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Dr Suzy Morton 🅾️➕ Profile picture
@TransfusionWM
Mar 26, 2018 • 6 tweets • 3 min read • Read on X
Our second #BSHTIP session of the day was more on transfusion indications. Cannot tweet this enough times...
hospital.blood.co.uk/media/28629/16…
In thrombocytopenia, ask WHY is the platelet count low? HOW can I correct it?
Is the patient at higher risk of harm from possibility of bleeding than risk of platelet transfusion? Usually the answer is 'no'.... #blooducation #BSHTIP
In ITP, platelets only indicated if the patient has severe haemorrhage. Correct treatment is steroids, or if plt >20-30, leave well alone! #blooducation #BSHTIP
In liver disease, there is a balanced reduction in procoagulant and anticoagulant factors. Often bleeding risk is not increased despite rising PT. Plasma transfusion not indicated in absence of bleeding or imminent procedure #BSHTIP
Especially important in liver disease as liver failure = high risk of TACO. Plasma dose if required = 15-30 ml/kg i.e. 1-2 litres #BSHTIP
Great summary article on haemostasis in liver disease here
asheducationbook.hematologylibrary.org/content/2015/1…
#blooducation

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More from @TransfusionWM

Dr Suzy Morton 🅾️➕ Profile picture
Aug 19, 2022
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.
Read 25 tweets
Dr Suzy Morton 🅾️➕ Profile picture
Aug 17, 2022
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.
There are 7 RTCs in England transfusionguidelines.org/uk-transfusion… (NB map hasn’t been updated to reflect recent changes) @london_rtc @NEY_RTC @SW_RTC @SEC_RTC
Read 15 tweets
Dr Suzy Morton 🅾️➕ Profile picture
Aug 5, 2022
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.
(for the #haemSpRs, that’s < 5 x 10^6 leucocytes/unit in > 99 % of units and < 1 x 10^6 leucocytes/unit in > 90% of units, both with 95% statistical confidence)
nhsbtdbe.blob.core.windows.net/umbraco-assets…
Read 10 tweets
Dr Suzy Morton 🅾️➕ Profile picture
Aug 4, 2022
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)
Read 11 tweets
Dr Suzy Morton 🅾️➕ Profile picture
Aug 4, 2022
Transfusion tips for new #haemSpRs, a thread
As a new ST3 I remember being told to book onto the @NHSBT transfusion course learningcentre.nhsbt.nhs.uk/catalog?pagena… and wondering why I needed to learn about transfusion ... 🙈
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.
Read 7 tweets
Dr Suzy Morton 🅾️➕ Profile picture
Oct 3, 2020
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…
Read 12 tweets

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