Been out of the loop for a few months but back in touch for one day only! It’s the face to face meeting of the patient facing NHSBT consultants… #mouthful#F2FNHSBT
Patient blood management is the core of what we do. Many key interactions with hospitals and regional and national teams #F2FNHSBT
Blood use is going down but as ever funding is also being reduced. Need to maximise use of pre-existing structures #NHSF2F
“NHS Improvement pathology networking in England: the state of the nation” is mandatory reading for all hospital transfusion haematologists #F2FNHSBT improvement.nhs.uk/documents/3240…
Integrated LIMS, hub and spoke models… all come with challenges specific to transfusion. How best to implement?
KAIs not KPIs now – key assurance indicators… #F2FNHSBT
Should UKAS and MHRA align inspections/regulations? #F2FNHSBT
Whole blood back on the agenda again. Universal LR prohibits true WB in the UK but RBC+ plasma is being worked up #F2FNHSBT
Also on the horizon: Rejuvenate – a study looking at rejuvenating ‘old’ blood. Universal plasma, epitope matched platelets to name a few focuses of current work #F2FNHSBT
Patient and public involvement, education, guidelines… the areas of work undertaken by the team go on #F2FNHSBT
Wider strategy in the organisation includes blood supply, microbiology, cell/gene therapies… #F2FNHSBT
Transfusion strategy symposium in March 2019 to work towards a 5y strategy of PBM, hospital transfusion labs, innovation into practice and expert panel discussion with key organisations and stakeholders #F2FNHSBT
Next Louise Sherliker updates on the work of the PBM practitioner teams #F2FNHSBT
3rd PBM survey will be going out in a few weeks #F2FNHSBT
National PBM accreditation group; should there be key areas that hospitals can self-accredit against? #F2FNHSBT
Need to consider issues about resource and implementation #F2FNHSBT
Lots of work being done nationally by the Getting it Right First Time organisation. An opportunity for transfusion medicine? #F2FNHSBT gettingitrightfirsttime.co.uk
PBM survey will provide benchmarking to allow transfusion teams to make a case for more support and resource locally #F2FNHSBT
Many PBM team successes in 2017-8: NICE endorsed audit tool, kite marked pt info leaflets, Oneg/Aneg plt tools to support good practice, informatics, blood component indicatn app, single unit transfusn work, nonmedical authorisatn of blood course #F2FNHSBT play.google.com/store/apps/det…
7000 users of the app, 60% returning users, pages viewed >84,000 times! Good work!! #F2FNHSBT
Future strategy for the PBM team looking at measuring outputs (?education ?wastage) and identifying key future issues; IT, anaemia management...?? #F2FNHSBT
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I had a personal request to do a tweetorial for the #haemSpRs on haemovigilance. Here goes. A #blooducation 🧵
Haemovigilance is a systematic surveillance of adverse reactions and adverse events related to transfusion’ with the aim of improving transfusion safety. transfusionguidelines.org/transfusion-ha…
We are very lucky in the UK to have @SHOTHV1, one of the first in the world to collate adverse events relating to transfusion - since the 1990s.
This morning I met with the chair and vice chair of the Midlands Regional Transfusion Committee, the Midlands Patient Blood Management Practitioner and the Customer Services Manager. What are their roles and what does the RTC do?
A #blooducation 🧵
RTCs serve to bring together Hospital Transfusion Committees to discuss best practice, implement new guidance and provide educational resources and events. They are run by clinicians and scientists working in hospitals, supported by @NHSBT.
Teaching our incoming haematology doctors today about transfusion in haematology patients. So who needs irradiated blood and why? A #blooducation🧵
All blood in the UK is leucocyte reduced (except granulocytes, but that’s another story). Despite this, a unit of red cells or platelets can have around a million residual white cells, mostly lymphocytes.
Every doctor starting in a new trust does transfusion training as part of their mandatory training. But why?
50ml ABO incompatible blood can kill a patient. ABO antibodies are naturally occurring (“everyone” has them) and they are IgM; they can activate complement and cause *immediate* intravascular haemolysis, causing release of free haem, endothelial activation, renal failure and DIC.
In most hospitals, blood banks require 2 samples (one may be historic) before releasing group specific (non-O) blood for a patient. This is to increase the chances of identifying a *wrong blood in tube* (pt whose blood's in the tube is not the pt whose details are on the outside)
It can be difficult to know where to start with transfusion – you can’t go on a ward round to find patients. BUT you do start with lab induction and your helpful #BMSes will show you around.
Excellent session on emergency paediatric transfusion #AABB20. Cyril Jacquot talking on pre hospital transfusion and summarising the literature.
28 day mortality following haemorrhage is higher in children than adults (unpublished data and substudies from PROPPR and PROMMTT)
Observational studies of large numbers of patients but with only very small numbers of paediatric patients suggest that pre hospital blood is not associated with an excess of transfusion reactions and in some studies is thought to have improved survival.
Whole blood, group O, high titre neg, used in paediatrics in Pittsburgh appears to be safe with no haemolysin-mediated haemoylsis in non group O patients (Leeper et al JAMA Pediatrics 2018) ncbi.nlm.nih.gov/pmc/articles/P…