Hello,
I work in an outpatient clinic which is attached to our hospital where we do numerous OP infusions with the exception of chemotherapy. We see patients from different providers throughout our area. One situation we recently experienced was a provider sent an order for 2 units PRBC with an H&H that was obtained 11 days prior. As a department we questioned if this is best practice and did communicate to the provider that we would like to draw an H&H prior to the transfusion to know where the patient's levels were to date. The provider had no problem with this order but we wanted to get some protocols in place as we felt a little uneasy about giving blood based off "old labs." I have combed through my facilities P&P, looked through INS SOP, contacted blood bank, and spoke to our pathologist and have not found or received any guidance about how old is too old regarding an H&H when it is being used to diagnose the need for a blood transfusion. Does anyone know of any literature stating what the "best practice" is concerning a transfusion and the related H&H?
Thank you,
Jessica
If there are any recommendations, they would be found in the Technical Manual published by AABB. Don't be fooled, this is not small manual, but rather a huge textbook. your blood bank should have a recent copy I would think.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you
Jessica Newsom
Hi!
I work in an out patient centre as well and I am in Canada, so things may be different. Here best practice is the patient must be symptomatic if anemia, regardless of the hgb. Some of our myelodysplatis patients aren symptomatic until under 70-75. Best practice is to transfuse based on symptoms, not just on hgb alone. BP also to transfuse only one unit at a time. Outcomes worsen the more blood products people receive. You can look up Transfusion Canada, Canadian Blood Servicens or Ontario Blood Services.
Giod luck!
K. McDonald RN, CVAA(c)