Transfusion Services

I think it could be a great help if we were to share experiences with disasters so we could all learn from each others' successes and failures. I think really big disasters make the journals, but what if we had a sort of database of them as well as smaller events on BBtalk? Whether it is an influx of patients, an internal system failure, weather or other natural issues, a transportation stoppage, an act of violence or some combination of these, it could provide helpful ideas. One obstetric patient in DIC is a disaster if you are 100 miles from the next closest hospital and you only stock 4 units of FFP and 16 units of blood. If you post an experience it would be good to…

I am ready to change our policy to do an immediate spin crossmatch along with each Gel IgG crossmatch so satisify "to detect ABO incompatibality". Although we have not been doing it for about 10 years, now I see no alternative. Any suggestions?

Hi All, So I would like to present a scenario that happened to me and get your input. I received a specimen from the ED for ABO/Rh testing on a young female (she had a miscarriage, which at the time I was not aware). We use the BD Pink (EDTA) blood bank tubes for all of our blood bank testing, this particular sample was about a little more than 1/4 of the way full (yes not the best sample, learned my lesson with this case) - there were no visible clots in the tube or in the cell suspension I made for testing (testing was done fairly quickly since it was only an ABO/Rh and we use a STATSpin centrifuge so I had results out within 20mins of it being collected). These…

1 homozygous 1 homozygous and 1heterozygous 2 homozygous anything goes

What department at your hospital manages each of these products? 1. Albumin 2. Clotting Factor concentrates 3. Rh Immune Globulin-intramusular 4. Rh Immube Globulin-intravenous (WinRho) 5. IVIg

How can we approve if we issued or dispense Blood or any Blood Products and returned with in 30 minutes is acceptable practise????? Urgent please:confused: Amer:confused:

And if you do - would you mind sharing your facility name? We have this requirement at Presbyterian Hospital in Albuquerqu, NM. Thanks!

Any advice on how often transfusion audits should be performed? I try to do as many observations as possible, but being the only person in my department I find very little free time to actually stand over nurses while they administer a blood product. I also think that if they know I'm watching, compliance will be artificially high. Should I involve nursing in the process or just keep it to myself here in the blood bank?

What is your protocol for when the floor wants to return a unit of RBCs that have been dispensed for transfusion?

I just received a phone call from the Transfusion Service Supervisor at a local Hospital. She stated that she was getting flack from her Medical Staff for requesting that the specimen drawn for a Fetal Screen, be drawn 1 hour post partum. I told her I had never done that anywhere I worked but that I would look into it. In thinking more about it, it occurred to me that we may not even have the Cord Blood and/or Cord Blood Orders within 1 hour post partum! We also do not consider Cord Blood Testing to be our top priority. That being said, we do of course perform the testing prior to the patient being discharged to assess any possible need for additional Rhogam. This Sup…

Have you seen the price increases from Immucor effective 7/1/08? Wow!!!!!!! I think they are selling "liquid gold"!!

How does everyone handle retyping of patients with no previous blood type history? I've heard of doing two separate blood draws, two techs doing typing from the same tube, two aliqouts from the same draw, and others, but I'm just trying to get a overall idea of what is the easiest way to do this.

I was asked by another facility about the QC that should be done on a panel. I have never worked at a place that has run QC on a panel. The closest thing that we do is use the panel cells to run QC on our antisera when antigen typing the patient or units. This is supposedly a question coming with TJC inspections. If anyone is completing QC on panels, could you please let me know what you are doing. Also is this done when a panel is received or each day of use of the panel? Thanks

My hospital is planning to implement a second sample for ABO/Rh for all patients that do not have historical on file. The hospital I work is a women and children’. We see from preemie to adult women and everything between. We are straggling (make physician happy) to come up with a cut of age to request second sample. My question is what is the cut off age to request for a second sample? Do you collect second sample on neonatal patient? We are thinking of forgoing requesting second sample for neonatal patient up to 4month old. What about patient age 4month-1 year?

I'm getting conflicting info from two sources. Our trauma service is asking us to update our massive transfusion protocol and to consider adding in guidelines for when physicians should start adding in components like thawed plasma and platelets, i.e. when X number of red cells are issued give Y units of thawed plasma and Z number of platelets. One of our Blood Bank physicians is reluctant to do this saying the trend is to get away from specific numbers. As far as the trauma service is concerned their patients are usually not in the ED for very long so for the most part they just transfuse red cells to keep the patient alive till he/she reaches the OR. Then the surgical …

I'm in the process of updating my panel procedure (we use Ortho 0.8% panel A and B, with Immucor Panocell 10 as a backup) and I want to do rule outs on homozygous cells. I wan to use the following rules: rule out on 2 homozygous cells (preferred), 3 heterozygous cells, or a combination of 3 cells of the above. I need to tap into your collective wisdom and knowledge. Where are the holes in this thinking and what do I need to fix or re-think?

this is the reason for my question! in case you have a patient with an antibody identificated, and need a transfusion today. But later on (a week or a month later) he or she needs another transfusion: Do you performe the antibody screening and full identification again, then give blood antigen negative, cross match negative or performe the antibody screening and cross match and just if the cross match appears positive, you do the antibody identification again? or do you do something else????

When we have a new patient it is required to draw 2 samples for the blood group. How do you streamline this? Thanks

If you find that a patient has an antibody history from another facility, of course you honor that antibody, but do you actually put it into the patient's history so that it becomes a part of that patient's record or do you just put a comment? Also, is there an AABB or CAP standard that mandates that you DON'T enter this as a part of the patient's history?

Hello,I am a new tech in training in a Reference Lab in a Blood Center.I would like to know more about absorptions.If anyone is good about explaining this process so that I could understand it.I know that if I think my patient has an autoantibody and an alloantibody that I am supposed to adsorb it with an allogenic specimen.Any opinions on this subject would be appreciated.Thanks,Bertie:confused:

I'm a little worried.....we had an esophogeal varacies patient bleeding out this afternoon....he has an anti-c so of course it was tough to keep up. After the initial 10 units given before a sample was obtained (these units c negative) we thought all our hard work is just being bled out, we would wait until bleeding was controlled and give antigen negative for the units that would remain in him. Last request for 4 (still uncrossed - but we finally have a sample) we called once again to ask how the bleeding was - still profuse - so no phenotyped blood issued. I left after an hour overtime leaving staff with 8 compatible units, FFP, cryo and platelet pools just issued …

First of all I am new here, and if this is in the wrong thread I am sorry. We are having repeated problems with a blood bank tech. She keeps making mistake after mistake and they seem to be getting worse. We work for a supervisor and a lab manager that do not know blood bank. The major problems started in July of this year. This tech missed 4-5 antibodies in a short period of time. She has also handed out the wrong unit of blood on two occasions. She also falsified patient results at one point. These problems kept compounding on each other and our supervisor seemed to be doing nothing to fix the problems. After taking the matter to HR the tech was "retrained" and…

Can I use incompatible different blood group in case of emergency like B+ to O+ pt or AB+ to O+ due to shortage of blood?

Recently, we switched to a different blood bank ID band and found out that surgery was routinely cutting off the blood bank ID bands that we had and reapplying them after surgery. The bands that we switched to cannot be reattached without taping. My question is how do other transfusion services deal with this problem? (Loss in the chain of identification) As a blood banker, I was shocked when I found out that this was so routine. Any anwers that you may have will be much appreciated.

Immuncor is coming out with a new Fetal Screen kit next year ( FMH RapidScreen) . It is replacing the current kit. Any thoughts on doing validation studies when we get maybe 1 positive patient a year??? Thanks in advance.