Leaderboard

Amazing how conservative they can be with transfusions when motivated.

We fill out a transfer form from the blood supplier to send with the units just in case the new facility will accept our units. With that paperwork, we include a note for them to call us if they receive the blood. We are also able to get the information from the flight team, if necessary. One of the major hospitals we send patients to in the "big city" will also send us a letter informing us of the disposition of any units they receive (that they were discarded!).

I agree 100% mollyredone, but, in the UK, such decisions as to whether or not the transfusion is involved in a death would ONLY be made by a doctor, and, if the death is unexpected, would go to a coroner and would certainly involve a post-mortem. The say so of a nurse would not be considered for one moment (as, indeed, the say so of a laboratory technician/Biomedical Scientist would not be considered, however experienced they may be - and quite correctly so too).

Never. I would like to see a reference for this if it is true. Donor blood doesn't clot due to the chelation of Ca, which should not, by itself, affect any routine coagulation assays or the patient's ability to clot. But it does have all those other preservatives in it. Reversal of warfarin is still very common by transfusion of 2 units of thawed FFP. Scott

Don't let the Beaker/Epic people tell you that only one day of training is sufficient for SafeTrace Tx. And ask to have the Beaker training and Tx training environments interfaced because the steps are much different when the information is interfaced as opposed to being just typed into Tx. Also, have someone verify the ADT/visit setup, when we went live, Epic would send a "discharge/transfer" notice across the interface whenever the patients were moved, to OR or radiology, for example. then Tx would discharge the patient and inactivate the sample, not the most ideal scenario when a patient is going to OR... We didn't see it during the validation because the test patients stayed nicely in their rooms the whole time!

The report from the allergist included information from a conversation with a transfusion medicine physician at the local medical school who apparently mentioned the possibility of plasticizers being responsible. I suspect that she overreacts to cytokines or something. She got through the procedure without needing any blood.

Agree with those above, you cannot report any test as positive when it wasn't. The unit did finally appear to be contaminated though. But I must add, a C&S on all febrile reaction units seems a bit overboard. We would generally only do a culture when our pathologist requests it. Scott

Years ago I worked in micro exclusively for 8 plus years. In my experience, especially with normally sterile fluids (e.g. CSF, blood) it was not unheard of to have a negative smear (NOS) followed by growth (usually rare colonies). We would review the slide to ensure we had not missed something on the smear. I always thought it was ALOT easier to call a "rare gram pos cocci" on a smear AFTER you got the growth on the plates - many times it looks like stain artifact / debris on initial read. You are initiating treatment on patients (many truly negative) calling a positive smear. This was a real problem with AFB smears and cultures with rare to few colonies growing weeks later. Now on review of the slide, the supervisor "sees" 2 small bacilli amid a lot of sputum debris! Really! That's why micro is a specialty - but still not perfect. Molecular testing has made a big improvement in this arena.

Soft Bank is by far the best BB LIS I've worked with.

We just went live with Beaker/Softbank. I was heavily involved in the build process for both systems - feel free to reach out to me if you have questions.

We also use SoftBank with Epic/Beaker....love SoftBank!

I have Epic for our EMR and SoftBank (standalone) for our BB system. I LOVE SoftBank. We had both systems for 6 years. Private message me if you have specific questions.

Malcolm, What was even more amazing was that they reviewed every transfusion and it was a rare one that didn't meet criteria! Simply amazing! But blood bank really can't review these deaths if there was no transfusion reaction called and no post specimen to work with and we don't know that the patient has even died. What can we do?