Dr. Will Flanary is an ophthalmologist and stand-up comic who moonlights as the hilarious “Dr. Glaucomflecken” on social media. The Glaucomflecken videos have earned him an enormous worldwide following, as he has gently parodied physicians of many specialties (including pathology). He and his wife Kristin (aka "Lady Glaucomflecken") join me to share their inspirational story, with NO blood bank learning whatsoever! Even so, you've gotta listen!

Continuing Education episode! Understanding reference lab techniques like adsorption, elution, and enzymes feels like learning a new language! Jan Hamilton is here with an incredible teaching interview to help you learn to speak “reference lab.” This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until June 22, 2025 through Transfusion News Continuing Education on Wiley Health Learning.

Continuing education episode! Advances in the practice of Transfusion Medicine happen regularly, and it can be difficult for both learners and those with more experience to keep up with the latest information. Further, many learners (and more “seasoned” types!) lack experience to evaluate strengths and weaknesses of the evidence in the medical literature. Dr. Rich Haspel joins me to describe how to evaluate evidence in the medical literature, and to discuss his take on low-titer group O whole blood. This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until May 4, 2025 through Transfusion News Continuing Education on Wiley Health Learning.

CE episode! To celebrate the 100th episode of Blood Bank Guy Essentials, Dr. Chaffin invites multiple previous guests (plus one brand new one!) to share brief "Pearls of Wisdom" with you. Learners of every level are sure to find Transfusion Medicine tips and tools to help care for patients in better ways. Thanks to all who have listened to this podcast in the past 7 years! This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until March 28, 2025 through Transfusion News Continuing Education on Wiley Health Learning.

Rh Immune Globulin prevents at-risk moms from making anti-D, but calculating proper dose can be challenging. In fact, numerous reports have suggested that we mess this up a lot! This episode is a teaching session with me and one of the pathology residents at Loma Linda University, Jessica Hudson. In it, I try to simplify the calculations and discuss some of the mechanics and details around the use of this amazingly effective medication.

Continuing education episode! If a research project has been going on for over 30 years, you would think it's probably pretty good, right? Well, that's how long the REDS research project, sponsored by the US National Heart, Lung, and Blood Institute (NHLBI) has been breaking new ground in Transfusion Medicine. The two co-chairs of the fourth phase, REDS-IV-P, are here to explain why the best is yet to come! This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until July 17, 2024 through Transfusion News Continuing Education on Wiley Health Learning.

Continuing education episode! For decades, medical personnel have been aware of the technique of “Acute Normovolemic Hemodilution (ANH),” the collection of blood immediately before surgery followed by infusion near the end. Dr. Steve Frank and his colleagues in the Bloodless Medicine Program at Johns Hopkins believe ANH is an underutilized strategy. He joins the BBGuy Essentials Podcast to share the details of ANH, and show how other facilities can implement ANH as a part of their overall Patient Blood Management Program. This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until June 28, 2024 through Transfusion News Continuing Education on Wiley Health Learning.

Continuing education episode! Blood shortages happen, but the one associated with COVID-19 is unique (and severe!). AABB Chief Medical Officer Dr. Claudia Cohn explains why and gives practical survival tips. This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until March 29, 2024 through Transfusion News Continuing Education on Wiley Health Learning.

Continuing education episode! Plasma product names are confusing, but few are as misunderstood as Liquid Plasma. Dr. Chris Gresens explains why LP might be perfect for your transfusion service. This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until March 8, 2024 through Transfusion News Continuing Education on Wiley Health Learning.

Continuing education episode! When most United States-based healthcare providers think of a hemoglobinopathy, sickle cell disease is the first to come to mind. That is understandable, given how frequently that disease is present in the US. However, worldwide, the various forms of thalassemia are a MASSIVE problem. Dr. Sujit Sheth takes us through the details around this deadly global disease, and how transfusion professionals can aid in care of thalassemia patients. This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until March 1, 2024 through Transfusion News Continuing Education on Wiley Health Learning.

Continuing education episode! Usually, red cell alloantibodies are simple (find an antibody, give antigen-negative blood), but occasionally, some of them don't follow the rules! "Antibodies of variable clinical significance" act differently in different patients, sometimes causing hemolysis and sometimes not. They can be very hard to manage, especially because almost all blood donors are incompatible. The Monocyte Monolayer Assay, developed by today's guest, Sandy Nance, and her colleagues at the American Red Cross, helps answer the question, “Do we search the world for rare units of compatible blood, or can we just transfuse ABO-compatible red cells out of our regular inventory?” It's a great story, and this is a rare chance to hear about the MMA from one of the original sources, and to understand how to use it today. This episode is eligible for FREE CME and Continuing Certification credit for physicians and P.A.C.E. contact hours for laboratorians until October 12, 2023 through Transfusion News Continuing Education on Wiley Health Learning.

