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BSIPHERD

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Everything posted by BSIPHERD

  1. BSIPHERD
    Surely you gest! But I do remeber that in my early days in the lab, we sharpened needles, washed the tubes we used for blood banking, made our own saline (it took two of us to shake the huge bottle), and used glass bottles to collect blood. And we used the mercury from the van slyke CO2 machine to shine our coins! Belva
  2. BSIPHERD
    What size syringe do you use? I know there are 60 cc syringes available. Also, I believe that for Charter Med syringes, their package insert states that a 24 hour expiration can be used for red cells in the syringe.
  3. BSIPHERD
    There are certainly a lot of specifics for ISBT128 with different codes based not only on product and attributes such as Irradiation and Leukoreduction, but also anticoagulant/additive used for collection, size of bag, open or closed system, etc. But now that we have it up and running, it seems most of the time to be just fine - however there can certainly be more instances when blood is imported by your blood supplier with different codes than are normally used by your supplier (particarly based on anticoagulant/additive and size of bag). Good luck with your implementation. Belva
  4. BSIPHERD

    Billing ABO Type

    BSIPHERD replied to las1247's topic in Billing

    As long as they are on different specimens. We don't charge for more than one a day, even if we need a new specimen (we would do it and then credit the testing charge).
  5. BSIPHERD
    Since our supplier splits them for us, our main problem is having a code for the split units and not being able to scan it with a bar code reader because Sunquest doesn't read the last characters. So for example we have a code for LR Red Cells that is E0382. The ISBT Code is E0382V00. If our supplier splits it in two for us, we have ISBT codes E0382VA0 and E0382VBO. Since Sunquest doesn't read the A0 and B0 (and since for component names you can only have 6 characters), we have named them A00382 and B00382 (we replace the leading E with the last two characters of the split - A0 and B0 in this case). Then we have to type in the component code rather than scan it like we do all other component types. Hope this helps, Belva
  6. BSIPHERD
    We have also used Shamrock for the ISBT 128 labels we need (such as those for 5 day plasma). We haven't had any problems with this.
  7. BSIPHERD
    We occasionally have a problem with hypotensive reactions and patients on ace inhibitors. I don't know of any literature that specifies a problem if the donor is on ace inhibitors.
  8. BSIPHERD
    Using Sunquest with ISBT128 is not a problem except for pooling and splitting. We have worked with our donor center to provide these services for us. Even then, for split units we have to use work arounds.
  9. BSIPHERD
    We require vitals to be documented on our transfusion record pre transfusion, at 15 minutes, post transfusion and 90 min post transfusion. We have had no more problems with lack on vitals (including BP) on severly thrombocytopenic patients than with other patients.
  10. BSIPHERD
    It really helps cut down on wasted units.
  11. BSIPHERD
    I would start with the guidelines that Sunquest provides when you do an update.
  12. BSIPHERD
    We worked with our blood supplier and prepare reconstituted whole blood for us for an exchange transfusion when needed. Thanks Nebraska Community Blood Bank!
  13. BSIPHERD
    You might want to check out the Reference Section on this site or the AABB Commendable Practices section on their web site.
  14. BSIPHERD
    I think you might have to contact the companies. They seem to have lots of prices depending on what contracts your hospital has, how much you use their products, and what methodologies you use. I recommend you also look at Medion and Biotest.
  15. BSIPHERD
    When I did a search on disulfide bond reductase, the only thing that I found that might have something to do with transfusion is the following: A protein disulfide bond reductase in plasma reduces the average multimer size of vWF secreted by endothelial cells. This activity has been isolated from ... www.jem.org/cgi/content/abstract/193/12/1341 - Similar
  16. BSIPHERD
    Thanks
  17. BSIPHERD
    Many Sunquest reports have bugs in them and they don't seem to be doing much about it. Customer service has really gone downhill at Sunquest recently.
  18. BSIPHERD
    Thanks
  19. BSIPHERD
    Thanks
  20. BSIPHERD
    Web link no longer active.
  21. BSIPHERD
    Thanks to all those who post articles. It is helpful.
  22. BSIPHERD
    I think we should all request that our suppliers do DNA-based testing on screening cells and panel cells. They would only have to do it once and have it available on a web site. This wouldn't be in place of serologic typing, but in addition. Then we would have information on a larger number of antigens, including Dombrock. And I think that would also give us information on those R2r" cells that we thought were R2R2. (I actually think we had one not long ago - nearly all our passive anti-D's were either reacting stronger with Cell 1 (R1R1) and with Cell 2 (R2R2) or were only reacting with Cell 1. The main reason that I could think of for this to occur was exactly what you suggest. Anyway, if we all request it, it would certainly carry some weight (I hope). I think this could be done using BioArray at the Philadelphia Red Cross. Belva
  23. BSIPHERD
    I've seen a couple of cases in my blood bank career that we attributed to plasma because we were able to verify that the red cell units transfused were Rh negative (D and weak D). However, with the recent discussion of Rh Del, I think there is another possible explanation that would need to be explored. If the red cell unit was a Del (types as Rh negative and weak D negative, will adsorb Anti-D and it can be eluted, and can stimulate production of Anti-D in Rh negative patients), that could also be an explanation. I think this would have to be ruled out before we could assume that the FFP from an Rh positive person had stimulated the Ant-D.
  24. BSIPHERD
    We have done validations in the past and I actually think PeG is the better method. However, we switched to Gel because we couldn't really afford to keep doing PeG. Both Ortho and Immucor/Gamma had raised the prices so much on reagents for it that it was costing us approximately 40% more on reagent cost to do tube testing than to do Gel. I would never have believed it but the double and triple digit increases had that effect. That being said, I think Gel actually is better for some Rh antibodies and occasionally Kell. However, PeG is generally better for Kidd antibodies. But there are certainly no absolutes for a given antibody. Good Luck - but make sure that you also look at your costs.
  25. BSIPHERD
    What ABO/Rh group is the patient? Did you crossmatch units and were they incompatible? Is this IgG or IgM antibody? Possibilities off top of my head - Anti-H or IH in A, B or AB pt, antibody to preservative in screening cells (try with washed cells), high incidence antibody (what is patient negative for).
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