Carrie Easley

Thanks, Brenda! I feel the same way. No matter how good a procedure, you have to understand the process enough to open it.

One of our issues is that our patients are not always in our blood bank system if nothing has been ordered during this stay. To issue to that person would require the blood bank to place an order in the HIS (Epic). We keep a "dummy" patient in the BB system so that we can issue to traumas that aren't registered yet, but that's not a great option when we know a name/MRN. All of your replies are helping me work through a plan, though. Thank you 😊

Rh neg moms and those with clinically significant antibodies. A physician may request one if they feel it's indicated for other reasons (a mom had a previously affected infant), but that's fairly uncommon. If a baby develops jaundice, we have a separate orderable for a venous or capillary ABO/Rh/DAT

Another one for hospital transfusion services: For those of you in complex blood banks (multiple ABID's, adsorptions, elutions, irradiation, neonatal aliquots, titers, student interns, Trauma, etc...), do you maintain a dedicated blood bank staff or are they all cross-trained in other areas of the laboratory? Thanks!

Thanks for your responses! We have a similar process for MTP. Patient care staff place an initial order set (they have to order as medications are included), and BB issues product per the prescribed ratio until the event is over. We have this routine down. It's the occasional orders for two uncrossed that nurses are having a tougher time getting in the system. I like the idea of the verbal order log. It would make retrospective review easy!

For those in a hospital transfusion service... Do you accept verbal orders for blood products? I'm particularly interested in urgent/uncrossed blood. Are your blood bank staff permitted to place the order in the hospital/lab order system? Thanks! Carrie

We use RadSure. Recently did a brief trial with RadTag....the techs preferred RadSure. They like the clear yes/no.

We sent two of our Clinical Engineers to the training. It is supposed to help with initial troubleshooting and basic tweaks. Can also help Rad Source determine the source of the problem and parts that should be brought. The Rad Sure engineer performs our annual PM. Dosimetry is incredibly easy...stick the canister they send in and run a cycle. At the risk of jinxing myself...we went live last April, and haven't had a downtime. It will also do 35mL syringes (in addition to the 60mL).

We are currently working on this as well. Our supplier has recently made type A liquid (never frozen) plasma available. We have built a new main product code, and utilized the ABO override Em_Issue set to Y in the 25.3 upgrade in the Alternate ABO/Rh Table. We tried it in the TEST system yesterday, and it worked well. It does create an exception @ emergency issue. At this point, we are only planning to permit the exchange for Trauma & MTP, so have not made the same override with other plasma products. That could change, though!

We've been extremely happy with the Rad Source. Service and extended downtimes on the Raycell were an issue since parts had to make it through Customs from Canada. Rad Source offers 24/7 phone support, if needed. We have had minimal problems. They are based in Georgia, and respond quickly if there is a issue. There is also a syringe adapter for neo aliquots. I don't know anything about disposal of a cesium device, but Rad Source did take care of of Raycell.

The T&S is included in our MTP and full trauma activation order sets. Both phlebotomy and blood bank are included in the page for both scenarios. Unless a patient expires immediately after arrival, it is very unusual for us not to get a specimen within 10-15 minutes.

We switched from a Raycell to a Rad Source 3400 X-ray irradiator about a year ago. We're very happy with it as it does not require plumbing...it has an internal water tank for cooling. The company is based in Georgia, USA and is very responsive.

Our compatibility tag is a 4X4 label (we don't take backing off) that we attach with a tag gun (like price tags on clothing). It's slipped through existing holes on front of the unit allowing comparison of the patient/unit info during read-off.

We are in an almost identical position as you....Level II, stat order takes 2 hours, minimum level is 3 apheresis platelets. We order additional if we have a daily user or multiple complex CV cases going on at the same time. One of our first steps when an MTP is activated is to increase inventory to 6. To make things more interesting, our supplier charges $100 to restock each unit we return.

We were using BCW, but now we have a genomics lab about 2 hours from our hospital. http://nybloodcenter.org/about-us/press-room/new-innovative-national-center-blood-group-genomics-created-nybc/ Both facilities provide transfusion/RhIg recommendations in the report. We send women who are pregnant or have potential to be.