFUSION OF HYPOXIC OR ACIDOTIC INFANTS • IRRADIATION Component ConsiderationsComponent Considerations
  6. 6. • PROVIDE SMALL VOLUMES • CONSERVE BLOOD PRODUCTS • ⇑ LEVELS OF 2,3 DPG • ⇓ MULTIPLE DONOR EXPOSURE • ⇓ CMV EXPOSURE • ⇓ COST Red Blood CellsRed Blood Cells
  7. 7. • QUAD PACKS/MULTIPORTION - closed – ASSIGNED UNIT INVENTORY – DECREASED DONOR EXPOSURE • MULTIPORTION - open system – INCREASED DONOR EXPOSURE • HALF UNIT/ FREQUENT DONATION – DECREASED DONOR EXPOSURE – DONOR COMMITMENT SMALL RBC ALIQUOTSSMALL RBC ALIQUOTS
  8. 8. Neonatal Dedicated UnitsNeonatal Dedicated Units
  9. 9. Quad Pack SystemQuad Pack System
  10. 10. Pediatric Blood FiltersPediatric Blood Filters
  11. 11. Neonatal/Pediatric Syringe with filter Sterile Connecting Device Advances in AliquotingAdvances in Aliquoting
  12. 12. Neonatal Syringe with FilterNeonatal Syringe with Filter
  13. 13. Neonatal Syringe & BagNeonatal Syringe & Bag
  14. 14. CODABAR LABELCODABAR LABEL
  15. 15. Sterile Connecting DeviceSterile Connecting Device
  16. 16. Sterile ConnectionSterile Connection
  17. 17. Sterile ConnectionSterile Connection
  18. 18. Sterile ConnectionSterile Connection
  19. 19. Sterile ConnectionSterile Connection
  20. 20. Sterile ConnectionSterile Connection
  21. 21. Sterile ConnectionSterile Connection
  22. 22. CODABAR SYRINGE LABELCODABAR SYRINGE LABEL
  23. 23. ISBT LABELISBT LABEL
  24. 24. W141606000555 E0226V00 W141606000555 E0226VA0 W141606000555 E0226VB0 W141606000555 E0226VA0 W141606000555 E0226VAa Dividing ISBT Product CodesDividing ISBT Product Codes W141606000555 E0226VA0 W141606000555 E0226VAb 2nd Bag 3rd Bag Parent Parent 1st BagParent
  25. 25. ISBT SplitsISBT Splits
  26. 26. Zebra PrinterZebra Printer
  27. 27. ISBT Labels on DemandISBT Labels on Demand
  28. 28. Neonatal Syringe & BagNeonatal Syringe & Bag
  29. 29. ISBT Syringe LabelISBT Syringe Label
  30. 30. Component Label VerifyComponent Label Verify
  31. 31. Transfusion RecordTransfusion Record
  32. 32. • Decisions ISBT or both codabar and ISBT – ISBT Modifications – Dividing: ISBT divide suffix V00 VA0, VAa etc… – Pooling: Generate a new ISBT pooled number – Regular modifications: Irradiation, thawing, washing, freezing, deglycing – Frozen products – Suppliers ISBT ISBT and Codabar?ISBT and Codabar?
  33. 33. • Modifying Units – Pre-printed 2x2’s – Stand alone software • Hema-Trax.LPS™ ISBT-128 : Microsoft Windows- 95/98/NT 4.0/2000/XP operating system platforms. DowntimeDowntime
  34. 34. Tracking SuppliesTracking Supplies --
  35. 35. • PLATELETS from WB – Not available in So Cal • PHERESIS – Aliquot as needed – Volume reduced - 4 hr expiration PLATELETSPLATELETS
  36. 36. • ABO COMPATIBLE • THAW – ISSUE – ALIQUOT AND ISSUE • FREEZE IN SMALL ALIQUOTS FRESH FROZEN PLASMAFRESH FROZEN PLASMA
  37. 37. Pediatric Blood PumpsPediatric Blood Pumps
  38. 38. Pediatric Blood PumpsPediatric Blood Pumps
  39. 39. Neonatal TransfusionNeonatal Transfusion Component ConsiderationsComponent Considerations Neonatal AliquotsNeonatal Aliquots Transfusion ConsiderationsTransfusion Considerations Component ChoicesComponent Choices
  40. 40. ReferencesReferences • Standards for Blood Banks and Transfusion Services 24th Edition • http://www.iccbba.org • http://www.aabb.org/Documents/Members _Area/Labeling/ISBT_128/isbt128plan090 6.pdf

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