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Showing content with the highest reputation on 02/19/2014 in all areas

  1. I manage a small 21 bed hospitals blood bank. There has recently been talk about letting us purchase a computer system for our blood bank. Currently we are using a logbook to record all reaction, and then inputting the results (not reactions) into our LIS. Does anyone know of an afordable software available for such a small hospital? Heres some numbers that may be helpful in determening what might suit us best: Our monthly averages T&S 300 antibody pannels 2 crossmatches 80 transfussions 7 We've gotten one quote for 12,000 instal, 1,500 per month, and that is not including the cost to intergrade with out LIS system for the lab. Thanks
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  2. Dear colleagues, I need your opinion about one query situation; could we extend the expiry date of empty blood collection bag, in line with the separated blood component inside? In other words, would we be able to use blood component inside bag after bag expiration date of collecting bag itself (i.e. PRBC will be expired at 30/3/2014 but the expired date of bag itself - even empty - is 20/3/2014). Also, I will be so glade if you attach here any documentation about my question… Thanks a lot for your cooperation
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  3. I agree with R1R2 - at least show that there is a cold there (at least do a cold screen) before assuming an unclear panel is just a "cold". Always check the heterozygous vs. the homozygous patterns first too. I have seen way too many weak antibodies over the years that did not fit a perfect panel pattern, but were anything but "just a cold". Prewarming is a weakened reaction system without any help from the current enhancement medias and it is perfectly capable of missing a bunch of stuff. I did have a reference lab tell me once that you could "prewarm" with enhancement medias too - "just prewarm the media too" and we have done some of that over the years, but not everyone does.
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  4. When you have a E, c antigen negative patient and they are making only anti-E, I can see screening donor units for both E and c, as since the patient has been known to have been exposed to E, they have almost certainly been exposed to c. And if they are c antigen negative, giving them c positive blood (which is quite common) will cause them to start producing anti-c. (likewise for C/e) But I do not see why they reverse should be true: needing E negative blood when the patient only produces anti-c? A person who is exposed to c antigen is much less likely to have been exposed to E, and the E antigen is relatively rare on donor cells (other antigens like Fya are much more common - no-one screens for those routinely either!) I may be mistaken here, but I believe one can look at the AABB manual and see the same argument. Scott
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  5. Leger R, Garratty G. Weakening or loss of antibody reactivity after prewarm technique. Transfusion. 2003 Nov;43(11):1611-4, and the articles listed below are germane to any policy development for the use of prewarmed testing in the blood bank laboratory. Mallory, D: Controversies in transfusion medicine. Prewarmed tests: pro - why, when, and how - not if. Transfusion 1995 35: 268-270.Judd, WJ: Controversies in transfusion medicine. Prewarmed tests: con. Transfusion 1995 35: 271-275. I'm not a fan of prewarming. I think there is a danger of prewarming away alloantibodies. You should also prove that there is cold reactivity first, and use other methods for detecting alloantibodies. We only use prewarming here as a very last resort.
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  6. 1) I do not know . For academic purpose. 2) if we rule out anti-E no need to give E- 3) For survey we try to rule out
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  7. Psyche's system used to be web-based rather than on your own server. When I looked at them 10 years ago they had not heard of electronic crossmatch. Meditech support is poor or was 5 + years ago when I last used it. The guy who trained me on the Blood Bank module back at their office in MA told me that you couldn't use a barcode scanner on the BB module! When I used Meditech I found fellow users on Bloodbanktalk and we formed an email group as we all converted to ISBT. They were much more helpful than Meditech Support. Meditech is a pretty well integrated system. It is extremely customizable so that various users seem to have almost different systems. It has some quirks--like you couldn't deal with an autologous unit that was labeled as Rh pos because the patient/donor was weak D positive and the patient sample was tested only at IS and thus was Rh negative. I would link the unit to the patient and the patient's blood type would change in Meditech to Rh positive! I hope they have fixed that by now. Definitely not built by blood bankers. Now we are on Horizon Blood Bank marketed by McKesson for Haemonetics (previously Wyndgate). Avoid McKesson products, especially for the HIS. We have used 2 different McKesson EMRs and the nurses and doctors are quite dissatisfied. HBB is fine because it is just the rebranded Haemonetics product. All McKesson modules are interfaced; it is not an integrated system so some parts don't play so well together.
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  8. I also want to know to know if there is a anti-E hiding in there behind the anti-c. We usually have a RZR1 cell on one of our panels, or can beg a drop from our reference lab, conveniently located just a few miles away. What you say makes sense Malcolm, but are you aware of any studies done to demonstrate that phenomenon, titering anti-E against reagent and donor cells? Maybe it'll be my project after I finish my transplanted poop study for Anna...........
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  9. That sounds like a very nice quote - my statistics are similar to yours, a few more panels and transfusions and a lot less T&S. Personally, I like HCLL - moderately expensive but worth it (to me) - I looked at Psyche's SBB, McKesson's Horizon (which is Wyndgate's Transfusion module), I know some folks that really like the Soft product; Meditech is good also. Make certain that what you purchase satisfies your needs with little "extra" effort on your part (like having to register and discharge pts routinely). Another kudo is don't use the validation templates provided but develop your own that mirror your operation. This is a bit time consuming but worth it in the long run as you will find all the "bugs" in your installation and can have them fixed to your liking before you go live. The FDA will want to look at your data - or at least see that you have reams of paper that validate your system. Good luck.
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  10. In the UK, the National External Quality Assurance Scheme (NEQAS) does not require that either anti-E be excluded in the case of an anti-c or anti-C be excluded in the case of an anti-e, but would expect either c- E- or C- e- blood to be cross-matched in such cases. The reason for this is two-fold. Firstly, R1Rz and R2Rz red cells (and RzRz, come to that) are very rare, and most hospital laboratories would not have access to such cells. Secondly, in the case of anti-e, it is not necessarily easy to exclude a pure anti-C anyway, because most apparent sera containing anti-C (anti-Rh2) actually contain a mixture of anti-C and anti-Ce (anti-Rh7), with the anti-Ce being the major part of the mixture. The reason why we would not go for cross-match compatible blood that has not been tested and found to be negative for the E or C antigens respectively, is because cross-matching is unreliable in detecting the presence of these antibodies. The screening red cells and the antibody identification red cells are selected to express these antigens maximally, and are in a medium that will preserve antigenicity (rather than the ability to carry and exchange oxygen), whereas the red cells in a unit are, of course, random in terms of the expression of antigenicity, and are in a medium that is designed to preserve the oxygen carrying capacity and exchange (rather than preserving maximal antigen expression). All that having been said, working, as I do, in a Reference Laboratory, we do go the extra mile and exclude the presence of either an anti-E or an anti-C, but it is actually a matter of professional pride, rather than a necessity!
    1 point
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