Reply To: Platelet Transfusions – When to transfuse

  • Regina Winfrey

    Member
    August 7, 2014 at 6:54 pm

     Criteria and/or justification for transfusion is based on the following guidelines from our blood bank and clinical judgment.

    1. Prophylaxis in thrombocytopenic patients
    2. Active bleeding in a patient with thrombocytopenia due to:
      1. Inadequate production of platelets,
      2. Dilution secondary to massive transfusion,
      3. DIC
      4. Sepsis
    3. Active severe bleeding in a patient with a qualitative disorder of platelets.
    4. Definition of criteria and documentation required.
      1. Platelet count < 10,000.
      2. Preparation for surgical, dental, or other indicated procedures in patients with platelet counts <50,000.
      3. Platelet count <20,000 and minor capillary bleeding, or <50,000 with more extensive capillary bleeding or bleeding from larger vessels, or risk there-of.
      4. Platelet count <100,000 and life threatening bleeding or risk there-of.
      5. Massive transfusion is defined as replacement of a patient’s estimated blood volume in a 24 hour period. Platelet counts must be used as a monitor for transfusion requirement during massive transfusion.
      6. Documented DIC with prolonged thrombin time, prothrombin time, partial thromboplastin time, decreased platelet count, low fibrinogen (<100 mg/dL), and/or elevated fibrinogen degradation products.
      7. Brain tumor patients <50,000.

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    Regina Wilkes
    CNL-St.Jude Children’s Research Hospital
    Memphis, TN
    United States
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    Original Message:
    Sent: 07-01-2014 05:11 PM
    From: Renita Kuiper
    Subject: Platelet Transfusions – When to transfuse

    This message has been cross posted to the following Discussions: Outpatient Staff Clinic Issues and Inpatient Staff Hospital Issues .
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     We would like to survey our fellow children’s hospitals in their platelet transfusion practices.

     1. Is there evidence-based practice guidelines you utilize in deciding when to transfuse 
         platelets?
     2. What is your lowest acceptable platelet count for patients who are going for a….
         LP? 
         Bronch? 
         Surgery?
         Line Placement?
         Endoscopy?
         *Are these numbers based on evidence-based guidelines?* 
     3.  Are your standards for transfusing platelets the same for inpatient and outpatient
          patients?   

    Thank you in advance for your assistance in our project.

         
        

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    Renita Kuiper BSN, RN, CPHON
    Helen DeVos CHildren’s Hospital
    Grand Rapids, MI


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