[Autoverification]

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

[Staffing!]

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.

[Procedure for Reconstituted Whole Blood]

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.

[OCTAPLAS]

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.

[BB Validation/New Server]

12 hours ago, Cliff said:

I'd suggest starting with who recommended a validation every two years.  We've gone many routes over the past couple of decades.  We've done the validation 100% inhouse (a lot of work) and hired people to do all that is allowed for an outside vendor to do (a lot of money).

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?

[Last Wash run in parallel with Eluate]

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.

[Pediatric and neonatal transfusion considerations]

You may be able to find something on the Pediatric Trauma Society site.

https://pediatrictraumasociety.org/education/Journal-Scan/2018/august.cgi

 

[Raycell IPDM]

On 7/20/2021 at 10:46 AM, rosi0017 said:

With the PR platelets we are irradiating less. But I've found that the IPDM will still let you scan a PR platelet Ecode without any sort of warning. I've asked the vendor for direction, but wondering if anyone here has had a way of warning techs.

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

[Neonate Platelet Aliquots - references?]

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.

[Dumbwaiter use]

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

[Dumbwaiter use]

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.

[Missing ISBT codes for bacterial monitored platelets (LVDS) in an open mode]

49 minutes ago, NLiveris said:

Hello:

Below is the information we received from ICCBBA regarding the bacterial monitored Platelets in an open system. 

Product Descriptions cannot contain a Bacterial Monitoring/Testing attribute in combination with any of the following:

•             Washed modifier

•             Open system attribute

•             Plasma reduced attribute

The Bacterial Monitoring/Testing attributes are used to indicate an extension of the expiry date, whereas Washed, Open, and Plasma Reduced shorten the expiration. Any of these three would conflict with the Bacterial Monitoring/Testing attribute within the same product description. 

If you wash, plasma reduce, or specify the product as an open system, then the Bacterial Monitoring/Testing attribute value would need to be omitted. 

 

Thanks 

 

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

[Missing ISBT codes for bacterial monitored platelets (LVDS) in an open mode]

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.

[Irradiated Units Missed]

4 hours ago, John C. Staley said:

Remember, complicating a process never makes it better.  

 

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

[Blood Bank Lead - Any advice, tips, ?]

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

[Acute Pain Transfusion Reaction]

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.

[Acute Pain Transfusion Reaction]

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

[Visual Inspection]

4 hours ago, mminhas44 said:

Could be platelet clumps..

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

[Patient re-type]

18 hours ago, tkakin said:

We also get a new draw if no patient history on all banded patients.  BUT Is it necessary to do a second ABO on a patient that is an O?  

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.

[Blood Bank staff]

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

[Thawed A Plasma Questions]

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.

[Acute hemolytic reaction by C3d?]

How many units of O were given?

[FDA Reportable?]

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

[Lui Freeze Elution]

On 7/28/2020 at 6:54 AM, Baby Banker said:

The Lui Freeze Thaw method is good for demonstrating anti-A, anti-B, and anti-A,B from small samples.  We used it to confirm that an infant had ABO HDN.  I'm not sure if we still have a procedure for it.  I work primarily with the Blood Bank Computer system now.

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

[IV vs IM Rho (D) Immune Globulin]

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.