Baby Banker

Being an assessor takes time and effort. However, if you are willing to put in the work, it is a good way to learn, and to get insight from another perspective.

We do exactly the same, excepting neonates and pre-surg patients.

I think the place to start is with the manufacturer. Look at the information provided with the product. If that does not answer your question, contact the company directly.

Is anyone aware of a pediatric institution which has a PBM program?

This is what we've always done. Are you familiar with the BloodTrak system? If so, what do you think of it? We don't have it, but the Blood Bank Manager put one in the budget.

https://www.helmerinc.com/products/pc3200i-platelet-incubator.html Helmer PC3200i

I don't know the model number off the top of my head, but we have a floor model Helmer Plt Incubator that has three shelves. In fact we have several pieces of Helmer equipment, and they have all been reliable. Also Helmer puts a lot of thought in the design of their products, and they will listen to you.

We haven't used any Typenex type band in over 20 years. If they are used correctly, they add value. If they are not used correctly, all they do is give a false sense of security. We do require two samples, and have done since about 2005. We are often able to get a sample from Hematology that meets our criteria, and so save the patient a stick.

You might look at whether the two blood banks have the same medical director and CLIA number.

We have an Exception Form that is used when we are going to make an exception to policy. Sometimes it is signed and sometimes not. It depends on the exception. If signed, it may be signed by either a pathologist or the patient's attending. This is dependent on what the exception is. When I was supervisor of blood bank, it was used most often because of supply issues. That may not be the case any longer since we now make no distinction between CMV negative and CMV safe products. Well, except for stem cell transplant patients.`

We generally wash older units of RBCs for ECMO. They still don't work quite as well (pH issues), but at least that takes care of the extracellular potassium. As has been mentioned, I would not worry overmuch about matching the baby's phenotype.

Yes. And the K+ was generally lower than in a 'real' unit of PRBCs.

As a historical note: We used to store whole blood quads meant for neonates upside down and upright. Can anyone hazard a guess as to why?

Something that most people don't think about is the size of the unit. I am in a pediatric facility and we have units of all sizes. The smaller the unit, the more vulnerable it will be to temperature change. There is also the issue of the time the unit is out being made into an aliquot, and the fact that, in most institutions, the processing into an aliquot will be done close to the time of issue. So if you have an aliquot that is close to RT when it is issued, and then it comes back, what do you do? I think the only way to adhere to the spirit of the regulation is to measure the temperature directly. However, in that case, you are going to see your rate of expired units go up. There are no easy answers here, and in my experience, most inspectors know this, and many of them do not pursue it too vigourously.

Send me an email, and I'll extract it for you. gerald.sapp@childrensal.org