marvy1

We have a database that downloads with or without network connection, all blood bank data 24/7. We also have an "iPeople" link that displays a downtime EMR Viewer icon during Meditech downtime. The downtime EMR viewer shows BBK history and transfusion history.

I use large saline (2L) bags from dialysis and add a small amount of yellow food color. For fake blood, I got a powdered fake blood that I made a concentrate from and then add a small amount to the 2L bags. I then use smaller bags (300mL) and spike the large 2L bags with the smaller bags to make the individual components.

Unfortunately in Canada, we cannot get pre-pooled cryo from our supplier. AABB Tech Manual does mention adding saline to aid in the pooling process which is what we do. I haven't done studies, but I would guess a substantial amount of cryo would get left in the bags without the help of saline to "rinse" it out.

I have seen a Rh positive patient transfused 3 Rh negative units and subsequently tested on the Echo. Echo reacts negative with both Anti-D4 and D5. When taken to the tube, get a 2-3+ mf reactivity with Anti-D reagents.

We are going to RFP this coming year for some new automated analyzers. We did a quick look this spring at what is out there. I am surprised no one is speaking about the Biorad analyzers: newly released IH 500, IH1000 (Gel based) and Tango Infinity (4th generation solid phase analyzer) along with stand alone Gel readers and centrifuges. Although we are not sure which direction we are heading, I think they are certainly worth mentioning.

I have a Sartorius electronic pipette that I have brought in to trial. It seems to function just fine. It has programmable volumes that can be stored into memory. Cannot speak to its long term durability.

I think those who are in the market for automated blood bank analyzers also need to look at what Bio-Rad is coming out with. I think both their Gel and solid phase automation platforms should be compared to the other vendor products.

I use the Vista Ovations and they are much precise and accurate then the overpriced Tipmaster. Make sure to get the one that is rechargeable (they sell non-rechargeable and rechargeable)

We do 1:20 dilution of ortho QC for gel using Gel diluen. If you are not diluting then (in my opinion) you are not going to catch problems b/c the antibody is so strong in the QC kit. By diluting it down to give you a 1-2+ reaction, you are more likely to see problems should they occur.

RN responsibility to look in computer to see if blood product is available If avail they enter "order" to release product which creates printout (in duplicate) in Transfusion Dept We issue products based on this printout and send 1 cc of product release paperwork with product. We make a phone call to # appearing of paperwork letting RN staff know product was sent RN staff is responsible to return this product release paperwork to Transfusion which lets us know product was picked up at tube station. IVIG and neonate syringes not sent by tube

We have seen Anti-D being ruled out when there is also an Anti-E or Anti-C present. We now test Rh neg patients by Gel if they are shown to have Anti-E or Anti-C by Echo. But usually our Anti-Ds show up ok on Echo.As for the weak reactivity vs Anti-D reagent on Echo, we do see a 1+ or 2+ lower reactivity of the Anti-D vs tube. At one point, we had even weaker reactivity on one of our Echos with the Anti-D reagent (we have 2 of them) and Immucor replaced the camera and reactivity increased. I also know "tweaking" the belt on the strip carrier arm can also change reactivity

Tightening or loosening the belt on the strip carrier can optimize the strength of the reverse cells. On the Echo I have found the strengths to normally be at least 1 grade less than tube strength. With regards to Gel vs Echo, I have found approx equal number of clinically signficant antibodies on either method that were not found on the other method (We use both Gel and solid phase methods)

Some patient samples just don't work with PEG. We would switch testing to, perhaps, tube Saline IAT.

We get a lot of patients reacting like this. Attribute reactivity on the Echo to an autoantibody. Do need notice cold autos coming up that much, so assume it is a warm (Echo supposedly on reacts with IgG). I'm guessing if you do tube DAT it might be microscopically positive for IgG? If saline IAT tube reactivity is negative we issue blood that is compatible by that method, especially if the patient was not recently transfused. I find autoantibodies love solid phase method.

I have used many Lab LIS systems over the years including Meditech and Soft. The set-up and underlying code of the Bank module in Soft is logic based. I am unsure what the Meditech system is based on, but it is not logic.