Platelets have been used to save the lives of patients with low platelet counts for decades. For the most part, they are considered a safe and effective means to correct the problem of a patient not having enough platelets of their own. Despite that, we have wondered for decades about whether or not platelets should be given to patients with certain diseases where their platelets are being removed from circulation, like ITP, TTP, and HIT. My guest in this episode, Dr. Ruchika Goel, looked at platelet transfusion in those three entities, and she has data to share with us that might change the way you transfuse these patients.

In 2017, Dr. Mark Yazer appeared on this podcast to discuss the burgeoning interest in “Low-titer Group O Whole Blood (LTOWB)” for massive transfusions, particularly in trauma settings. Since then, more data and experience are available to guide the use of whole blood for trauma transfusion. Dr. Yazer updates us on the latest whole blood and incompatible plasma transfusion data, and clears up once and for all the "clear fluids" debate! Plus, there's some hockey trash talk...

Despite guidance in a 2015 publication from international experts in immunohematology and transfusion medicine, many clinicians and laboratorians have yet to integrate RHD genotyping into routine practice when a patient’s RhD serologic typing is weaker than expected. In this interview, international immunohematology expert Sue Johnson shows us how we can do better! NOTE: CE credit has expired for this episode.

Transfusion reactions that involve the heart and/or lungs, especially TACO and TRALI, are responsible for more transfusion deaths than any other entity. In this interview, Dr. Cserti-Gazdewich focuses on these two reactions and gives tips and strategies to identify, manage, and prevent them. NOTE: CE credit has expired for this episode.

Warm autoantibodies have a well-deserved reputation as tough challenges, creating unfamiliar situations for both clinical and laboratory staff. I interviewed the authors of two recent papers that outlined best practices in this situation to gain some clarity and help!

Blood transfusion is less likely to transmit infections today than ever. Through a combination of screening questions, donor testing, and direct treatment of blood products, the vast majority of opportunities for transfusion-transmitted infections are eliminated. In this learner-focused interview, Dr. Suchi Pandey from Stanford outlines current strategies to keep blood safe. NOTE: CE credit has expired for this episode.

Every now and then, the routine practice of Blood Banking/Transfusion Medicine gets intimidating. A difficult patient situation arises here, an impossible choice looms there. What do you do when there are no easy answers? Drs Mark Fung and Jay Hudgins are expert Transfusion Medicine practitioners who have years of experience dealing with these “scary” situations! In this special Halloween 2020 episode, they are here to help learners with ideas on how to approach some seemingly impossible situations. NOTE: CE credit has expired for this episode.

Every now and then, when a transfusion service does a pretransfusion workup, they find that the patient's plasma is incompatible with EVERY other red cell! In other words, NOTHING is compatible! These situations are intimidating, and can lead to delays in transfusion. Dr. Jill Storry is an international immunohematology expert, and she shares practical tips for what to do and how to recognize the three main patterns of panagglutinins. NOTE: CE credit has expired for this episode.

Special episode! In the midst of the COVID-19 pandemic, does convalescent plasma from recovered patients offer fresh hope for those who are critically ill? The medical leaders of the two largest blood collectors in the US are here to help us work through the challenges and triumphs for COVID-19 convalescent plasma.

Let’s be honest: Some hospital transfusion committee meetings feel like a waste of time! However, Dr. Carolyn Burns thinks transfusion committees are not hopeless! In this interview, she outlines her practical steps for building the perfect transfusion committee. She discusses how to recruit members, how to find “champions,” what to discuss and analyze, and shares what she has observed in the most effective transfusion committees. Whether your facility is doing a great job already or you are reading this and thinking, “I’m supposed to be reviewing transfusion stuff?”, Carolyn will help you go beyond just “checking the boxes.” NOTE: CE credit has expired for this episode.

In this emergency episode, recorded on March 16, 2020, I discuss actions blood collectors and hospitals should be thinking of now to preserve the US blood supply, as well as a look at the global COVID-19 pandemic. We also briefly discuss convalescent plasma and its potential role.

The 32nd edition of AABB Standards became effective in April 2020. Rich Gammon, Chair of the BBTS Standards Committee, is here with the Top 10 changes you need to know! From blood donors to recipients, these changes will keep you in touch with best practices in Transfusion Medicine, even if your facility is not AABB-accredited. NOTE: CE credit has expired for this episode.

