Name of the Procedure:

Platelets, Each Unit (P9019)

Summary

A platelet transfusion involves infusing a concentrated number of platelets into the bloodstream. Platelets are small blood cells that help with clotting, crucial for preventing and stopping bleeding.

Purpose

Platelet transfusions are administered to treat or prevent bleeding in patients with low platelet counts or dysfunctional platelets. The goal is to increase platelet counts to a safe level to ensure proper clotting and minimize bleeding risks.

Indications

• Severe thrombocytopenia (low platelet count)
• Chemotherapy-induced thrombocytopenia
• Bone marrow disorders such as leukemia
• Preoperative and postoperative patients at risk of excessive bleeding
• Platelet dysfunction disorders

Preparation

• No fasting required.
• Patients may need blood tests (e.g., CBC - Complete Blood Count) to assess platelet levels and overall blood health.
• Medication adjustments: Some anticoagulants or antiplatelet drugs may need to be paused.

Procedure Description

1. Patient Identification: Confirm patient identity and blood type compatibility.
2. IV Line Placement: A sterile intravenous (IV) line is placed, typically in the arm.
3. Platelet Unit Ready: A unit of donor platelets is prepared and cross-matched.
4. Infusion: The platelets are transfused through the IV over a period of 30-60 minutes.
5. Monitoring: Vital signs and patient condition are monitored during and after the transfusion.

Tools & Equipment:

• IV catheter
• Platelet storage bag/unit
• Blood warmer if required

Anesthesia/Sedation:

• Generally not needed.

Duration

The transfusion typically takes 30-60 minutes.

Setting

Usually performed in hospitals, outpatient clinics, or specialized transfusion centers.

Personnel

• Registered Nurses (RNs) to administer and monitor the transfusion
• Physicians or Hematologists to order the transfusion and oversee patient care

Risks and Complications

• Common: Mild fever, allergic reactions, chills
• Rare: Severe allergic reactions, transfusion-related acute lung injury (TRALI), infections
• Management: Medications such as antihistamines or corticosteroids can manage most reactions.

Benefits

• Immediate increase in platelet counts.
• Reduced risk of bleeding and associated complications.
• Patients can often see improvements within a few hours to a day.

Recovery

• Observation period post-transfusion to monitor for late reactions.
• Patients can generally return to normal activities soon after, unless otherwise instructed.
• Follow-up blood tests may be required to assess platelet levels.

Alternatives

• Medications: Drugs like romiplostim to stimulate platelet production.
• Treatments for Underlying Condition: Addressing the root cause of low platelets (e.g., treating an infection or changing chemotherapy). Pros: Less risk of transfusion reactions. Cons: Slower improvement in platelet counts.

Patient Experience

• During the procedure: Mild discomfort from IV insertion; most feel nothing during the transfusion itself.
• After the procedure: Possible mild side effects like fever or chills; reassurance provided by medical staff.
• Pain management: Not typically necessary, but medications are available if patients feel unwell.

By understanding the above details, patients and their families can be better prepared for the platelet transfusion process, contributing to a smoother experience and recovery.