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Intracranial Hemorrhage and Platelets

We speak often about evidence based indications to support Patient Blood Management (PBM). An effective PBM program requires continual incorporation of the newest knowledge on all blood products including platelets to benefit patients. The decision to transfuse platelets in the…


COLLABORATION IS KEY FOR PATIENT CARE!

In the April issue of Transfusion journal, Joseph et al reported their 1 ½ -year experience with the use of 4 Factor Prothrombin Complex Concentrate (4F-PCC) for urgent reversal of Vitamin K antagonists (Transfus 2016;l 56: 799-807). As the authors…


ICD-10 and Transfusions: What You Need to Know

Have you considered how the new ICD-10 coding system impacts reimbursement rates relative to patient blood management and transfusions? The ICD-9 medical coding/reimbursement system was replaced by the Center for Medicare and Medicaid (CMS) in early October, 2015 with the…


The Impact of Excessive Use of Troponin Tests in the Emergency Department – Too Much of a Good Thing?

Just as we have learned about blood transfusion overuse, so too we now know that overuse of lab tests can be costly and cause patient harm. Cardiac Troponins (cTn) are markers of myocardial necrosis, and because of their high cardiac-specificity,…


Addressing the Transfusion Needs of Pediatric Patients

Children and neonates are physiologically distinct from adults, and there is frequently an “evidence gap” we cross when we apply practices that are known to be effective in the adult world to our younger patients. Children have unique medical needs…


TEG and ROTEM: What is the potential for improving patient blood management?

If you’re a frequent reader of this blog, it’s likely that you’ve already made the commitment to embrace the principles of patient blood management (PBM), a laudable decision to be a responsible steward of a precious resource, a champion for improving patient care…


Transfusion-Transmitted Diseases Should Still Be On Our Radar Screen

Current evidence highlights restrictive transfusion practice and its association with decreased morbidity and mortality.  Serious adverse events can occur with transfusion, thus there must be careful consideration of the risk/benefit ratio when making the medical decision to transfuse. While TRALI,…


Usefulness of Standard Plasma Coagulation Tests in the Management of Perioperative Coagulopathic Bleeding: Is There Any Evidence?

Reprinted with permission from David Slater, M.D., Community Regional Medical Center Lab Medical Director. Dr. Slater wrote this Laboratory Update article for the Community Medical Centers Physicians’ Edition newsletter, January 2016.   This study in the British Journal of Anaesthesia (vol…


Zika Virus

Does the Zika virus, a single-stranded RNA-enveloped arthropod borne flavivirus, represent a challenge for blood transfusion? Flavivirus transmission occurs through blood transfusion (viz. phylogenetically related West Nile Virus and dengue virus) and there are two suspected Zika transfusion-transmitted cases in…


The Clinical Nurse Specialist: An integral resource for a successful patient blood management program

In the United States alone, blood transfusions represent billions of dollars of healthcare costs with approximately twenty one million units of blood components transfused each year.1, 2 Obtaining compensation for components and transfusions continues to be a struggle as reimbursement…