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  1. Yesterday
  2. Hello LabKat, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions please don't hesitate to ask. LabKat joined on the 01/17/2020. View Member
  3. Cliff, thank you for your kind remarks. I think We are in this together to take care of patients. What ever we can do to do the very best care we can in spite of the limitations is the approach we should take. Working together we can do that! Review Donor exclusion factors US Transfusion 0120.pdf
  4. Last week
  5. Yes. Last month we implemented a trial program where our supplier got our standing orders from another location. We are a very large facility and our standing order is at least 100 RBCs a day. During the beginning of the trial (no returns allowed) we quickly got oversupplied, at one point we hit twice our optimum level. Our O Neg inventory was unethical. The supplier agreed to take back some of the units because there was a glitch in the cancelling process. I insisted they also take back some of the O Neg. Sorry, I hope you don't feel I was blaming any suppliers. I do not envy the job you have, it must be really hard keeping a facility like us, and the rest of the country, happy.
  6. David and Cliff, I appreciate your frustration. Blood suppliers are well aware of the critical nature of their products and cringe each time they are compelled to supply less than the request number of units. Does your facility have an active part in the acquisition and stewardship of these DONATED gifts? I would think working with your supplier to find a way to increase the available inventory would be of benefit to all. For example does your facility help publicize blood drives and or encourage staff to donate. Does your facility hold successful blood drives? Do you monitor the utilization of especially precious products. I cringe when I hear an O neg about to expire went to a non-Rh neg donor in order that it not be "wasted". If an Rh positive unit would have worked, the unit WAS wasted because I bet somewhere in the system is an Rh negative recipient waiting for that unit. The literature suggests that 50% of the time this is how Rh negative units are allocated. Please try to import Rh negative units on the open market. At a meeting today one of our customers commented that to get Rh negative units they would need to purchase proportional equivalent number of non Rh negative units. So for example if you want to import 7 0 negs you would need to accept 93 Rh positive products. And this is the experience of the blood centers. I think your accountants would fuss if your attrition doubled from the extra blood you had to take. The low titer group O whole blood will take a toll on the availability of O positive blood. Because the expiration date is 21-35 days depending on the anticoagulant we will be approaching O positive donors more often to meet trauma resuscitation needs. This is the only business I can think of where the Product is voluntarily given by someone who will never know the good deed they did. Unlike product manufacturers, we cannot go to a plastics company or a drug company and ask them to just increase their production to adjust for changes in utilization. We do not PAY blood donors. We try to convince them blood donation is an honorable thing to do...and oh by the way we will give you a t-shirt. As a result we are not supplying a commodity, although blood centers are treated like vendors and are compelled to bid against each other producing ever slimmer margins. Think about whether you would want to issue blood that said PAID DONOR on the bag. Historically this has not worked too well, but it might be a way to increase donor participation. I suggest, rather than blaming the blood supplier, opening a dialog with them and being prepared to do some work on your part to help improve the blood supply would be more productive. No one wants patients to die for lack of an appropriate blood product when transfusion is indicated.
  7. Also low in southern new england; we were unable to make a full Rh-neg MTP pack this week for an Oneg postpartum bleed.... fortunately they didnt use all the reds and the Rh-pos came back to us. eesh!
  8. This is not acceptable. Can they import from other regions? I won't tell you what we stock (it's a lot), but we have all of our inventory at optimum levels at this point.
  9. its actually getting worse here. Cannot get any group Os except for emergent use. No stock replacement. I am an overstock and I am at my critical low levels and still can not get a routine delivery (even though I am transfusing 2 O pts - one w an antibody. Was thinking about writing OpEd Editorial: Your Blood Supplier Says You're Going To Die. Here in Northern NH/Vt I have polled the 7 hospitals in this region. We have a total of 16 O Negs (and I have 6 of them). Didn't even ask about O+. My neighboring hosp called to ask if we had O+ to ship. They had a bleeder and were down to 2u. Blood supplier not sending them any. No emergent and no stock replacement.
  10. Appreciate Kip's observations. above. Here our rationing policies involve cooperation between the four regional hospital systems along with the supplier that serves us. We have decreased transfusion thresholds for many types of patients--if a physician wants to override we are passing the request down the administrative line for approval when expedient. All hospitals are keeping inventories low voluntarily. If there is a real emergency at one of the hospitals the others will transfer stock as needed. Things are a bit better this week. Hope this is blowing over. Scott
  11. Hello Cyndeemarie, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions please don't hesitate to ask. Cyndeemarie joined on the 01/15/2020. View Member
  12. This is what I thought also, as the cells had been re-spun maybe it changed the proportion of adult to fetal cells.
  13. Hello vkp, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions please don't hesitate to ask. vkp joined on the 01/15/2020. View Member
  14. Send me your e-mail and I will send you my paperwork on MTPs.
  15. I believe newborn and maternal red blood cells do not have exactly the same density. So, on 2 different sampling even from the same tube of packed cells, you may have diff. proportions of maternal vs newborn red blood cells. It is the same in case of transfusion, as transfused cells are heavier, depending on the way RBCs are sampled (bottom/middle/top of packed cells) you may have diff. results/pictures (DP, no DP...).
  16. The first and second cassette are the same specimen, the only difference was the washing of the cells between the first and second runs. I don't have an explanation as to why washing the cells changed the reactions from 0.5+ to mixed field but it seems to have increased the strength of the group B cells. There should be no incubation of cells and sera, it was performed on an analyser and they are immediate spin, even if slight delay in centrifuging the sera and cells should be separated until centrifugation. The APT test is alkaline denaturation, identifies cord blood from adult blood. The first specimen definitely had adult blood in it.
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