Background. Pedipacks prevent wastage of blood components but they are not used efficiently in pediatric clinics. Methods. Red cell concentrate (RCC) and platelet concentrate volumes transfused in the last eight months in the pediatric clinics were screened. To calculate the wastage of blood components, the number of transfused pedipacks, whole unit RCC, and platelet units were screened from transfusion laboratory digital records to show the number of whole RCC units or platelets units used instead of pedipacks. The study results were shared with physicians and transfusion laboratory staff and they were trained on the subject in meetings. Two years later, the transfusion laboratory records were assessed again to evaluate pedipack usage. A google questionnaire was also submitted to the transfusion laboratories of other hospitals to assess the use of pedipacks. Results. RCC and platelets were used in 82.9% of the transfusions, and 31.2% of RCC and 18.4 % of platelets were transfused to patients ≤12 months. During the study period, 569 pedipacks and 117 random donor or apheresis platelets separated into satellite packs would be required. But only 48 pedipacks of RCCs and 24 units of random donor platelets/apheresis platelets separated into satellite packs were used. After two years, in RCC transfusions of 0-12 month-old patients, the transfusion laboratory release of pedipacks increased to 67.9% from 13.5%. Other centers were not also using pedipacks efficiently. The main reasons were unawareness of the subject, the blood bank delivering two units of pedipacks even when only one unit was ordered and the risk of not using the second pedipack before the expiry date, and the short expiry date of irradiated pedipacks. Conclusions. By increasing awareness of the subject, the collaboration of the clinic and laboratory and solving bureaucratic problems, rational use of blood components can be achieved.

ÖzetMeningokoksemi; purpura fulminans, septik şok ve çoklu organ yetmezliğine neden olabilen özellikle küçük çocuklarda mortalitesi çok yüksek bir hastalıktır. Erken tanı konularak yoğun tedavi uygulanması önemlidir. Bu yazıda meninkoksemi nedeni ile takip ve tedavi edilen dört vaka tartışılmıştır. İki vaka erken agresif tedavi ile tamamen düzelirken bir vaka yaklaşık üç saatlik bir gecikme nedeni ile tedaviye cevap alınamayarak ex olmuş, bir vaka iki parmak ampütasyonu ile iyileşmiştir. Erken tanı ve agresif tedavi uygulanan hastalarda mortalite önlenebilmektedir. Ateş ve bilinç değişikliği nedeni ile başvuran ve şok bulguları tespit edilen hastalarda döküntü de bulunması durumunda meningokoksemi düşünülerek erken agresif tedavi başlanması hayati önem taşımaktadır. ( Sakarya Tıp Dergisi 2017, 7(2):105-108 ). Anahtar Kelimeler: Erken agresif tedavi, meningokoksemi) AbstractMeningococcemia is characterized by purpura fulminans, septic shock, and multiple organ failure, and mortality is especially high in young children. It is important early diagnosis and intensive treatment. In this article, four cases followed and treated with the diagnosis of meningoxemia were discussed.Two cases were fully improved with early aggressive treatment,whereas one case died due to late admission, and one case was improved with two finger amputations. Mortality can be avoided in patients with early diagnosis and aggressive treatment. It is vitally important to initiate early aggressive treatment for meningococcemia if a rash is present in patients with a history of fever and altered consciousness and in whom shock findings are detected. ( Sakarya Med J 2017, 7(2):105-108 )