frenchie
Content Type
Store
Profiles
Forums
Blogs
Events
Frequently Asked Questions
Gallery
Downloads
Glossary
Links Directory
Questions
Jobs
Vendors
Posts posted by frenchie
-
-
Are there anyone here accepting red blood units from other (not so busy hospitals) that are about to expire (ie within 7 days of exp.) in order to maximize blood utilization? We would like to do this at our facility and the medical director is wondering if we should request the temp charts copies... or we should just go with trusting the lab and as long as the units are properly packaged according the ARC requirements? If so, do you have a procedure in place? Thank you!
-
With the COVID pandemic, my institution demoted me and resulted in a significant pay cut. I decided to leave and go where I feel welcomed and valued for my 30+ years of experience in BB and as a generalist, LIS and manager. I have been on call, even during my vacations for over 5 years, coming in the middle of the night, holidays and weekends. I am leaving a no one is trained to do elutions, Ob titers, Dara protocol and master log review. I feel bad, but administration seems to realize nor care that I am just leaving an empty opening in the schedule! I have read all the previous postings from 2018, and the shortage and lack of recognition of our profession keeps getting worst!
-
On 4/13/2016 at 4:38 PM, mollyredone said:
We have Meditech 5.67. When products are ordered from the floor or in the lab, they are either PPH, PRBC, or FFP with appropriate CMV or IRR properties if needed. In our product menu we have apheresis platelets of PPH, PPH 2 or PPH3, red cells are PRBC, ARBC or ARBC 2, FFPT, AFPT and liquid plasma fall under FFP. Does that make sense?
ETA: in our external reports the products are only reported out as the first three items.
Hi Mollyredone,
We also use Meditech 5.67. About your platelets, you mentioned that you have PPH, PPH 2... is it because they have different product code from your blood supplier? We are supplied by ARC and sometimes they are sending us 2 PPH with the same unit number but different codes. Meditech is suggesting me to create in a new product for each code, but they are several ones...!
And how do you set up Meditech the different product codes so nursing/providers can order them as PPH?
Thanks,
Helen
-
-
In this case, what are you guys doing for reporting patient testing? Are you going back to tube with enhancement
?
We are using manual gel, seeing false positive reactions with negative QC and patients, Ortho is supposed to send us a new lot # of IgG cards.
-
On 11/8/2016 at 0:55 PM, ADawson said:
Hi Everyone,
Is there anyone out there that has experience with Meditech's TAR? We are in the process of validating this for our blood bank. If so I would appreciate your help with the following:
-
Do you use an additional form of identification (Typenex bracelet)? No, only patient's account # from wristband.
- If so are you using it for all products? We currently use typenex for packed cells and Rhogam. We don't require it for ffp, pheresis, or cryo. Our LIS tech is telling me it has to be used for all or none in TAR because of the way the parameters have to be answered. Rhogam is not TARed.
- If required for all products do you use a different one for each product?
- What form of identification or requisition do you require at the time of issue? Type and screen results and crossmatch for RBCs (with MRN and patient's full name)
- What information from the unit and/or the patient do you require nurses to verify (scan barcode) at bedside? the patient's account number is scanned from the wristband, unit number,product code and blood type. The expiration date is not scanned because we do not have a printer$$$ for new expiration dates ie FP.
- What other issues have you encountered? More will be revealed...
Thanks So much in advance. I really want to keep changes to the process on the blood banks end to a minimum if possible, but will definitely do what's necessary for the safety of our patients. That's what its all about.
We are in the training process for nursing, go live date in December 2016. Nothing will really change on the BB side, other than easier access to vital signs monitoring/auditing.
Good luck to you!
-
Do you use an additional form of identification (Typenex bracelet)? No, only patient's account # from wristband.
-
Hi everybody!
We recently "failed" an API proficiency event for DATs:
Tube DAT AHG (POLY)=positive 1+
IgG gel DAT=positive 1+ (expected result was negative)
So, here's what I did:
Repeated both DATs, results were the same. I washed the cells x3 and DAT gel was negative. I called API because 84 other labs reported the same positive result, and was told to contact the manufacturer because they believe there is an issue with the IgG gel cards. Before calling Ortho TS, I reviewed QC of reagents (MTS diluent, IgG cards) and MTS centrifuge and pipettes preventative maintenance, everything was satisfactory. I also reviewed the IFU, section Samples for DAT. TS informed me that the quality of the PT specimen is probably the cause...
