BloodBanker80
Content Type
Store
Profiles
Forums
Blogs
Events
Frequently Asked Questions
Gallery
Downloads
Glossary
Links Directory
Questions
Jobs
Vendors
Posts posted by BloodBanker80
-
-
Bringing back this old post
Would anyone be willing to share their current policy that meets AABB standard 5.7.4.5? We wash cells using the COBE cell washer. Thank you!
-
We are revising our mass casualty/ disaster plan. The computer system we use (Sunquest) is not ideal for Emergency Release of products because if you use it, it automatically collects the TS specimen. We are keeping the E-Release/Mass Casualty on downtime. Does anyone use unit tags that are carbon copy? This seems like it would be the next best process in chaos to keep up with who is getting what. We do use carbon copy transfusion records - but in mass casualty situation would rather use just the unit tag.
Also, how would your facility handle physician signatures for uncrossmatched blood?
Any advice is greatly appreciated!
-
On 09/10/2018 at 9:53 AM, R1R2 said:
No need to take a separate internal temperature providing your digital temp is accurate. You will need to validate your digital readout to NIST and then you are all set.
Thank you!
-
Good morning all,
I can rationalize the need for this, but is there a regulation somewhere stating (other than specific manufacturer instructions) that it is required to take internal temperatures of freezers for comparison to digital readouts?
We have 2 older freezers that have user manuals that aren't very helpful. One is for FFP/Cryo less than/-18C and the other for Tissue less than/-70C. They do have chart recorders and digital temperatures that we record daily.
We take internal temperatures on our Refrigerators and Platelet Incubator... so what about the Freezers? Having trouble calibrating an internal thermometer +/-1C of the NIST at that low of temp. We ordered new digital NIST certified thermometers and they were reading 2-3 degrees from the digital readout.
Any input is greatly appreciated - I'm completely done with these freezers at this point haha.
Thank you!
-
On 06/24/2017 at 1:59 PM, butlermom said:
We have Cerner and our test for neonates is called "Baby Type and Screen" and includes 2 orderables: "Baby ABORh," and "Mom ABSC" (mom antibody screen). Our workflow:
- Transfuse order for RBCs is received in blood bank
- We go find the pedi lavender from hemo and add-on a Baby Type and Screen and a Crossmatch. The Baby T&S consists of a blood type on the baby-"Baby ABORh" (just a forward type, of course) and the Mom's antibody screen-"Mom ABSC."
- Usually we have already performed cord blood testing so we have a blood bank comment which shows the mom's name and medical record number (our cords have both mom's and baby's label on the sample and we add the comment to the baby's profile while doing the cord blood workup)
- We look up the mom's record to see her antibody status
- If no antibodies, we result the "mom absc" as negative.
- We select a neonate crossmatch and it is "compatible" once we scan the unit number for the aliquot. No serological crossmatching is done. We only transfuse O pos and O neg to babies.
- If mom has an antibody, we use antigen negative blood for the baby. Again no serological crossmatch required.
- We use the "neonate protocol" to override the sample expiration so our neonate samples are good for 4 months (Cerner actually calculates it as 120 days from the date of birth.)
I hope this is helpful.
Thank you for sharing! I was wondering if anyone can help with this situation:
Mom: Anti-D and Anti-c
Neonate: Positive DAT - Eluate Anti-D and Anti-c
If we result the Eluate as anti-D and anti-c on baby, this will require AHG XM/ honoring of antibodies (Dneg/cneg transfusions) well passed neonatal time period.
How does anyone else result this to reflect these antibodies as 'passive' or temporary?
Thank you for any feedback!
