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Best Practices in Neonatal Transfusions

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  • 1. Company LOGO BEST PRACTICES IN NEONATALTRANSFUSIONS Jacque Tagliere, MT(ASCP)SBB
  • 2. Neonatal Transfusion Component Choices Component Choices Component Considerations Component Considerations Neonatal Aliquots Neonatal Aliquots Transfusion Considerations Transfusion Considerations
  • 3. Component Choices Component Choices • Red Blood Cells • Fresh Frozen Plasma • Platelets
  • 4. Red Blood Cells Red Blood Cells • 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
  • 5. Component Considerations Component Considerations • 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
  • 6. Red Blood Cells Red Blood Cells • PROVIDE SMALL VOLUMES • CONSERVE BLOOD PRODUCTS • ⇑ LEVELS OF 2,3 DPG • ⇓ MULTIPLE DONOR EXPOSURE • ⇓ CMV EXPOSURE • ⇓ COST
  • 7. SMALL RBC ALIQUOTS SMALL RBC ALIQUOTS • 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
  • 8. Neonatal Dedicated Units Neonatal Dedicated Units
  • 9. Quad Pack System Quad Pack System
  • 10. Pediatric Blood Filters Pediatric Blood Filters
  • 11. Advances in Aliquoting Advances in Aliquoting Neonatal/Pediatric Syringe with filter Sterile Connecting Device
  • 12. Neonatal Syringe with Filter Neonatal Syringe with Filter
  • 13. Neonatal Syringe & Bag Neonatal Syringe & Bag
  • 14. CODABAR LABEL CODABAR LABEL
  • 15. Sterile Connecting Device Sterile Connecting Device
  • 16. Sterile Connection Sterile Connection
  • 17. Sterile Connection Sterile Connection
  • 18. Sterile Connection Sterile Connection
  • 19. Sterile Connection Sterile Connection
  • 20. Sterile Connection Sterile Connection
  • 21. Sterile Connection Sterile Connection
  • 22. CODABAR SYRINGE LABEL CODABAR SYRINGE LABEL
  • 23. ISBT LABEL ISBT LABEL
  • 24. Dividing ISBT Product Codes Dividing ISBT Product Codes W141606000555 E0226V00 Parent 1st Bag W141606000555 E0226VA0 W141606000555 E0226VB0 Parent 2nd Bag W141606000555 W141606000555 E0226VA0 E0226VAa Parent 3rd Bag W141606000555 W141606000555 E0226VA0 E0226VAb
  • 25. ISBT Splits ISBT Splits
  • 26. Zebra Printer Zebra Printer
  • 27. ISBT Labels on Demand ISBT Labels on Demand
  • 28. Neonatal Syringe & Bag Neonatal Syringe & Bag
  • 29. ISBT Syringe Label ISBT Syringe Label
  • 30. Component Label Verify Component Label Verify
  • 31. Transfusion Record Transfusion Record
  • 32. ISBT and Codabar? ISBT and Codabar? • 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
  • 33. Downtime Downtime • 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.
  • 34. Tracking Supplies Tracking Supplies --
  • 35. PLATELETS PLATELETS • PLATELETS from WB – Not available in So Cal • PHERESIS – Aliquot as needed – Volume reduced - 4 hr expiration
  • 36. FRESH FROZEN PLASMA FRESH FROZEN PLASMA • ABO COMPATIBLE • THAW – ISSUE – ALIQUOT AND ISSUE • FREEZE IN SMALL ALIQUOTS
  • 37. Pediatric Blood Pumps Pediatric Blood Pumps
  • 38. Pediatric Blood Pumps Pediatric Blood Pumps
  • 39. Neonatal Transfusion Component Choices Component Choices Component Considerations Component Considerations Neonatal Aliquots Neonatal Aliquots Transfusion Considerations Transfusion Considerations
  • 40. References • 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