Those who oversee blood collection organizations wrestle constantly with two questions: “How can I keep my blood donors safe?” and “How can I keep the recipients of the blood we are collecting safe?” These twin responsibilities shape decisions and policies in blood donor centers worldwide. Dr. Mindy Goldman, Medical Director at Canadian Blood Services (CBS), is deeply involved in the evaluation of those core questions. As a result, I wanted her to describe Canada’s decisions on two big issues: First, whether to impose an upper age limit on blood donors, and second, how long to defer men from blood donation who have had intimate contact with other men. NOTE: CE credit has expired for this episode.

With the FDA's 2019 publication of their Final Guidance on how to prevent patients from receiving platelet products contaminated with bacteria, it finally feels like pathogen reduction technology is about to "get real" in the United States! There was a time, though, that modern versions of pathogen reduction existed only in the minds of some really, really smart people. One of those brilliant minds is my guest, and his name is Dr. Ray Goodrich. Ray shares the backstory of how modern pathogen reduction techniques came to be.

Far too many platelet transfusion decisions are made by evaluating a single laboratory value (the platelet count). Dr. Joe Sweeney believes we need more information to make better choices. Platelet transfusion decisions can be complex, and there is wide practice variability both within institutions and among different subspecialty services. In this interview, Dr. Sweeney describes current platelet transfusion guidelines and a more thorough approach to caring for thrombocytopenic patients. NOTE: CE credit has expired for this episode.

On September 30, 2019, the United States Food and Drug Administration released the long awaited final guidance on bacterial risk control in platelets (see episode 076 for more details). One way that transfusion services can fulfill the recommendations in the guidance is to implement pathogen reduction technology. Dr. Pat Kopko and her team at the University of California-San Diego are well ahead of the curve, as they implemented PR-platelets in their hospital WAY back in 2017! Along the way, UCSD and their blood supplier (American Red Cross) had to answer many difficult questions and make many decisions. Pat joins me to describe lessons learned, with an eye toward where this all fits with the FDA guidance. NOTE: CE credit has expired for this episode.

Over the past several years, the United States Food and Drug Administration has considered many proposals for how to decrease the risk that a vulnerable patient would receive a platelet transfusion containing bacteria. On September 30, 2019, FDA released their "Final Guidance" with multiple recommendations that can appear confusing at first glance. This interview with Dr. Pat Kopko from UC-San Diego is designed to be a "first impression" tour through the options in the guidance. NOTE: Every facility should form their own impressions and determine their individual best course. I highly recommend focused conversations between blood suppliers and transfusion services to decide what is best in YOUR setting!

Are we ignoring the most important coagulation factor when transfusing bleeding patients? Melissa Cushing thinks fibrinogen's contribution to survival of bleeding patients may be under-recognized. She describes the current evidence for early fibrinogen replacement in the bleeding patient, logistical challenges transfusion services face, studies providing insights to desired fibrinogen target levels, and future options to provide early fibrinogen replacement with increased efficiency and safety. NOTE: CE credit has expired for this episode.

Transfusion-associated Graft-versus-Host Disease (TA-GVHD) is a notoriously deadly but thankfully rare transfusion complication. Blood banks have used irradiation of cellular blood products for decades to prevent TA-GVHD, but clinicians and laboratorians still sometimes misunderstand what irradiation does and does not do. Dr. Chris Tormey from Yale details the past, present, and future of blood product irradiation in this practical and timely interview. NOTE: CE credit has expired for this episode.

More and more trauma surgeons are asking their hospitals when they can get low-titer, cold-stored, group O whole blood ("trauma whole blood"). This product, discussed in depth in episode 040CE, is one that comes with lots of choices, and Drs. David Oh and Mike Goodman from Hoxworth Blood Center and the University of Cincinnati led their hospital through those decisions. They join me to share their insights, lessons learned, and practical tips. Please note: This is not intended to be a recipe! Every facility must make their own decisions on how to implement trauma whole blood (if they do so at all!). This interview is meant to demonstrate how one facility successfully introduced the product, and what they learned while doing so.

For decades, neonates (especially in the United States) have been given platelet transfusions at considerably higher platelet counts than thresholds used in adults. New data suggests, however, that "less may be more" when it comes to transfusing platelets to these tiny and vulnerable patients! Dr. Martha Sola-Visner, a neonatologist from Boston, joins me to discuss the results of a recent large study that challenges our assumptions about neonatal platelet transfusion. NOTE: CE credit has expired for this episode.

This month, the American Society for Apheresis (ASFA) released a new version of their epic document called “Guidelines on the Use of Therapeutic Apheresis in Clinical Practice” in the Journal of Clinical Apheresis. It is, in many ways, the standard document that professionals in this field refer to when faced with a patient who may need treatment. One of the co-editors of the “Special Issue” (as it is also called), Dr. Nancy Dunbar, joins me to explain why you need to get your hands on the new guidelines right away!

