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Discussion

Question about transfusion- PICU

I am in orientation in the PICU coming from NICU (4 years) and I had a really rough assignment the other day which I made some errors. I was infusing 20m/hr of ffp's to my patient. Because I think my brain was going too fast trying to learn everything and trying to help my patient. I mislabeled the ffp's as platelets.

My boss told me the next day I didn't know the difference between platelets and ffp's. I know the difference. I just mislabeled it wrong.

I keep going over that day in my mind over and over again because I got a lot of negative non constructive critisim about that day. In thinking about the ffp's I think I might have used the wrong filter tubing and used the platelet filter tubing instead of the blood. What happens when you use platelet filter for ffp's.? I feel terrible, and I don't know if I harmed my patient or not or even helped him.

Featured Replies

Honestly I've worked peds and adults and neither population had a special filter for Plateles or FFP, just regular blood tubing.

I don't have any peds experience but I have run FFP and platelets and if memory serves me correctly I used regular blood tubing for both. Don't beat yourself up.

  • Expert

FFP and platelets look pretty much alike, the main difference being the size of the unit. (I gave both yesterday, along with albumin, cryoprecipitate and packed cells and they all ran through the same kind of tubing. We only stock one type of tubing for blood products.) I think the bigger error would have been GIVING FFP when the patient needed platelets, or vice versa. A labelling error on the pump is really a non-event since once the infusion is over, that label is gone. I'm sure your hospital has a method of labelling the blood products released by the blood bank, a label that ends up part of the patient's permanent chart and that's the label that matters. The only way labelling the pump incorrectly could impact the patient is if someone were covering you for a break or something and needed to be sure of what was running. I still think though that this was blown way out of proportion. Maybe in future take that extra few seconds to be sure your label is correct.

  • Author

Thank ya'll do all ya'lls support. Thank you Janfrn, you replied in another one of my posts. I decided to leave the PICU with 2 months under my belt. I was told when I was hired I would get 3 months adn when I started it changed to 6 weeks. During my orientation process my preceptors gave me vague, contradictory, and misleading feedback and comments. The orientation was not very helpful at all.

  • Expert

I'm sorry that was your experience with PICU, nickel. I'm sad to say that my unit is doing some of those same things with new staff. Out of our September batch, half have quit before they were even partway through their orientations. We're all appalled that so little attention is devoted to making sure these new staffers are safe and well-prepared. How can anyone feel like they know what they're doing if they're paired with somebody new every shift and have no idea who will be helpful and who won't? It's awful. But I'm at a loss as to how to fix it.

The preceptors on our floor take a course to be preceptors. They are assigned one trainee and that trainee stays with only them until they are off orientation. The preceptors also make a little more an hour when they are training someone.

  • Expert

NICE!! Our hospital doesn't provide anything like that. Not only are there no real criteria for being a preceptor, but there are many shifts these days when the person orienting a new staffer has only been off orientation themselves a few weeks. The only time a preceptor is paid extra (65 huge cents an hour) is when they're paired with a fourth year nursing student. Otherwise it's a ton of additional responsibility with absolutely no reward other than a job well done.

I believe that the difference between FFP and platelet is that FFP does not contain Platelet but clotting factors. when you labeled platelet can confuse other people with physician's order.

  • Expert
I believe that the difference between FFP and platelet is that FFP does not contain Platelet but clotting factors. when you labeled platelet can confuse other people with physician's order.

This post is nearly 4 years old. Obviously the OP has resolved the problem long ago.

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