Freaking out. FFP = "fresh frozen platelets" or "fresh frozen plasma"

Nurses General Nursing

Published

Started freaking out about this at home. Of course, I didn't think about it when I was ON SHIFT. Had a lady scheduled for a colonoscopy today. Her INR was still pretty high, so I got a telephone order from the physician (who wanted me to enter the order) for Vitamin K administration--no problem--and to transfuse 2 units FFP if her INR was greater than 1.8. Her INR came back 1.36, so at least this won't be an administration issue. I put in the orders for "FFP" in our system, but now I don't know if I ended up ordering PLASMA or PLATELETS. I could find out, of course. Someone please tell me, is it plasma or platelets that would be used to LOWER an INR? Is it too late for me to go back and correct the order if it is entered incorrectly? HELP!

Not a nurse yet (student here) but I have always heard it be referring to plasma

Specializes in Emergency, Trauma, Critical Care.

FFP is Fresh Frozen Plasma.

Don't know your computer system. The nice thing is she didn't need it anyway. Chances are if there's an error and it did need to be given someone else would catch it.

Platelets are just always ordered as platelets...and usually come in a 10 pack. They are only ordered if a patients platelets are low typically or they see active bleeding.

I would go ahead and call and give them a heads up that you may have made a mistake and ask someone to double check the order. It's an easy fix.

Thank YOU!!

He did specifically say "FFP". I did order "Set up FFP".

I'm good here. Next time I'm there I will check it out on our system.

*whew*.

Specializes in Emergency, Trauma, Critical Care.

Yeah if you put in FFP you're fine. Nothing else is referred to as FFP. At least you will really know your blood products now. :)

Specializes in Emergency, Telemetry, Transplant.

Yes, plasma. Just a quick comment though...I have seen platelets ordered in 4 and 6 packs (I had never seen an order for platelets before, so I kinda chuckled with a "6 pack" order.

So, FFP is used to lower an INR, then? Makes the blood more viscous?

You guys are great. Thanks for the support.

Specializes in Emergency, Telemetry, Transplant.
So, FFP is used to lower an INR, then? Makes the blood more viscous?

You guys are great. Thanks for the support.

Try and get out of the habit that anticoagulants (such as coumadin) actually make the blood thinner. Then you will realize that their reversal agents (FFP or vitamin K for coumadin) do not "rethicken" the blood. Coumadin (warfarin) actually prevents the liver from producing certain clotting factors, and, in turn, the blood clots less readily and one the the measures of clot formation--prothrombin time (PT)--increases. (Liver failure can lower production of the factors and result in an increase in PT/INR and an increase in unwanted bleeding) In order to standardize the measument of PTs from lab to lab, "international normalized ratio" (INR) was created. Higher INR = higher PT = more anticoagulated (commonly said that one's blood it "thin" but this is not really accurate).

The FFP contains the depleted clotting factors, which means the blood is more coagulable. Hence, this means a lower PT and a lower INR. PT/INR is a lab value. Remember to think about what is acutally go on when the lab value goes up and down, and this can make it easier to understand the actions of both the medication and the antidote.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

This is why, in the age of computers, telephone orders should go away!

Excellent. Thank you. And your gentle admonishment is noted and well taken. I will cease thinking of blood as either "thick" or "thin".

Thanks again, all of you. You put my mind at ease AND educated me. Much better than simple berating, which is all to common in nursing.

Oh, man!! RIGHT??

He gave me the orders during assessment/med pass, and I said, "So, will you be putting the orders in, sir?" He said, "NO! That's why I'm calling you!"

arggh.

Specializes in Oncology; medical specialty website.
Thank YOU!!

He did specifically say "FFP". I did order "Set up FFP".

I'm good here. Next time I'm there I will check it out on our system.

*whew*.

Next time, if you're unsure about the order, clarify it with the MD before taking it.

I always wonder at posts where people come here asking if they made a mistake and what they should do to correct it. Your first action should be to call your NM/department and discuss your concerns. Asking for suggestions here after you've straightened out the situation is fine, but let your department know first.

+ Add a Comment