-
12 hours ago, tsanders0703 said:
We use a Fluke 561 IR thermometer for temps on our blood products. We send it for calibration annually and test it monthly against a NIST thermometer at freezer temp (-28 to -30C), refrigerator temp (about 4C), room temp (21-22C), and thaw bath temp (35-37C) . We wrap a unit at the specified temp around a NIST thermometer long enough for it to equillibrate, then hit it with the IR thermometer. It always correlates within 1C of the NIST, except at freezer temps, which is a little further from 1C. We don't use it to take the temperature of anything in the freezer, but there may come a time where that is useful. I hope this helps
Yes, that helps! Thank you
-
On 12/12/2016 at 2:13 AM, cheru26 said:
Anybody using QC module in Cerner millennium? Can you share your experience and SOP how to set it up. Thanks
Did you ever start using the QC module in Cerner? We are looking into it now
-
On 03/03/2018 at 12:32 PM, Eagle Eye said:
Anyone is using infrared thermometer to take temperature of returned units?
Do you get reproducible reading?
How do you take temperature? DO you have procedure you can share?
How often do you send it for calibration?
Make and model of the thermometer in use please?
I'm bringing this post back
.. What did you come up with for the infrared thermometers? I'm looking into this as well, would these be considered electronic as in CFR 606.60 Equipment Frequency of calibration required monthly? Thank you
Electronic thermometers Monthly. -
21 hours ago, Yvette said:
I am validating the igloo coolers to maintain temperature between 1-6C. I place refrigerators gel packs on the bottom, the red cells, a barrier and a bag of ice. However, the red cells go out of temp (>6C) for a hour and back in. The coolers are kept at ambient temp. Is anyone conditioning the coolers with ice first?
Yvette -
We use a ice/barrier/product/barrier/ice to validate ours. Coolers are kept at room temperature. We validate with minimum number of product and then the maximum number of product that the cooler will be used for. Is this a new process or are you revalidating a current one?
-
Thank you Scott!
-
3 hours ago, AMcCord said:
When I was diluting red cells to 0.8%, I ran QC straight from the bottle for tube (because we always do QC for tube), then repeated with the diluted cells for gel. The QC on the 0.8% dilution is going to cover the entire process, including the dilution step, and the reagents. We made up fresh cells every 24 hours, as required by the manufacturer.
Thank you SO MUCH for the feedback!! We perform QC on the 3% (tube method) upon arrival - did you dilute the entire panel every 24 hours for use? Or only do so when needed... how did you decide which specific antibody to use as QC? We will only be diluting as needed, mainly for select cells/rule outs.
-
26 minutes ago, SMILLER said:
I think you need to follow the advice in the CAP response. How does your ER ID patients when they come through the door? They should already have downtime procedures for patient ID (as well as a John Doe ID procedure). I believe our registration system assigns a new MR (Medical Record) number if there is no other admission on the system. For John (or Jane) Doe names, we simply use a system that reflects the year and "Doe" number (Doe2018-14, John). So our two identifiers are at the minimum the name and MR number. Practically, we require a birth date for history purposes as well as date/time, etc.
I would think that you may want to start with ER and find out what they are doing down there for ID on these types of patients. In the US, you MUST h ave two Identifiers for everything.
Scott
Thanks Scott! Currently, ED shows up with a 'Tag number' that is then used as the patient's Financial Number (or visit number). I'm not sure at what point they are given an actual medical record number/name. We do not have a refrigerator in ED - so we release a lot of coolers before the patient arrives. The Tag Number is currently being used as an identifier on the specimen tube (which is OK per CAP in trauma situations, strangely.....)
Which LIS do you use? Do you wait and print unit tags once product is requested or are they pre-labeled with all info except patient?
-
Help!!
We are revising our emergency blood release process (including MTP).. For those of you who are CAP - how do you comply with this in emergency situations? I've gotten some feedback in a few posts, but nothing that we can use to work for us as of yet.
It seems trauma specimens only require one identifier, but products need 2. I've also included a response from CAP regarding my inquiry. Thank you for any feedback
"For blood products, even for trauma patients, there must be two identifiers as stated in TRM.41350. Typically emergency rooms use pre-defined "temporary" patient identification numbers that are later merged with the real patient medical record number once established. The CAP does not dictate the process for the temporary identifiers as long as the facility keeps them unique for the patients in question."
