When a hospitalized patient with a history of transfusions due to MDS (blood disease) needs a transfusion due to low hemoglobin, what are the “orders” that must be made to obtain the proper blood.? And are there min standards that are considered acceptable in the orders? Or are the orders needed MUST DO’S. Please advise. Thank you! Robin
MDS is a group of disorders that happen when the bone marrow doesn't make enough healthy blood cells. This means the patient may need a blood transfusion due to low hemoglobin. There is no special order for the patient. You will need to order a blood type and antibody screen test these two tests are often referred to as type and screen tests. If this is the first time the patient comes to your hospital a confirmation blood type test may be required. In addition to ordering tests, you should keep the special blood requirement for this patient in mind. Patients with this condition may need to be transfused often, and that leads to a higher chance of the patients developing antibodies. The more antibodies patients develop, the harder it is to find a compatible unit and the longer it will take to find a compatible unit. Sometimes you may not even find a compatible unit. When that happens, we will give the best match unit for the patient. A best match is different from a compatible unit. A best-match unit is the best we can do for the patient right now. The benefits of giving the best match should outweigh the risk of not receiving it. One of the complications that the patient could develop from the best-match unit is a transfusion reaction. For MDS patients, it is recommended to give irradiated blood. A patient with a transfusion reaction is better than not having a patient at all. This is similar to a sickle cell patient who frequently needs transfusion. We usually give phenotype matches to avoid patients making antibodies.
When a hospitalized patient with a history of transfusions due to MDS (blood disease) needs a transfusion due to low hemoglobin, what are the “orders” that must be made to obtain the proper blood.? And are there min standards that are considered acceptable in the orders? Or are the orders needed MUST DO’S. Please advise. Thank you! Robin
MDS is a group of disorders that happen when the bone marrow doesn't make enough healthy blood cells. This means the patient may need a blood transfusion due to low hemoglobin. There is no special order for the patient. You will need to order a blood type and antibody screen test these two tests are often referred to as type and screen tests. If this is the first time the patient comes to your hospital a confirmation blood type test may be required.
In addition to ordering tests, you should keep the special blood requirement for this patient in mind. Patients with this condition may need to be transfused often, and that leads to a higher chance of the patients developing antibodies. The more antibodies patients develop, the harder it is to find a compatible unit and the longer it will take to find a compatible unit. Sometimes you may not even find a compatible unit. When that happens, we will give the best match unit for the patient. A best match is different from a compatible unit. A best-match unit is the best we can do for the patient right now. The benefits of giving the best match should outweigh the risk of not receiving it. One of the complications that the patient could develop from the best-match unit is a transfusion reaction.
For MDS patients, it is recommended to give irradiated blood.
A patient with a transfusion reaction is better than not having a patient at all. This is similar to a sickle cell patient who frequently needs transfusion. We usually give phenotype matches to avoid patients making antibodies.