Alloimmunization after red blood cell (RBC) transfusion is a huge challenge in the treatment of sickle cell disease (SCD). Even when donors and patients are "matched," anti-Rh antibodies in patients with sickle cell disease are formed way often than we would like or expect. Further, Dr. Stella Chou has shown that nearly a third of patients with those new antibodies actually have hemolytic transfusion reactions! It's a huge problem. In this interview, Dr. Chou, a pediatric hematologist from Philadelphia, shows that the problem comes in part from widespread genetic RH variations in both Black blood donors and patients with sickle cell disease. She models a future direction that may help us finally solve this problem once and for all: Genotype matching of donors and patients! NOTE: CE credit has expired for this episode.

Over the past 15 years, Transfusion-related Acute Lung Injury (TRALI) has caused in more deaths than any other complication. Since many cases are caused by antibodies in blood donors, blood collection establishments around the world have taken numerous steps in an effort to prevent TRALI (also known as TRALI "mitigation"). Dr. Beth Shaz and a group of distinguished researchers decided to investigate and see if they could quantify the impact of the interventions. They looked at over 10 million transfusions across 9 states in the U.S., and their results may surprise you! NOTE: CE credit has expired for this episode.

Most blood bankers will tell you that cardiac surgery can lead to some of the most intense interactions between a transfusion service and an operating room. Over the decades, we have seen wide variations in how much blood surgeons transfuse, even among those practicing in the same hospital! Those times are changing, however. Dr. Pierre Tibi is a busy cardiac surgeon in Arizona who also happens to be a Patient Blood Management champion! Pierre joins me to pull back the curtain on what is really happening in the OR, and offers his thoughts on how we can all care best for our cardiac surgery patients (even those getting a "re-do!").

It feels like everyone is talking about patient blood management. That's a GOOD thing, but does it really mean what they think it means? Dr. Carolyn Burns joins me to discuss "Five Things Patients and Physicians Should Question" regarding blood management, and what she has to say may show you that you are NOT doing everything you can or should with PBM in your facility. NOTE: CE credit has expired for this episode.

Here's what we thought we knew: IgA deficiency leads to anaphylactic transfusion reactions. Not so fast! Dr. Gerald Sandler from Georgetown University noticed something when he was in charge of one of the US national reference labs: Hardly anyone with true anaphylactic reactions actually had IgA deficiency and anti-IgA! There's more to the story, and Jerry is here to share it with us (including why it's still ok to look for IgA deficiency in these patients).

Jehovah's Witnesses refuse transfusion based on strong religious beliefs, but the "rules" can be confusing. Transfusion Medicine professionals are often called to help clinicians manage Witnesses' care (despite the fact that these patients will not accept most of what we supply!). In this interview, Jed Gorlin details how to be helpful, respectful, and a great team member in the care of Jehovah's Witnesses who refuse transfusion.

Granulocyte concentrate has been around for as long as apheresis platelets, but the product has come into and out of favor repeatedly over the years. While the most recent randomized trials were disappointing, Dr. Ron Strauss believes a closer look at the data from the famous "RING Study" convinces him that if we transfuse a "modern," high-dose granulocyte concentrate, the results can be very positive! Let's look together at the history and future of granulocyte transfusion. NOTE: CE credit has expired for this episode.

Ever since the introduction of anti-CD38 (daratumumab, or DARA), blood bankers have been hearing about a new chemotherapy agent, anti-CD47, that would interfere far more in our testing than anti-CD38. Well, anti-CD47 is here (in trials), and it lives up to its reputation! Connie Westhoff and her team report on results from blood bank testing of patients taking the drug, and what you can do to overcome the problems. NOTE: CE credit has expired for this episode.

For patients who might need blood transfusion, the ideas of donating their own blood (“autologous donation”) and/or choosing their blood donor (“directed donation”) seem VERY appealing! However, Dr. Julie Karp explains the good reasons why both special donation types are getting less and less common, and tells us what role, if any, each has in today's Transfusion Medicine. NOTE: CE credit has expired for this episode.

You know all about AABB Standards, but how do you make them practical? Anne Chenoweth gives great tips to make your next assessment better! NOTE: CE credit has expired for this episode.  

Nancy Dunbar says a few simple adjustments to "the rules" we learned long ago could reduce shortages of O-neg RBCs, AB plasma, and platelets! NOTE: CE credit has expired for this episode.

A 25-year-old, A negative female needs blood. She will receive RhD-negative RBCs, of course, but what about antigen matching for Kell, or for other Rh antigens? Meghan Delaney explains her study, "AMIGO," in which she tried to determine if there is evidence that such matching is important.

Venous thromboembolism after surgery is a huge problem, and we may have underestimated one big contributing factor: Red cell transfusion! Ruchika Goel and colleagues put together the first study to primarily address the role of perioperative red blood cell transfusions in developing postoperative venous thromboemboli, and she is here to tell us what they found. NOTE: CE credit has expired for this episode.