Thank you for your inquiry,
Lilly Petkovic, MT(ASCP)SBB
Laboratory Accreditation Program -
On 02/19/2016 at 11:12 AM, David Saikin said:
this is what our vendors are recommending (Ortho). I pretty much use my Ortho panel to deal with scenarios like the w+ cell2 and RhIg anti-Ds. I use other vendors' panels, diluted to 0.8%, for most of my antibody ID's.
I'm bringing back an old post here
... If you dilute a 3% panel cell to 0.8% is there any additional QC you perform? It is stated that the diluted cell suspension is stable for 24 hours - is this sufficient? Thank you!
-
On 05/18/2018 at 11:30 AM, AMcCord said:
We use the FinalCheck system in the same way as David uses BloodLoc, and before that, a Typenex band. I've never had a problem with inspections using this kind of process. We see JC, CAP and CLIA.
Interesting! I really like these systems. How do you prepare your units for Massive Transfusion/Emergency Release Sets prior to patient arrival? We are looking for a way to pre label (without handwriting) as much as possible before the call comes in. We are AABB/CAP/FDA........ Oh my!
-
On 05/18/2018 at 1:23 PM, JWiles said:
We have been using LF1 form (FORM WITH LABEL) for over 10yrs and they are awesome. We use them for all of our products. We get them from Standard Reg. company. CT/1000ea.
Do they have a website? I've tried google and didn't have any luck?
Thank you!!
-
Thank you for the suggestions! I wasn't able to find anything yet... I'm looking for the transfusion record printed paper that gets issued with product (and has a peel off sticker to apply to the unit of blood/plasma/platelet). I'll keep digging on those sites to be sure I didn't overlook something
-
On 05/16/2018 at 3:04 PM, Eman said:
When we were bringing up a platelet collection system I asked the manufacturer some questions about the bag volume limits (100-400mL) and time spent where the volume was greater than 400mL. This scenario occurs for example when a 500mL intended-double is collected, but stored in one bag until counting/processing begins after the collection. That manufacturer said you could go up to 24 hours "out of range" before you compromised the product. Similar concerns about the storage concentration, the manufacturer has validated an acceptable platelet concentration range, odds are your volume reduction process results in a concentration greater than their validated upper limit.
With your closed system scenario I'd be uncomfortable giving the volume reduced product more than 24 hours without having validation data showing viability past that point. Due to container, volume and [PLT] concerns.
At a previous employer we volume reduced platelets and they were pretty ugly products, my current employer no longer volume reduces platelets, we give multiple divided aliquots instead.[sorry for reiterating some of the points made earlier. they're good points
]
Excellent information! We do try to use the product as soon as possible, but outdate at 24 hours. You bring up an interesting point, when we combine a 'double bag' into one... the expiration has to be changed to 24 hours. Although we don't routinely do that ahead of time, we wait until the nurse is here to pick it up.
-
On 05/14/2018 at 10:41 AM, slsmith said:
Our traumas are assigned MR#s before they are arrived and given a doe name, it is usually a name of a car (Mercedes, Doe). The sex is usually known and the dob is the same for all patients (100 yrs old). The computer system we use (Cerner Millennium) allows us the dispense the units with a exception flag telling us the unit isn't crossmatched ,do we want to override and why (we pick emergency). A transfusion tag is generated but the area which usually states compatible says uncrossmatched and across the blank area of the tag which usually has special attributes(irradiated) there is a statement saying "emergency dispensed, uncrossmatched.
Thank you for the feedback! We also use Cerner, so I'm very appreciative of any further assistance you can provide. We switched to Cerner one year ago, so we are trying to find the best way to incorporate it into our process. Going off assumption from your post: You have units allotted for emergency with segments pulled but do not actually label them until emergency room/OR would call and say they need them or show up with the name/MRN. You will Dispense using your emergency process then attach the printed labels? Once you have dispensed, and the dust settles (patient identity is known and specimen received), you go into Correct Inventory/ Emergency-Dispense function and merge it with that patient?
