Carrie Easley

Just got the book today (as well as the positive DAT work-up counterpart)! Looking forward to incorporating these case studies into new employee training.

We use type A liquid plasma (never frozen) for traumas and massive transfusions until type-specific/compatible can be thawed.

Congrats!!! I think many of us have our own version of Malcom in our mind 🤓

An amazing honor and well-deserved. The knowledge you share spans continents and grows exponentially!!!

That’s awesome Mabel! Is this workflow just in OpTime, or can it be used in other settings?

Interesting! Could you please share the size/complexity of your transfusion service?

We are also Softbank/Epic users. We currently use a BB armband for alias patients, but are moving away from it. Even with patients admitted with an alias, we have at least three unique identifiers without the BB armband. The patients are rapidly admitted with a unique, pre-built, never to be repeated alias name, an MRN that will stay w/ them the entire admission (merged to a prior MRN after discharge if applicable), and the CSN/stay number that stays with them throughout the admission. These pieces of info are on hospital armband, specimen labels, transfusion records, and all compatibility labels. Even after MRN's are merged, you can search for the alias MRN and it will take you to the actual MRN. It's all extremely traceable. We have experienced multiple traumas and MTP's simultaneously. I was told that Epic does not offer a field for the BBID.

Malcom is, of course, correct. Epic is a hospital information system/electronic medical record. They have a laboratory module called Beaker, but do not have a blood bank information system. Epic users have to integrate a stand-alone B.B. system (Meditech, SoftBank, Sunquest, etc...) with it. Epic has a blood product administration module (BPAM) that allows electronic scanning of patient and unit at the bedside (in lieu of paper records). It’s not really fast enough for a massive transfusion situation at this point so we struggle to find an alternative in the most stressful times. Rover is a handheld device that phlebotomists use for positive patient ID and real-time collection label printing.

We are an Epic user and use BPAM for everything but MTP, Trauma, and uncrossed units. Surgery is an interesting hybrid of paper and OpTime (Epic anesthesia module). I chair our MTP committee, and BPAM is simply not fast enough for rapid administration at this point...it basically creates a flow sheet of documentation for every unit. I’ve seen a mock of an MTP module, but so far it’s only for Op Time (not trauma bay, L&D, EMD, cath lab, etc...) We have, however, created some ways to get the units documented on paper into the patient’s I/O. We don’t use Blood bank bands for most patients, but were still using for patients admitted with an alias (most trauma admissions). We are about ready to discontinue in that setting as well. Rover is a great thing! What B.B. system are you on? I’m happy to share all we have learned the hard way. Message me, and maybe we can find a time to chat?

I was there as well! He was an excellent speaker. We should find a way to post when there is an upcoming B.B. event so that some of us may meet in real life.

We match Rh/K/Fya for all peds SS patients and all adult SS patients who have made at least a single RBC alloantibody. We make every effort to send warm autos for RBC genotyping and match everything we reasonably can. Our blood supplier maintains an online antibody registry for their customers, so it helps with continuity of care if people hospital hop (assuming all customers utilize it).

Virtually same workflow. We set for 3 days post-op; maximum 14 days from draw as long as not pregnant/transfused in last three months. Our latest upgrade (25.3.1) automatically resets outdate if patient happens to get a packed cell in that pre-op window.

The fetal screen definitely has its place...just not for antepartum bleeds (at least the kits I’m familiar with). I keep hoping our Hematology department will bring flow in so we can ditch the K-B!!!

Agreed! Mine too.

Yes. Our OR nurses document every four hours. If the cooler temp reaches 6 degrees C, they call and request a new cooler with fresh blocks. We have quite a few cases that easily exceed four hours. We also put temp indicator stickers on each unit to make sure they weren’t left out of the cooler. We validated at RT, Trauma Bay (warm extreme), and CV surgery suite (cold extreme). We did those for both maximum (6 units) and minimum (1 unit). Message me if you need more specifics!