Blood Utilization Initiative at Baptist

In our continued efforts to enhance patient safety, Baptist Health System seeks to encourage our physician staff to use an evidence-based approach to blood product transfusion for all of our patients. We hope the information presented here will assist you as physicians to deliver evidence-based transfusion therapy to all of your patients.

Why Give 2 When 1 Will Do?

BHS Hemoglobin Critical Value to be Lowered
Read the letter from Emily E. Volk, MD
Physician Order for Blood Component Transfusion - Neonate
Physician Order for Blood Component Transfusion - Adult-Pediatric
Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB*
Blood Transfusion Practice Guideline
Practice Guidelines for Perioperative Blood Transfusion and Adjuvant Therapies
Blood Conservation Update
Platelet Transfusions

For more information contact Alex Miller, R.N.
Regional Director, Blood Utilization
Phone (210) 297-9652

Do You Know About the Ret-He Lab Test?

  • Ret-He is a direct estimate of the recent functional availability of iron and may identify iron deficiency earlier than traditional parameters. 
  • Ret-He is an established parameter in the National Kidney Foundation guidelines for assessing the initial iron status and IV iron replacement of hemodialysis patients with chronic kidney disease. 
  • A low Ret-He is indicative of iron deficiency. 
  • With a Ret-He above the normal range, a patient may not respond to additional iron therapy. 
  • Ret-He is done at all BHS hospitals with the same sample that the CBC is done, when Ret-He is ordered by the physician.  
For more information, call Jennifer Rushton, MD, at (210) 572-4314 

Click here to download the Ret-He Powerpoint

Click here to download the Ret-He Article

Immature Platelet Fraction

A new automated method to reliably quantify reticulated platelets, expressed as the immature platelet fraction (IPF), has been developed utilizing the XE- 2100 blood cell counter with upgraded software (Sysmex, Kobe, Japan). The IPF is identified by flow cytometry techniques and the use of a nucleic acid specific dye in the reticulocyte/optical platelet channel. The clinical utility of this parameter was established in the laboratory diagnosis of thrombocytopenia due to increased peripheral platelet destruction, particularly autoimmune thrombocytopenic purpura (AITP) and thrombotic thrombocytopenic purpura (TTP).

Reproducibility and stability results over 48 h were good. An IPF reference range in healthy individuals was established as 1Æ1–6Æ1%, with a mean of 3Æ4%. Patients in whom platelet destruction might be abnormal, were studied and two of these patients followed serially during the course of treatment. The IPF was raised in several disease states. The most significant increases in IPF values were found in patients with AITP (mean 22Æ3%, range 9Æ2–33Æ1%) and acute TTP (mean 17Æ2%, range 11Æ2–30Æ9%). Following patients during treatment demonstrated that as the platelet count recovered the IPF% fell. These results show that a rapid, inexpensive automated method for measuring the IPF% is feasible and should become a standard parameter in evaluating the thrombocytopenic patient.

Click here to download the IPF Powerpoint 

Click here to download the IPF Article