Baby Banker

A question for those of you who have interfaced instruments: are you using autoverification.

We are experiencing all of that. The fact that my hospital refuses to even think about sign on bonuses makes it even worse. The hospital down the street has an $8-12K bonus and their benefits and pay were already better than ours. I saw a few weeks ago that a hospital in Philadelphia is offering a $20K sign on bonus.

We do this too, but the sops already posted have everything in them that is needed. I would caution you to not use saline as a diluent. We had a physician insist on it ages ago, but it doesn't work. You really need the oncotic pressure from plasma or albumin. If the concern is kernicterus, some places will use albumin. That's not usually why we do an exchange. We are usually confronted with a sickle cell patient with chest syndrome.

We've had it for a couple of studies, but we don't routinely stock it. We have SafeTrace Tx. I built a new product type for solvent detergent treated plasma. That prevents anyone from filling an octaplas order with regular plasma and vice versa. The product code for the pictured product is X0003. It will change to X0007 when it is thawed.

Also, if you waste time and effort on validation that is not necessary, you have less of both to do necessary validation. I mean what's next? Validating the change is the oxygen/CO2 ratio due to staff breathing?

In my opinion, you can run an antibody screen on the last wash instead of a full panel. Of course if the screen is positive, you'd want to run a full panel. I have never known the last wash screen to be positive.

You may be able to find something on the Pediatric Trauma Society site. https://pediatrictraumasociety.org/education/Journal-Scan/2018/august.cgi

I have it built into the computer system. It won't let you irradiate a PR platelet.

There is a section in the most recent Technical Manual (20th Edition from 2020) on platelet transfusions in neonates and children. It begins on page 685.

By the way, the AABB recently published a book on the validation and use of pneumatic tube systems to deliver blood products.

We have a Central Transport Department that picks up most of our blood from the Blood Bank, even during MTPs (MTP=Massive Transfusion Protocol). We have a pneumatic tube system, but we don't use it for blood products except when sending them to our satellite lab in the CV unit. We don't have insulated carriers; I don't even know if that is an option, but the transport time is so short that it doesn't matter, and since it is going to another lab, we are confident that it will be taken out of the PTS station quickly and put into controlled temperature storage. When I worked next door (large university hospital) they started using their pneumatic tube system to send blood all over the hospital. This was 'suggested' by consultants as a way to save money. They have had some challenges, but overall I think it works ok. Our pharmacy uses the PTS, but I don't know what procedures they have in place to ensure the right drug goes to the right place. I know they have them; I just don't know what they are.

What do you do with a syringe aliquot that is made from a unit that has had bacterial testing?

I am at a pediatric hospital as well. I requested open codes for the LVDS components our suppliers will be sending us. After we irradiate them of course.

O how I wish I could convince people here of that!

Get to know your staff, but remember that you are not there to be their buddy.

There can be back pain in an HTR, although there are LOTS of other things that can cause back pain. HTRs generally have multiple symptoms due to the severity of the reaction., and can actually be caused by other things than immune response.

There can be back pain in an HTR, although there are LOTS of other things that can cause back pain.

I agree. If you hold the unit up to a light, can you see platelet swirling?

It is best from an operational standpoint to do the same thing every time. If you always do a second type on patients without a history, you won't forget to do one.

We have dedicated staff. There were too many errors otherwise.

We still use AB, but we are pediatric only, and we often don't know how big the patient is at the beginning of an MTP. Our thinking is that the smaller a patient is the easier it would be to give them too much anti-B, or at least enough anti-B to potentially cause problems.

How many units of O were given?

Yes, this does need to be reported. There are specific time intervals for reporting, I believe.

I checked and we do not have a procedure for the LUI Freeze-Thaw technique any longer.

IM injections of a viscous material are traumatic. This made IV Rh Immune Globulin IM injections less desirable for a thrombocytopenic Rh negative female being given Rh positive platelets.