Richard Gammon, MD

@ValerieMagutu @AABB Good point on inventories! #AABBpeptalk

@AABB A1: We often use whole blood for trauma. With leaner inventories, WB is preferred as an MTP pack may not be readily available #AABBPEPtalk

Q1: First up: whole blood for use in trauma. Has your facility adopted this practice? If so, what have been the advantages, disadvantages or pitfalls? Please include A1 in your response. #AABBPEPTalk

@NourAlmozain @AABB @NHSBT Yes- centralized data bases can be a big advantage for access of data. We have sickle cell disease patients in US that go to several different hospitals and it is always an adventure when they return with the development of new antibodies. #AABBpeptalk

@RichardGammonMD @AABB One of the things that I am impressed within the NHS is how approachable previous care providers for any given patient. Data related to transfusion are almost centralized within the @nhsbt

Time for Q3: Hospitals are often contacted for transfusion and antibody history for patients with SCD. What is your facility’s policy for safely transfusing patients with SCD if the hospital does not have a phenotype on file and the patient has developed an antibody?#AABBPEPTalk

@DrRiyamia @AABB @NourAlmozain I'm glad to hear and falls into best-practices! #AABBpeptalk

@RichardGammonMD @AABB @NourAlmozain That is interesting indeed. We don’t encounter problems and infact require our staff to check. It is considered as part of the medical care of the patient, and holding that information would be more harmful if a delayed reaction occured. #AABBPEPTALK

@NourAlmozain @AABB How readily do find the facility releases the information. In the US there is sometimes hesistancy do to patient privacy concerns. #AABBpeptalk

@AABB Cont a2 , if the patient has developed an Ab with unknowns phenotype. We make our best to contact the lab where the patient has been previously investigated & relay on genotyping #aabbpeptalk

@AABB At our pediatric hospital the red blood cells and plasma dosages are lowered and we aliquot an apheresis platelet depending upon three weight categories. What do you do? #AABBpeptalk

Last up! Please share how you handle pediatric massive transfusions. Do you provide whole blood or components in a 1:1:1 ratio? Does patient weight or blood volume change the number of components that you provide per phase or round? Please use A4 in your response. #AABBPEPTalk

@DrRiyamia @AABB Glad to see you were the lead author #AABBpeptalk

@RichardGammonMD @AABB A3 cont. We are in a search for a genotyping platform to use in our population. Considering lack fo data of genotypes among Omanis, we needed to validate a method for selection. We just published our data of RBC genotypes in Omanis 😃 onlinelibrary.wiley.com/doi/abs/10.111… #AABBPEPTALK

@NourAlmozain @AABB Great thanks for the reply #AABBpeptalk

@AABB All #SCD patient are phenotyped in house, genotyped in a reference lab. #aabbpeptalk A3

@MSromoski @AABB It has substantially increased compliance at one facility. The only issue is that when paper or downtime forms are needed, there is less proficiency for scanning and the documents sometimes are lost.#AABBpeptalk

@AABB A2. In process of moving to electronic. The dream for me is the quick, efficient, correct transfusion consent and directives in EHR. Currently, PBM RNs work with patients who decline components to complete a note in EPIC with patient wishes

Ready for Question 2? Some facilities are moving from the terminology "informed consent for transfusion" to "transfusion directive,” which includes refusal. Is your facility doing this? What is your experience? Please use A2 in your response. #AABBPEPTalk

@NourAlmozain @HermelinMD @AABB @SSMHealthSTL @impactlifeblood @GlennonTrauma An article in Transfusion and Aphersis Science doi.org/10.1016/j.tran… showed out of 72 Rh (D) negative patients 17% formed new Rh group antibodies after exposure to Rh (D) positive RBCs. #AABBpeptalk

@HermelinMD @RichardGammonMD @AABB @SSMHealthSTL @impactlifeblood @GlennonTrauma Evidence suggests that alloimmunization is less likely to occur in trauma patients , was this the case for your Patient?

@Cthherbal @AABB Colleen, thanks for the reply #AABBpeptalk

@AABB Yes we’ve had one designed this way (includes refusal option) for about 3 years. No complaints to note. I do look forward to when this process can be made electronic instead of a paper trail.

Some facilities are moving from the terminology "informed consent for transfusion" to "transfusion directive," which includes refusal. Has your facility considered this? Join today’s #AABBPEPtalk to discuss PBM in the hospital. #blooducation

@HermelinMD @AABB @SSMHealthSTL @impactlifeblood @GlennonTrauma Great pic of whole blood #AABBPepTalk

@AABB We ❤️love whole blood @SSMHealthSTL. We transfuse her blood for all of our trauma patients, adults and pediatrics. For adults we use RhD pos but for kids we use RhD neg. Thank you to our blood center @impactlifeblood and amazing donors for this lifesaving product. #aabbpeptalk

@AABB Does anyone use an electronic consent and do you find this reduces errors #AABBPepTalk

@DrRiyamia @AABB Arwa thank you for the reply. Do you handle Jehovah Witness patients the same way with refusal. #AABBPepTalk

@RichardGammonMD @AABB Hi. This is Arwa! Nice seeing you here @RichardGammonMD 😃. For A2. We continue to use transfusion consent. It is easier for the patients to understand considering the need for translation. Refusals are documented in the medical records of the patient. #AABBPEPTALK

@AABB Let us know your experience #AABBPepTalk

@MSromoski @AABB This is a concern as well with some of the facilities to which I work

@AABB A1. Some resistance to use in general. Also, hesitation from nursing on whether they ‘are allowed’ to transfuse while blood without specific training.

@jaylewis_99 Do your physicians use whole blood?

@NourAlmozain @AABB @ChrisBocPro Love the shot, looks like Fall there!

@AABB @RichardGammonMD @ChrisBocPro Hello, it is Nour TM fellow, UK.

Welcome to today’s #AABBPEPtalk with @RichardGammonMD, medical director at OneBlood, and @ChrisBocPro, senior director, Standards Development and Quality Initiatives, at AABB! Please reply to this tweet to introduce yourself.