Isolated nonspecific reactions ("antibodies of undetermined specificity") on antibody workups can delay transfusions, but it may be impossible to determine whether or not they matter to the patient. Brenda Grossman explains possible causes and potential solutions when these annoying but common situations arise.

Patients with liver disease often have basic coagulation laboratory values that seem AWFUL, and as a result, they receive almost 1 in every 5 blood products transfused in hospitals! Jeannie Callum thinks that’s too much, and shows us how to improve our practice. NOTE: CE credit has expired for this episode.

"I never KNEW about that paper!" Most of us have felt that way when we miss some new Transfusion Medicine fact, especially early in our careers. In this interview, two of the editors of a synopsis of 2016-17 BB/TM literature summarize recent developments you should know. NOTE: CE credit has expired for this episode.

In the 2+ years I've been doing this podcast, more people have asked, "when are you doing ABO discrepancies?" than any other topic. Well, here you go! Let's learn the essentials with Dr. Nicole Draper, who loves ABO discrepancies! See www.BBGuy.org/054 for the visual part. 

Alloimmunization has been a mystery for decades, but Chris Tormey has new answers for why patients make antibodies that we wish they didn't! NOTE: CE credit has expired for this episode.

Most everyone is aware that PBM programs involve things like improving physician blood ordering practices by “tightening up” approved thresholds for transfusing red cells and platelets, especially. Many have heard cute little phrases like, “Hey, why give 2 when 1 will do?” to describe current thoughts on transfusing one unit of red cells as a default instead of two units as a default. What I’ll bet many do NOT know, however, is the fact that you can do all of those things and you can still miss what may be, in my opinion, pretty close to the most important part of PBM: Detecting and managing pre-operative anemia before the patient is ever admitted! Dr. Aryeh Shander wants you to know just how important it is.

In episode 050CE, Sue Johnson outlined sample requirements and antibody detection testing. Now, the knowledge bomb continues as she helps us understand how to choose compatible blood products and TEST (crossmatch) them to make sure they are compatible. Sue finishes the job by solving six cases illustrating common challenges in compatibility testing.

Continuing education episode! To those less familiar with testing and processes in blood banks, the process of Pretransfusion Testing can feel confusing and intimidating. There are tons of rules, and we feel compelled to hold everyone and everything involved to a VERY high standard! Sue Johnson returns to the podcast in part 1 of a discussion of the first two steps in pretransfusion testing, and she will help you understand the "why" behind the tests.  NOTE: CE credit has expired for this episode.

Continuing education episode! When a patient has TOO MUCH of a good thing, transfusion medicine professionals must sometimes step in and assist in removing red cells, plasma, and/or platelets. Dr. Jeff Winters will help you understand why YOU need to know about these procedures, even if you are not directly involved in therapeutic cytapheresis in your facility. This episode is eligible for FREE CME and SAMs/CC credit for physicians and P.A.C.E. contact hours for laboratorians through Transfusion News Continuing Education on Wiley Health Learning.

Major surgeries with no blood, for both Jehovah's Witnesses and others? Post-operative patients who don't need transfusion because of massive blood draws? These things are not only possible, they are happening right now, and Dr. Steve Frank, Medical Director of the Johns Hopkins Bloodless Medicine Program, is here to discuss the essentials of patient blood management carried to the extreme!

Cytomegalovirus can cause all kinds of problems in susceptible transfusion recipients, but even an AABB Expert Panel couldn't say exactly how to make blood "CMV-safe!" John Roback was senior author the committee report, and he's here to clear the air...maybe! NOTE: CE credit has expired for this episode.

Every two years, like it or not, our friends at the AABB issue a brand-new version of their Standards for Blood Banks and Transfusion Services (though we usually just call it “Standards” for short). The 31st edition goes live on April 1, 2018, and it contains a number of important changes. Pat Ooley, Chair of the Blood Bank Transfusion Service Standards Committee, joins me to share his “Top 5 Changes” you need to understand and implement. Pat also takes some time to help us understand the role of this publication that impacts hundreds and hundreds of transfusion and donor facilities in the US and a few international countries. He also walks us through the entire process on how new and revised Standards come into existence.

In his nearly 45 years at the National Institutes of Health, Dr. Harvey Klein has been at the center of a mountain of uproars, crises, and changes in transfusion medicine. He's got tons of fascinating stories and opinions, and he's here to share the "Past, Present, & Future of Transfusion Medicine." Don't miss it!

