Canterbury DHB

Context

Platelet Transfusions

Ideally, platelet transfusions should be of the same ABO and Rh(D) groups as the patient. The supply of platelets may make this impossible to achieve. If Rh(D) positive platelets have to be given to an Rh(D) negative woman of childbearing age or a female child, Anti D will need to be given.

See:

In This Section

Indications

Verbal Orders

Indications

Administer one adult therapeutic dose (>2.4 x 10¹¹) of platelets (all platelet concentrates are irradiated) on the same day for the following indications:

Morning Platelet Count <10 x 109/L

Morning Platelet Count <20 x 109/L

Note: If daily platelets are not being given when the platelet count is <20 x 109/L, daily fundoscopy must be performed.

Morning Platelet Count <30 x 109/L

Morning Platelet Count <50 x 109/L

Morning Platelet Count <100 x 109/L

Note: Thorough examination of the patient for haemorrhagic symptoms must be evaluated and documented daily.

If poor platelet increments are suspected, check a post platelet count 1 hour after the infusion. Patient may become refractory to platelets due to HLA antibodies, which can be checked by sending a 10 ml clotted sample plus 4 CPDA tubes (yellow top) to the Blood Bank. However, consider other causes such as sepsis, DIC, hypersplenism, etc. In this setting, platelets given throughout day 1 ATD 8 hourly, frequently prevents evidence of clinical bleeding.

Refer to the Platelet Refractory Guidelines.

All NZBS platelets are irradiated.

Note: See the NZ Blood Tissue Typing form.

Verbal Orders

Verbal orders within the haematology department are governed by three policies/procedures. Each has a specific process that must be followed to ensure the order remains valid and legal:

About this Canterbury DHB document (5107):

Document Owner:

Steve Gibbons (see Who's Who)

Issue Date:

August 2014

Next Review:

August 2016

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5107