Samples for Direct Antiglobulin Test (DAT)
• Samples intended for direct antiglobulin testing should be drawn into EDTA to prevent in vitro complement binding. If EDTA is unavailable, specimens drawn into ACD, CPD or CPDA-1 are preferable to non-anticoagulated clotted specimens. Red blood cells should be tested within 24 hours after collection. Clotted samples should not be refrigerated. Some samples such as cord blood, blood stored for extended periods of time, or blood that has been incompletely anticoagulated, may develop fibrin clots or particulates. The fibrin clots or particulates may interfere with the ID-MTS™ Gel Test and cause red blood cell entrapment at the top of the microtube. Testing should be repeated using red blood cells that have been washed to remove the clots or particulates.
• Red blood cells that are stored for extended periods of time may become coated in vitro with complement and globulin proteins. Those samples coated with IgG will then test as DAT positive with this reagent.
• Rouleaux caused by serum or plasma with abnormally high concentrations of protein (such as in patients with multiple myeloma or Waldenstrom’s macroglobulinemia or from patients who have received plasma expanders of high molecular weight) may infrequently cause difficulties in the ID-MTS™ Gel Test interpretation.9 False positive results or hazy reactions may occur with these samples but are rare. Samples exhibiting rouleaux should be washed several times in saline and retested.12 Laboratories are advised to consult their approved procedures.
• Hemolyzed and grossly icteric blood samples may cause difficulty in interpretation, and test results should be used with caution.
Now, I need to find the root cause and corrective action. I am thinking about a few options, one of them would be to wash all DAT positive in gel and supporting this with a validation/study.
But before, I would appreciate everyone's opinion and experience.
-
4 minutes ago, Dansket said:
In our facility, Nursing orders either the Post-partum RhoGAM protocol on the mother with the Cord Blood Workup on the newborn or the Ante-partum RhoGAM protocol. After completion of appropriate testing, Blood Bank automatically assigns RhoGAM syringe to mother (if indicated) and notifies Nursing the mother is candidate and RhoGAM syringe is ready for injection. This is a one step process for Nursing.
Does Nursing look at the mother's blood type and if Negative, order one of the 2 Rhogam protocol or it is ordered no matter what?
-
Problem: Physicians/Nursing are ordering Rhogam on post-partum patients, but does not always include the Fetal Screen. A few inexperienced techs missed to add on the Fetal screen, consequently, Rhogam was given without the FS and I see it only during my result review.
Question to my colleagues: Do you have a different way in your LIS to order Rhogam, meaning ante vs post-partum? I thought I could create a post Rhogam profile: Rhogam, FS, blood type, DAT tube(IFU recommendation). Ante Rhogam profile would only include Rhogam and TS.
Thank you in advance for your input!
-
We do separate the plasma from the red cells, it has been a big learning curve for the techs, I had to monitor for several weeks and finally got 100% compliance for tech initials and date.
We do ISXM in gel buffered card, so it is easier for us to have a clean, red cell free plasma prior to testing.
-
20 hours ago, SMILLER said:
Note that the method section also mentions checking for a "cell button". But are methods the same as a Standard?
Scott
Well, I prefer to apply the methods as a standard... Here are the forms I have created, I do this once a year...
-
22 hours ago, ANORRIS said:
My helmer says to flush weekly...can't find flushing in AABB, and I don't see calibration in either.
My Helmer mentions that too, but because we use the cell washer about once a week, I am deviating from the manufacturer's recommendation (with pathologist approval).
Calibration (yearly function) is from AABB, method section USB card.
-
22 hours ago, SMILLER said:
Helen,
As of today, we are indeed, thinking of forgetting about the whole check-for-a-cell-button thing. But how do you "verify a wash cycle"?
Scott
Scott, the wash cycle is verified when I perform "day of use QC" with a positive and negative DAT poly in tube. I do not like to use the word "assume", specially in Blood Bank, but if the QC is successful, we "assume" that the wash cycle function is performing adequately.