I've known Dr. Pat Kopko, Director of Transfusion Medicine at UC San Diego, for over 30 years! For this episode, we decided to have a conversation about the "essential" things we wish we would have known back when we started on our respective paths to being blood bankers. Pat and I get really, really practical, and give you tons of useful information, including tips, memory tools, and facts presented in a memorable way. This episode is one for all of you who don’t do blood banking every day: Residents, medical students, clinicians, non-blood bank pathologists, nurses, non-blood bank laboratory scientists, and anyone else who doesn’t live in our world all the time! So, pull up a chair, eavesdrop on two friends talking the “Essentials,” and enjoy! NOTE: CE credit has expired for this episode.

Everyone everywhere in transfusion medicine is talking about patient blood management! What is not often discussed, however, is just how to monitor practices, and what we should do to get started or get better. Mark Fung joins me to discuss 6 practical tips to influence transfusion practice in your hospital. His real-world strategies will help anyone involved in improving transfusion practice! NOTE: CE credit has expired for this episode.

An 80 year old male with acute leukemia is getting a platelet transfusion, he begins to feel short of breath. The nurse overseeing the transfusion asks the hematology fellow, "What do you want me to do next, doctor?" The fellow feels his pulse quicken, and he prepares to give his best answer... Situations like this are real and occur every single day in hospitals around the world. Many studies have shown a significant lack of basic transfusion medicine training for clinical physicians, and a not-too-surprising accompanying knowledge gap, even for those in specialties like hematology.  Dr. Rich Haspel and colleagues from the BEST Collaborative set out to define the problem AND come up with solutions! He shares both in this episode.

During the 1980's and 90's, U.S. blood collectors asked more and more (and then MORE) questions of our volunteer blood donors, to the point of absurdity. Dr. Mary Townsend was an original (and current) member of the task force that changed all of that, and she is here to help you understand why we ask what we ask! Note: This is NOT a Continuing Education episode. See BBGuy.org or TransfusionNews.com for more information on continuing education.

In the remote history of transfusion medicine, life was simple. We had exactly one product: Whole blood. Things changed, and for the last 50 years or so, we began to separate whole blood into red cells, plasma, and platelets. As we learn more and more about what works and what doesn’t in trauma resuscitation, some are looking a return to whole blood. Dr. Mark Yazer is helping to lead that discussion, specifically to the use of low-titer group O cold-stored whole blood, which he calls “the ideal pre- and early in-hospital resuscitation fluid!” In this episode, Mark returns to outline his case for that outrageous statement! NOTE: CE credit has expired for this episode.

Febrile nonhemolytic transfusion reactions get no respect! Clinicians think they are a nuisance, and so do most blood bankers! However, a recent paper from Dr. Christine Cserti-Gazdewich and group suggests that they may be a bigger deal than you think. NOTE: CE credit has expired for this episode.

Hemolytic Disease of the Fetus and Newborn (HDFN) seems simple, but there are lots of pitfalls! Dr. Greg Denomme is your guide to HDFN clarity!

What if everything we know (or think we know) about learning is just wrong? Traditional, "sage on the stage" lectures don't foster long-term retention, nor does slogging through an article or book chapter. Dr. Justin Kreuter has studied the research, and he's here to guide us to what does work, and steps to take toward mastery of blood banking and transfusion medicine!

New paradigms in trauma transfusion require prompt delivery of plasma in increased amounts. This has led blood banks to start using group A plasma instead of AB in these emergency settings. But, is the practice safe? Drs. Stevens and Dunbar share new evidence!    

Yes, platelets are tiny, but they can cause lots of problems and controversy! Dr. Rick Kaufman (lead author of the AABB Clinical Practice Guideline on platelet transfusion), joins the podcast to discuss what the evidence shows and what we can and can't say about platelet transfusion. The lack of evidence might really surprise you!

Dr. Josephson returns to the podcast, and she is back in style! Blood bankers may struggle with the details of red blood cell transfusion to neonates, as there are important differences between this group and the adults and older children we are more accustomed to transfusing. Cassandra is your guide, and she answers "Five Essential Questions about Neonatal RBC Transfusion." When should we give RBCs to babies? What about "old" RBCs; Does age of blood matter? Is preservative important? Should the RBCs be modified? How do I test for compatibility? This is a fun and fast-moving episode. Visit the show page at BBGuy.org/034

Interactions between Blood Bank and Emergency Department staff in stressful times (like massive transfusions) can be difficult. Good news: A world-renowned ER physician says it doesn't have to be that way! Dr. Scott Weingart of the EMCrit podcast joins me to discuss how we can understand each other better.

"Have a steak! Eat your spinach!" Age-old advice from blood collectors to donors, but is it good enough? Jed Gorlin shows us why the old iron ways may not best!

