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lysol works, but bleach is best used to use phenol, but too many rats developed cancer from it, soooooooooooo had to get rid of it.

Attached is the checklist I borrowed from another institution. BB Competency Check List.pdf

My facility is in the final stages of implementing an OB Hemorrhage Protocol, which will be different than our Massive Transfusion Protocol. The California Maternal Quality Care Collaborative is an excellent resource for information on OB Hemorrhage. This is a link to their website https://www.cmqcc.org/ob_hemorrhage. Hope this helps!

If the antigen testing is actually performed by the blood center, we do NOT repeat the testing. They mostly send us "historically" typed units which we then reconfirm at our institution.

We had a case recently where a patient came in through the ER, she gave the nurse an Antibody card for a Jka that was identified years ago in Texas. When we called to get more info we were told that the patient was not coherent and no family was available. We did the screen (positive), and antibody Id and found a E, K (no sign of the Jka). 2 units were set up(E,K,Jka neg) and transfused. The next day they ordered 2 more units, a nurse from the floor called to say that the patient was insisting she had another antibody card that she could not find. I spoke to the patient and she told me she had 2 cards from different hospitals, she was also able to tell me all (or at least several) of the hospitals she had been transfused at. I proceded to call all of them and found another hospital in Texas that had identified E, c. We antigen typed the units she was given and 1 was c positive. Post transfusion had a lovely c. Morale of the story...Always listen to the patient....

For reasons such as this, whenever I have a positive antibody screen on a new patient, I call the floor and ask if the patient has been transfused before and, if so, where. I then call that facility and get their history. In transfusion medicine, we have to be investigators who are willing to turn over every stone.

I would antigen type the patient. If K negative, we would transfuse with K neg units (easy enough to find them). We would probably add the Anti-K to his account with a note that it came from the patient. A couple years ago we found an Anti-E and Anti-c on a patient and prepared compatible units. When we were getting ready to issue them, the nurse called and said the patient would like to speak with us. I went up and she told me that she had "antibodies, but doesn't know what that means, and she had a horrible reaction many years ago". She insisted I call the hospital where she received the blood, even after I assured her that we found the antibodies. I called the hospital and they had Anti-E, c, and Jka. WHOA!!! Ever since that lovely lady was insistent, I listen to patients.