Helen
-
We have a Helmer, and according to the operator's manual and AABB:
-Day of use*: check tubing, drain and tubing connections, clean and dry interior after usage
-Monthly: Flushing the system, Mesure saline (when changing saline cube)
-Quarterly: RPM, Timer, Verify wash cycles, decant operation and physical condition
-Yearly: Calibration with AHG, Function verification
We do not perform cell button re-suspension check between washes.
*We perform Weak D in gel, so we use the cell washer only for DAT poly in tube and for Fetal Screen.
Good luck in your research!
Helen
-
-
Hi! Have you ever got feedback from this post? I am in the same situation...
thanks,
-
On Tuesday, October 16, 2012 at 2:29 PM, jayinsat said:
It is a custom report for us.
Jayinsat, is it possible to know how your custom report is built?
-
Happy lab week everyone!
I am trying to make a weak anti-D dilution so I can get a weak to a 2+ reaction with IgG gel card and screening cells I and II. This dilution is very unstable, even frozen. I am curious to see what others are using?
Thanks!
-
20 hours ago, goodchild said:
Hi everyone,
Doing an informal survey for anyone willing to contribute. If you're willing to respond but not in the thread itself, please feel free to message me.
- When do you perform an elution? (e.g. all positive DATs, all positive DATS within 3 months of transfusion, IgG positive only)
- What method is utilized for the elution?
- What method is utilized for testing the eluate?
- How is the eluate tested? (e.g. screening cells, full panel, specially selected cells)
- Feel free to mention any special notes/criteria for which I may not have though to ask.
Thanks in advance to all participants!
1. Elution done on all DAT pos transfused or pregnant patients within last 3 months
2. Acid elution with ELU kit
3. Gel method
4. Eluate and last washed and patient's cells with Screening cells, if pos a full panel is performed
We do a lot because our pathologist requires that all crossmatched patients must have a gel DAT ;( so we cannot transfuse the patient until elution is done and negative.
-
Are you using gel, tube? We primarily use gel, tube is our back up.
Hope you will find them helpful,
Frenchie
-
No, we have TAR 5.67, but thank you RW00D57 for the info. I might have more questions for you in the future as I am working with nursing to set parameters. Do you have a barcode printer when you thaw plasma or irradiate units? We don't have one currently and I am wondering if it will be required with TAR to scan the expiration date...
-
Hi,
Anyone is currently using the TAR module? We are in the process of setting parameters, and it would be great if I can have some advices... like my first question is what barcode is scanned, MRN or Account#?
Thanks,
-
On 2/20/2016 at 2:11 PM, John C. Staley said:
I am fairly certain there is no requirement for a backup method. On the other hand, most blood bankers I know suffer from a level of paranoia that requires they have at least one back up method if not two or three. I think determining the need for a back up method would balance on the size of your facility and how much of an impact your only method being down would have and how long being down would likely be. My guess is that instead of an entirely different method you would be better served by have backup for any critical equipment like the centrifuge required for the gel technology.
The other aspect of a back up method is it's use in working out problem patients. Again, if you have a reference facility within a reasonable turn around time then you would probably be better served by utilizing their expertise instead of attempting to maintaining competency in multiple methods within your staff.
Just my 2 cents worth.
We have gel, our back up method is tube for ABO/RH and LISS/tube AB screen. I am looking for the regs about what frequency a parallel testing should be done (ie twice a year) and do you perform 1 pos 1 neg for AB screen and where to find this info?
Thanks!
-
On Tuesday, March 01, 2016 at 1:04 PM, Dansket said:
Frenchie,
Is there an Order/Entry interface between your HIS and the Meditech BBK module or are all BBK tests manually ordered in Meditech?
Yes, there is an interface between BB module and HIS (which is also a Meditech product).
And how do you set up Meditech the different product codes so nursing/providers can order them as PPH?
?
Meditech BB module and antibody screen reference range
in Transfusion Services
Posted
Anyone using Meditech for their blood bank module here? If so, do you have a reference range for antibody screen that appears on the provider's reports?
Our DOH (NY) requires a reference range for all test results, and I am not really satisfied with Meditech customer service answer (ie to attach manually a reference range everytime an ABS is resulted...). Just wondering what everyone else is doing.
Thank you!
Helen