Ever feel like you are missing something? If you aren't using Twitter to keep up with blood banking advancements, you should be! The 140 character platform is so useful for connecting with others, learning from conferences you can't attend, and developing your own vision and presence. This roundtable discussion takes you through the essentials of blood banking on Twitter. Jerad Gardner, Kate Pendry, Justin Kreuter, and Sandy Minck show you the way!

One little amino acid makes all the difference in sickle cell disease! Dr. Eric Gehrie explains why sickle cell patients are so challenging for blood banks, specifically focusing on the huge problem of alloimmunization (making RBC antibodies) after transfusion.

Molecular (genetic) testing is everywhere in medicine today, and the blood bank is no exception! You don't have to be an expert geneticist to see how it all fits, however. Meghan Delaney joins me to present 7 practical uses for molecular testing in transfusion medicine.

For such a simple test, the Direct Antiglobulin ("Coombs") Test confuses the heck out of most every blood bank student, to say nothing of many clinicians! Sue Johnson is here to guide us to better understanding of this most excellent immunohematology test.

Neonatal alloimmune thrombocytopenia (NAIT), the disease with many names, continues to confound blood bankers everywhere! The conversation goes like this: "This baby has a low platelet count...is it NAIT?" Dr. Brian Curtis tells Dr. Chaffin how to take the right steps to find the answer, both in the real world and the exam world.

Jeff Winters described the essentials of therapeutic apheresis in BBGuy Essentials 025. He is back today to address how to use those principles to treat Thrombotic Thrombocytopenic Purpura, or "TTP." This terrifying disease, caused in adults primarily by a deficiency of an enzyme with a funny name, "ADAMTS13", can be rapidly fatal if not promptly diagnosed and treated.

It is very common for trainees and practitioners of Transfusion Medicine to have low levels of comfort and experience with therapeutic apheresis procedures. It just “feels” complicated! Fortunately for us, Dr. Jeff Winters, editor of the Journal of Clinical Apheresis, past president of the American Society for Apheresis, and director of the very busy therapeutic apheresis service at Mayo Clinic, is an enthusiastic and willing guide!

Dr. Will Savage from Harvard University joins Dr. Chaffin to discuss Allergic Transfusion Reactions (ATRs). Allergic reactions have become pretty widely known as "nuisance reactions" to blood bankers and clinical staff, and it's easy to think that we understand them. Dr. Savage and colleagues have shown in numerous recent publications, however, that we don't yet fully "get it" with ATRs. He opens our eyes in this last BBGuy Essentials Episode of 2016. Thanks for listening this year (over 25,000 downloads!).

Dr. Jeff Carson is lead author of the 2016 AABB RBC Transfusion Threshold Guidelines published online in JAMA in October 2016. This article updates the 2012 AABB Guidelines, and incorporates lots of new information from recently published studies. He joins Dr. Chaffin to discuss how to use these guidelines in everyday practice.

Red blood cells, in most countries, can be stored for up to 42 days. In the last ten years, there have been numerous observational studies suggesting that "older" blood may be harmful to recipients. In one of my favorite interviews, Nancy Heddle, lead author of the INFORM study (NEJM Oct 24, 2016) tells us why we shouldn't worry!

Despite having possibly the silliest acronym in the history of medicine (in Dr. Chaffin's opinion!), TACO is a very serious disease. It is responsible for the second-most number of deaths from transfusion every year in the United States (and is #1 in the United Kingdom). TACO is not something to mess around with, but far too many clinicians and blood bankers fail to give it the respect it deserves. Dr. Garrett Booth joins Dr. Chaffin in an energetic and fast-moving discussion of the "ins and outs" of TACO.

Most would agree that today's transfusions are really safe from potential infectious disease transmission. There are still a few situations that worry blood bankers, like the risk of bacterial contamination of platelets (despite our best efforts) and emerging infections like Zika virus. One potential solution to these issues is called "pathogen inactivation" (also called pathogen reduction by many). Dr. McCullough tells us all about it! (Note: This is an updated version that eliminates the 15 second gap left in the first version at 45 minutes or so)

Cryoprecipitate is easily the most misunderstood blood product, and lots of confusion surrounds it (not just among clinical folks!). Dr. Chaffin and co-host Dr. Heidi Shafi give you five "Essentials" of cryoprecipitate to set record straight!

Many, many clinicians routinely order premedication of their patients with acetaminophen and diphenhydramine before transfusion, believing that using those medications will prevent allergic and febrile transfusion reactions, respectively. Maybe not! Dr. Heidi Shafi discusses the available data that says that this practice may not make sense.

It's easy to push the panic button when a suspected transfusion reaction occurs! Blood bank doctors and lab scientists interact with clinical staff more than at any other time when dealing with suspected and confirmed transfusion reactions. Dr. Mark Fung from University of Vermont (editor of the AABB Technical Manual) takes us through a detailed look at how to manage these situations calmly and systematically.

