Platelet Approval Guidelines

Principle
The demand for platelet products can be greater than the available supply.  This is because demand is episodic and shelf life is short.  To ensure effective use of platelet inventory and avoid inappropriate use of a limited resource, platelet approval guidelines and criteria are established.

Purpose
This policy provides criteria for platelet product approval.

Scope
The policy applies to the Transfusion Service section of Laboratory Medicine.

Policy
A.        Platelet approval is inventory dependent.  When products are in short supply, the patients most in need of platelet support will receive first consideration.  Medical director or resident review may be required to identify these patients.

B.        Requests for platelet products that appear excessive or unreasonable should be referred to the medical director or resident for evaluation.

C.        When inventory is adequate, patients who meet the following criteria are approved to receive platelet products.

1.         Surgery, ECMO or M1W patient.

2.         Patient with platelet count < 30,000 uL.

                        a.         Platelet count must be performed in past 24 hours.

3.         Neonate with platelet count < 100,000 uL.

4.         Neurosurgery patient with platelet count < 100,000 uL.

5.         Patient with platelet count < 50,000 uL who is bleeding, unstable, post-operative or requires platelets immediately prior to an invasive procedure.

                        a.         Patient is considered post-operative for 24 hours.

D.        Patients not meeting approved platelet criteria are referred to the resident for evaluation.

1.         Obtain the following information prior to calling the resident:

                        a.         Name of the ordering MD and Simon page number.

                        b.         Patient location.

                        c.         Indication(s) for platelet transfusion.

i.          Ask the nurse taking care of the patient what the indications are for ordering the platelet transfusion.

                        d.         Current platelet inventory level.

             2.         Contact the resident with patient and platelet order information.

a.         Clearly document resident's decision to approve or disapprove platelet order on request form.

 Reference

 N/A

Copyright © 2005 Madory Consulting
Last modified: 03/05/06