Baby Banker

We do. We use plain clear zip lock bags. We have used biohazard bags in the past. We stopped because there was a concern that the patients might think we were giving them biohazardous units.

Looking back over, I realized that I did not specify that the patients I am talking about are the ones on chronic transfusion therapy and are transfused about every three to five weeks. They have all either had a stroke or have been identified as being at high risk for stroke.

We limit our matching to a group that is generally manageable. It has been some time ago since I looked at their recommendation, but the Sickle Cell Foundation was recommending matching further than we do. We do find that these patients develop 'warm autoantibodies' which I think are or may be a reflection of the myriad other antigens that we do not match. That being said, our practice has been successful in preventing stroke overall in a disadvantaged and usually overlooked (in my area) group of children. We have done a pretty good job of indoctrinating the patients and their families to get in touch with us when our patients go to another facility.

We do our best to avoid them having multiple antibodies by...wait for it...antigen matching. I agree with Ex-Limey that our sicklers who are prone to stroke have more than enough going on without having even a mild reaction. We have had a few patients with hyperhemolysis and they are the very devil to treat. The ideal would be to stop transfusions, but that is a very difficult decision to make with these patients. Also, since we are a pediatric facility, the family may decide to go elsewhere to continue transfusions.

We antigen match our sickle cell patients who are on chronic transfusion therapy for the five major Rh antigens, Kell, Fya, and Jkb. At least that is what we started with; it has grown from there. One of the issues we see in our area is that most of the units are from white donors. Most if not all of the new patients are typed and matched for V/VS and Jsa. These antigens are rare to non-existent in whites, but are found in a sizable percentage of blacks. So when you target black donors to be able to match the Duffy and Kidd antigens, you may be setting your patients up to make anti-V/VS and or anti-Jsa.

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.`