Question: Do you keep the emergency consent form with you, pre labeled with unit numbers - or does the courier picking up the units bring it already signed?
-
We are looking for a new vendor to provide our transfusion product forms/labels that are FDA approved to adhere to the component. Any suggestions are greatly appreciated!
Thank you!
-
On 12/06/2017 at 8:32 AM, kate murphy said:
We do much the same as most, but we prepare in advance. "Unknown, Patient" with a special ER-#### Medical record # in the lab system to allocate and print tags. 2 O Pos for males, 2 O Negs for females are kept on hand at all times.
Unknown patients in the ER are banded with a trauma # only until they are identified. The emergency release form the ER sends to us has this #. All we need to do is hand write this number on the already printed tags and send to the ER. 30 seconds. When the patient is identified and we get a real medical record #, we either merge or re-allocate. Usually we can track/trace all units.
Specimens with only a trauma # are good as long as that the is the identification the ER/OR is using. When name/MRN changes, we need a new spec.
We do enough emergency issue, that having units tied up tagged is not a problem. This system works well for us.
We need 2 specs to confirm ABO. We will issue group O rbc and AB plasma.
Kate -
This is a similar idea we looked at after observing the process performed at another trauma center. It seems the major difference is you handwrite the number, whereas they go ahead and dispense in their system to this fictitious name/number at the time of pickup. Nursing personnel attach patient labels to the tags at time of transfusion. Do you all keep a list of already registered special ER-#### to use from? Or do you have like 5 that you use over and over? Which LIS do you have? We use Cerner, trying to figure out the best way to preprint those product tags....
Also, do you use your Emergency Release form with the units so it's already pre-labeled with the units - then have it returned with physician signature?
Thanks!
Christy
-
15 hours ago, ICCBBA said:
If you have access to the 31st edition of the AABB Standards for Blood Banks and Transfusion Services handbook, Reference Standard 5.1.8A is a table that provides the expiration times for a number of blood components (e.g., platelets, RBCs, plasma). This should provide some guidance for the expiration of your volume reduced platelets. Hope this helps!
Kaytee
No luck
They conveniently left that product out haha ! thank you though!!
-
23 minutes ago, Cliff said:
Technically, they cannot as they are not a law setting organization like the FDA.
I would not go past the 4 hours, but we do not volume reduce. Platelets are living, "breathing" cells and you are greatly increasing their concentration and ability to transport oxygen.
Good point... I should blame FDA then haha. Thank you!
-
11 hours ago, Ensis01 said:
I seem to remember that the concentration of platelets in plasma is an important part of QC for the 5 day expiration, something about pH changes over time I think, which may be why platelets come as singles, doubles and triples? I would check/clarify with your blood bank/supplier. As applejw said; you are changing the environment, which may impact the functional survival of the stored platelets.
Thank you! That makes total sense and correlates with what I found in The Bethesda Handbook of Clinical Hematology online... I will check with my supplier and see if they can provide some feedback as well. Good idea!
.. What did you come up with for the infrared thermometers? I'm looking into this as well, would these be considered electronic as in CFR 606.60 Equipment Frequency of calibration required monthly? Thank you
... If you dilute a 3% panel cell to 0.8% is there any additional QC you perform? It is stated that the diluted cell suspension is stable for 24 hours - is this sufficient? Thank you!
They conveniently left that product out haha
BB positions in Louisville, KY
in Job Postings
Posted
If you are looking for a job as a dedicated blood banker, come check out all that we have to offer! Our busy Transfusion Service provides for a diverse patient population ( i.e. NICU, ECMO, Sickle Exchange, Maternal/fetal). We have 3 positions open!
1. Full time: nights/12 hr shifts
2. Part time: days/ .5 FTE
3. Student: PRN
Visit https://nortonhealthcare.com/careers to apply!