In July 2016, I updated you on the current U.S. strategy on preventing Zika transmission by blood. As expected, things have changed, and this is a short update to let you know what is happening as of September 2016.

Plasma transfusion is not as easy as it sounds! Over half of transfusions have been shown to be unnecessary. Dr. Jeannie Callum from Toronto joins Dr. Chaffin for this extensive discussion designed to dispel some myths and show you how it SHOULD be!

Talk of Zika virus has been all over the news for months, and especially so in the last few days of July 2016. Dr. Chaffin and co-host Dr. Heidi Shafi take a look at how the identification of local transmission of Zika in South Florida impacts blood donation and transfusion in the United States.

Dr. Emily Volk from the Baptist and Tenet Health Systems joins Dr. Chaffin to discuss Patient Blood Management (PBM). It seems like everyone today is talking about PBM, from hospital administrators to clinicians to laboratory scientists to pathologists. This episode is a big picture look at some things to consider when thinking about implementing or improving a PBM program. Dr. Volk has been a part of two very successful PBM programs, and she shares some of what she has learned with us.

Joined by my new "Ask the BBGuy" co-host, Dr. Heidi Shafi, I take a detailed look at Transfusion-associated Graft-vs-Host Disease (TA-GVHD). This transfusion complication is by far one of the most dangerous, fatal in over 90% of cases. I start from the basics and outline the details of TA-GVHD, and discuss the implications of a game-changing 2015 article on the topic.

In transfusion medicine, infants and children are NOT just "little adults!" Dr. Cassandra Josephson joins Dr. Chaffin to discuss 5 things you should know about pediatric transfusion today!

Drug-induced Immune Hemolytic Anemia challenges both established blood bankers and beginners alike! It's tough, but Pat Arndt from American Red Cross Southern California joins Dr. Chaffin in a conversation to outline the basics and give you a way to understand how drugs and antibodies and red cells interact. 

Since U.S. FDA approval of the multiple myeloma drug with the funny name, "daratumumab," in late 2015, blood bankers have had a lot to learn and still can be confused about the drug's effect on testing. Dr. Kaufman is an international expert on this topic, and he helps clear the mysteries of DARA with practical strategies you can learn right away!

Dr. Kristine Krafts from the University of Minnesota and pathologystudent.com joins Dr. Chaffin to discuss her "Top Five Tips to Make Your Next Presentation Awesome!" Great presentations don't just happen. They take planning, preparation, and practice. If you want your next lecture to be great, Dr. Krafts shares five very practical tips for setting yourself up for success as a presenter!

Dr. Kevin Land from Blood Systems International joins Dr. Chaffin for an interesting and sometimes hilarious look at common blood bank beliefs, including viral disease risk, O-negative blood use, transfusion and mortality, and "young vs. old" blood.

Dr. Minh-Ha Tran from University of California Irvine joins Dr. Chaffin to discuss the "Who, Where, What, Why, When, and How of Massive Transfusion!" Dr. Tran offers tons of great tips, data, and discussions. See example slides on BBGuy.org.

Dr. Chaffin opens the "Ask the BBGuy" mailbag to discuss D variants, Liquid Plasma, transfusion choices when warm autoantibodies are present, and directed donor unit management.

Dr. Connie Westhoff from the New York Blood Center outlines D variant types (weak and partial D in particular) and describes a way to manage pregnant ladies and transfusion recipients with this serologic type.

Dr. Magali Fontaine from the University of Maryland joins Joe Chaffin to discuss several challenging transfusion service issues and possible new solutions. Topics include CMV, platelet choices in refractory patients, ABO issues with platelets, and age of blood.

Dr. Anne Eder, Chief Blood Services at the National Institutes of Health, joins Dr. Chaffin to discuss Septic Transfusion Reactions. In this episode, Dr. Eder discusses the ways that blood centers limit and detect bacterial contamination of apheresis platelet products, signs and symptoms of septic transfusion reactions, and how transfusion services and clinicians can work together for early diagnosis and treatment of these potentially deadly reactions.

Dr. Pat Kopko from UC-San Diego talks with Joe Chaffin about a practical (and quick!) approach to patients refractory to platelet transfusion. She outlines a strategy to get maximum benefit to the patient as quickly as possible.

Dr. Yazer helps explode some of the persistent misconceptions that blood bankers and clinicians have about whole blood-derived platelets. Currently, 90% or more of platelets transfused in the U.S. come from apheresis collections, and most blood centers do not use whole blood derived platelets. Dr. Yazer discusses the differences and surprising similarities between the two types of platelet product.

This episode is an introduction to the vision and structure of the Blood Bank Guy Essentials Podcast, a new venture from Joe Chaffin, MD.