Episode 314: Plasma and Cryoprecipitate Administration: The Oncology Nurse's Role

"Transfusion safety is really a registered nurse activity, and I just continue to reiterate the blessing of nursing assessment, getting those vitals before the transfusion, and then monitoring them closely and stopping the transfusion if they have a reaction, because that's really an assessment, and we can't delegate that to nonlicensed staff. And so that's really why we just celebrate that nurses have such a great role in transfusion safety," Renee LeBlanc, BSN, RN, manager of the infusion services office at Fred Hutchinson Cancer Center in Seattle, WA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about administration of plasma and cryoprecipitate. Music Credit: " Fireflies and Stardust " by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to plasma and cryoprecipitate administration. Episode Notes The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities . Oncology Nursing Podcast episodes: Episode 234: Oncologic Emergencies 101: Thrombotic Thrombocytopenia Purpura Episode 228: Oncologic Emergencies 101: Disseminated Intravascular Coagulation Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome ONS Voice articles: Nursing Considerations for Adverse Events From CAR T-Cell Therapy Manage Thrombosis in Patients With Cancer ONS courses: Essentials in Oncologic Emergencies for the Advanced Practice Provider Oncologic Emergencies ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) Clinical Journal of Oncology Nursing article: STAT: Cytokine Release Syndrome ONS Huddle Cards Cytokine Release Syndrome Disseminated Intravascular Coagulation AABB (Association for the Advancement of Blood and Biotherapies, formerly American Association of Blood Banks) American Association of Clinical Oncology Blood Bank Guy (Joe Chaffin, MD) Joint Commission: Patient Blood Management Certification Review Process Guide 2021 To discuss the information in this episode with other oncology nurses, visit the ONS Communities . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library . To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org . Highlights From This Episode "Plasma is indicated for massive transfusions and emergent reversal of warfarin therapy–related intracranial hemorrhage. Nurses may also see plasma ordered pre-op for multiple coagulation deficiencies or factor XI deficiency." TS 2:58 "Surgical centers performing procedures with large-volume blood loss would be a prime location for staff to be experts in transfusing plasma and cryo. Nurses caring for patients with cytokine release syndrome may be familiar with monitoring for hypofibrinogenemia. Cryoprecipitate in this setting may be given more prophylactically than for a patient who's actively bleeding or having a procedure." TS 6:48 "Plasma coagulation factors have a short half-life. Transfusing as close to the procedure will ensure the highest level of factor activity at the time of the procedure. Nurses can ensure best outcomes through care coordination and timing the transfusions as close to the procedure as possible. So we don't want to start transfusing plasma at midnight if the factors are going to be expiring and their procedure isn't until 9:00 in the morning." TS 10:40 "One of the questions that I get sometimes, especially with plasma, is, 'I don't have time to be at the bedside for 15 minutes for four units.' Remember that each unit is a different donor, and what they eat, what kind of antibodies they have, whether they were pregnant—it's all part of that experience. It's not the same plasma product given four different times or three different times. And so just really drawing nurses into the value of being at the bedside for that first 15 minutes of that final determination of acceptability and tolerance." TS 14:20