platelets and blood . . . .

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Homunculus

Homunculus

SDN Caveman Administrator
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Physician
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15+ Year Member
we know the risks involved, we wouldn't give them if we didn't think they needed them. now give us the damn blood products without b*tching about it! 😛 😛 😎

-your friendly neighborhood gimme what i want and no one gets hurt caveman
 
That's it, that's inflammatory. You're banned! You and all your aliases! 😛


Actually, the blood bank has run out of products because you clinicians used this argument too many times! Therefore, you will have to just apply some pressure for a few hours until your residents can donate more!

Now go donate some more! And stop doing unnecessary procedures!
 
Do they really know the risks?

Did you know that 73 people in the US died from being given incompatable blood products last year? (most from hanging wrong unit, second from sending the wrong sample to the blood bank)

The chances of getting HIV, HCV, etc...are at all time lows. But, the risks of getting the wrong unit, product with bacterial contamination, TRALI (transfusion related acute lung injury) and antibody formation have all remained relatively constant and are significant. I doubt most of these things are even talked about to the patient prior to giving blood by most clinicians.

Blood banking is very serious business and a very large source of liability claims for pathologists nationwide.

-kicks cavemen in the butt on a regular basis...."no blood products for yooooo"
 
Apologies to whoever wrote the trolley song.


"Clang, clang, clang," went the TRALI
"Ding, ding, ding," went the (rhythm monitor).
"Zing, zing, zing," went my heart-strings,
For the moment I (got that transfusion) I fell.

"Chug, chug, chug," went (my bloodflow).
"Bump, bump, bump," went the (clots),
"Thump, thump, thump," went my heart (and then it stopped),
When he gave me those mismatched platelets I just dropped.
 
Platelets are my buddy's worst enemy at this point (see my previous post in the Anti Medicine Thread). Anyways, me, him, and some friends went out tonight and he said he could only drink 2 beers because the neurologists said so. Since when were neurologists experts on how much one could drink? WTF 2 beers?!?!?!? Tall or short? He ended up drinking 2 talls so does that count as 3 or 4?

Anyways, he decided to drink very slowly...for a person who usually out-drinks me by far...he milked those 2 beers quite professionaly. And the rest of us drank extra imn his honor.
 
Okay, but when your IgA deficient hemophiliac patient with Type O neg, Cellano neg, Duffy A neg, E neg , and Kell neg blood needs a splenectomy...YOU TRY TO FIND HIM BLOOD HE DOESN'T HEMOLYZE FROM ACROSS THE ROOM!

Or when your platelet refractory recurrent AML patient has a plt count of 5K, YOU find the B-matched HLA units (B44 B7 A27) for him, after his first platelet bag "bumped" his count to <5K!

Ohhh, who misses their BloodBanker now...

Mindy
 
GreatPumpkin said:
Do they really know the risks?

Did you know that 73 people in the US died from being given incompatable blood products last year? (most from hanging wrong unit, second from sending the wrong sample to the blood bank)

The chances of getting HIV, HCV, etc...are at all time lows. But, the risks of getting the wrong unit, product with bacterial contamination, TRALI (transfusion related acute lung injury) and antibody formation have all remained relatively constant and are significant. I doubt most of these things are even talked about to the patient prior to giving blood by most clinicians.

Blood banking is very serious business and a very large source of liability claims for pathologists nationwide.

-kicks cavemen in the butt on a regular basis...."no blood products for yooooo"
Click to expand...

Ahh,

The Great Pumpkin has returned.
 
Mindy said:
Okay, but when your IgA deficient hemophiliac patient with Type O neg, Cellano neg, Duffy A neg, E neg , and Kell neg blood needs a splenectomy...YOU TRY TO FIND HIM BLOOD HE DOESN'T HEMOLYZE FROM ACROSS THE ROOM!

Or when your platelet refractory recurrent AML patient has a plt count of 5K, YOU find the B-matched HLA units (B44 B7 A27) for him, after his first platelet bag "bumped" his count to <5K!

Ohhh, who misses their BloodBanker now...

Mindy
Click to expand...

Mindy,

Have you actually seen a Cellano (-) person that is IgA deficient 😱 ? I've seen an IgA deficient patient before, but have never seen a patient that was Cellano negative.
 
so much anger. 🙁 my post even brought out the old-timers :scared:

(for that you yonuger folks should be happy 😛 )

without violating any patient confidentiality rules, the patient we needed our platelets for was a relapsed ALL case with great vessel thromboses that threatened to clog our only central line-- whose platelent count was crapped out due to emergent chemo and who had a raging esophagitis due to emergent radiation. we had to anticoagulate her for her vessel disease but also had to worry about her bleeding out. our heme onc attending consulted other heme-onc colleagues as well as a literature search on the parameters to be used on this patient for platelet transfusion. then they went *below* this number to split the difference and make it easier for path to approve it. and we still had to fight to get them. not once, but twice.

yes, there is an occasional unicorn among the zebras that will simply look at a transfusion and die. but there are also patients who are unnecessarily delayed in getting their transfusion b/c some blood bank pathologist has a big head. 😛 🙂

it's all good though. i still like you guys. 😀 👍

--your friendly neighborhood gimme two units of unleaded caveman
 
Yup, the Cellano neg. I've seen one...

[Gripping back of chair tightly, beady eyes fiercely staring out towards the Charles River, wondering if she'll ever--ever--be the same again...]

Mindy
 
Mindy said:
Yup, the Cellano neg. I've seen one...

[Gripping back of chair tightly, beady eyes fiercely staring out towards the Charles River, wondering if she'll ever--ever--be the same again...]

Mindy
Click to expand...

Mindy,

I've never seen anything that is that troublesome :scared: . (Bows to Mindy, I'm not worthy 😉 ) The closest that I've come to seeing anything that unusual, was that one of the instructors for my Med Tech Clinicals had seen a Bombay.
 
I have a giant head.

I also like to tell people that they have to resubmit samples when they're improperly labelled. Gotta teach those peds interns to make sure it's labelled right before they send it down, when they spent an hour drawing samples from a 2.5 kg infant on an art stick. Especially when they wake me up at 0200 about it.
 
we old-timers have used this ol website for everything. i remember getting help with admissions and MCATs, now I'm giving residency advice.

so old. so old.
 
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