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

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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!

op, this is also why you don't want to use "blood thinners" as a term when you teach your patient about anticoagulation. it makes them think about water in the milk and turpentine in the paint, and this is clearly not the concept they need to know when they have to take anticoagulation medications. people understand the terms "clot" and "clotting," and if you tell them that this medication makes their blood clot a little less well so they don't develop clots in their legs or heart, this then makes it easier for them to understand the idea of watching for abnormal bruising or bleeding.

i know that even their doctors will tell them that they are going to be taking a "blood thinner," and this term is used in the popular press all the time. i write letters to the editor on this, and explain that what the doctor means is...

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OCNRN63,

Um, yeah. Thanks. (Not.)

Read what I said earlier about the value of "not berating." You see, I am in the future ALSO, and I well see the error of my ways. No need to bring that back to the fore. I will take care of the flagellating, thanks.

And also note that I started second-guessing myself well AFTER the orders were said and done. And it turned out to be second-guessing. I did everything correctly, as it happens, and just suffered a small attack of insecurity. To me, this is not a reason to discuss anything with my department or report myself to my manager. I do know enough to get clarification at the time orders are given. I read back EVERY order EVERY time, no matter how impatient the doc is.

So glad to hear you "always wonder" about people using this forum to check things out after the fact. The thing is, much learning actually happens this way, moral judgement to the propriety of same notwithstanding.

If you care to educate me, love to hear it. If your aim is to have a free slap at my face, we're done here.

To everyone else, thank you again.

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GrnTea,

Yes, this point is well taken. I actually prefer to use correct terms and explain them. So I am in the habit of saying "anticoagulant" to patients, and not "blood thinner." I do explain it in terms of clotting, etc.

I did, however, think that platelets or plasma might actually add bulk to the blood, and that is clearly erroneous. Much better to think of it in terms of presence and quantity of clotting factors.

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OCNRN63,

Um, yeah. Thanks. (Not.)

Read what I said earlier about the value of "not berating." You see, I am in the future ALSO, and I well see the error of my ways. No need to bring that back to the fore. I will take care of the flagellating, thanks.

...

If your aim is to have a free slap at my face, we're done here.

Relax.

1) If you think that was a case of lateral harassment, you have no idea what it can be like.

2) I am pretty sure OCNRN was using you as an example of many other posters who DO use the forum inappropriately to discuss mistakes that should be first be addressed directly. Please don't take it personally, I think it was a comment on the general.

3) You did state your concern that you may have ordered the wrong thing and wondered whether it was too late to fix it. That things turned out in your favor this time should not support a pugnacious attitude.

4) I do understand the case of second-guessing and asking around first, especially if you are working in a punitive environment. You are asking a forum of RNs who represent a diverse set of beliefs about our practice. If you are ready to put your question out there, be willing to accept a variety of responses.

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I guess I am confused. You did everything correctly and were basically wondering what the initals stood for? And the patient never even rcvd said med? Why are ppl yelling at you? haha This forum is so silly sometimes :) Next time just google :p

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Why are ppl yelling at you? haha This forum is so silly sometimes

??????

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What's your question Vespertinas? :)

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Specializes in Emergency, Telemetry, Transplant.
I guess I am confused. You did everything correctly and were basically wondering what the initals stood for? And the patient never even rcvd said med? Why are ppl yelling at you? haha This forum is so silly sometimes :) Next time just google :p

I think the question is 'who yelled at her?' While on this (or any online) forum, it is impossible to display the fact that you are not yelling at someone. Everyone answered appropriately, and if you think people yelled at her, I think you need to work on the relationship between constructive criticism and teaching/learning.

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Specializes in ICU.

Definitely fresh frozen plasma. Platelets is usually sent as a "pack" or platelets and is used to fix platelet levels. If a patient needs an urgent procedure and the INR is high they will usually order FFP close to the procedure to reverse the INR temporarily. FFP has many clotting factors.

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Specializes in ICU.
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.

Just be humble, say " I want to make sure this is correct", and clarify the order. They can't get mad at you for that. They know that theres a constant rotation of new nurses. They appreciate that you want to ensure things are right.

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Specializes in Oncology; medical specialty website.
OCNRN63,

Um, yeah. Thanks. (Not.)

Read what I said earlier about the value of "not berating." You see, I am in the future ALSO, and I well see the error of my ways. No need to bring that back to the fore. I will take care of the flagellating, thanks.

And also note that I started second-guessing myself well AFTER the orders were said and done. And it turned out to be second-guessing. I did everything correctly, as it happens, and just suffered a small attack of insecurity. To me, this is not a reason to discuss anything with my department or report myself to my manager. I do know enough to get clarification at the time orders are given. I read back EVERY order EVERY time, no matter how impatient the doc is.

So glad to hear you "always wonder" about people using this forum to check things out after the fact. The thing is, much learning actually happens this way, moral judgement to the propriety of same notwithstanding.

If you care to educate me, love to hear it. If your aim is to have a free slap at my face, we're done here.

To everyone else, thank you again.

Well, it was certainly not my intention to "slap" you. Since you took my post with such hostility, I will refrain from further discussion with you.

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Specializes in Oncology; medical specialty website.
Relax.

1) If you think that was a case of lateral harassment, you have no idea what it can be like.

2) I am pretty sure OCNRN was using you as an example of many other posters who DO use the forum inappropriately to discuss mistakes that should be first be addressed directly. Please don't take it personally, I think it was a comment on the general.

3) You did state your concern that you may have ordered the wrong thing and wondered whether it was too late to fix it. That things turned out in your favor this time should not support a pugnacious attitude.

4) I do understand the case of second-guessing and asking around first, especially if you are working in a punitive environment. You are asking a forum of RNs who represent a diverse set of beliefs about our practice. If you are ready to put your question out there, be willing to accept a variety of responses.

Thank you. Exactly.

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