Blood component utilization before and after implementation of good transfusion practice measures in a pediatric emergency department

Abstract Objectives We aimed to determine the pattern of blood component utilization in pediatric Emergency Department (ED) and compare the utilization rate before and after the implementation of simple good transfusion practice measures. Material and methods This was a prospective pre/post interventional study was conducted between February 2015 and June 2016. The study included 3 phases [1] Pre-intervention phase (6 weeks) consisting of baseline data collection [2] Intervention phase (3 months) involving education on transfusion triggers and periodic mailers about good practice and designated 'transfusion resident' for supervision. [3] Post- intervention phase (6 weeks) collecting data while continuing interventions. Results During pre-intervention, 379 blood components [Packed red cells(PRBC) - 227, Platelet concentrate(PC) - 78, Fresh Frozen Plasma(FFP) - 74] were requested for 280 children; 195 were transfused with an overall utilization rate of 51.5%. PRBC had the poorest utilization rate (30%) followed by PC (72%) and FFP (96%). About 79% of the requisitions sent by residents in first training year were not utilized before intervention. Indications such as anticipated surgery, congenital heart disease, pneumonia and sepsis had lower utilization rate. Post intervention, there was 14% reduction in blood component requests (325 requests in 258 patients). Both overall utilization rate (56%) and PRBC utilization (37.4%) showed improvement but the difference was statistically not significant. Conclusions Red blood cells were the most frequently requested blood components yet poorly utilized in ED. Simple interventions targeting providers in early stages of training could potentially improve the blood component utilization and transfusion practices in busy emergency departments.