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Posts posted by Baby Banker
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Some of you have already specified this, but for those of you who require a current specimen for plasma, do you have the same policy for platelets?
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We have two Helmer DH8 units. We love them. We are a level one trauma center and we have MTPs. Our thawers have always been able to keep up. In general, Helmer products are good.
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I email them when I have a question. They have been very helpful.
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On 9/30/2019 at 1:53 PM, Sharion Marshall said:
We use cool shield bubble mailers. The bags are silver and are insulated and they are actually mailers. The bags help retain the temperature of the blood. We issue a lot of blood and sometimes when the blood is returned for whatever reason, the blood is too warm even though it was returned within 30 minutes. The price of the bags are not bad. You will have to order 5 cases at a time to get the discount price. The company is ULINE shipping supplies. Google cool shield bubble mailers to see what they look like. So far, we are pleased with them.
Do you re-use them?
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You should also address the zygosity of the cells used to rule out.
Do you do selected cell panels where you use cells from different panels (after you've done a standard panel)?
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Change Control started in Blood Bank in our lab, but now the whole laboratory uses the process.
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On 12/20/2019 at 10:43 AM, halogen said:
Blood banker/generalist currently on a travel assignment in a small LifePoint facility out west. Have used several software systems for blood bank over nearly four decades ranging from 1000 bed level 1 trauma centers to 25 bed hospitals in the sticks. Cerner classic and C. Millennium are fine. Sunquest Classic was very good and the new GUI is doable but has limitations and is somewhat primitive. Meditech was not terribly good for blood bank but was doable. Emergency release was the worst on that system. I used HCLL at one facility and was not impressed. I've used SafeTrace most recently and only at my current assignment. I believe their version hasn't been updated in a decade or more. It is the WORST software I've ever used - of any kind - transfusion service or not. I certainly hope that other facilities don't have the enormous issues with their SafeTrace software that my current facility does. Also, my current facility is not set up for ISBT128. The facility at which I work is a trainwreck in many respects for lack of management and corporate neglect so it's no surprise that no one has worked out the kinks; therefore, I don't want to condemn SafeTrace entirely as a result. I've not worked with Softbank but would love to since many techs have highly recommended it.
We are on SafeTrace Tx version 3.13. We upgraded last June. Based on my experience with Haemonetics and other vendors, I don't think the FDA would allow a vendor to be ten years without an upgrade.
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3 hours ago, L.C.H. said:
oops, John C. Staley - sorry for the abbreviations!
MFM = maternal-fetal medicine; FOB = father of baby
I wondered if you were testing fecal occult blood.
- AMcCord and BankerGirl
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We use issue to mean dispensing the product to staff who will take it to the patient's location. We don't use the term collected except in the context of drawing specimens. I suspect this is a British English vs. American English 'issue.'
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We have an anonymous phone line as part of our Corporate Compliance Department. You probably do as well.
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As noted above, irradiation changes the product code. For example when E0226 is irradiated it becomes E0224.
Our computer system changes the product code and prints the appropriate label. Irradiated is part of the description of the new product code and prints on the new label.
The sticker you asked about is similar to one we used back in the 'Codabar Days.' However it does not suffice on it's own now.
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We tube blood, but only to our CV Lab. We do a transfer in our BECS, which is SafeTrace Tx.
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Pneumatic tube systems generally have a way to set a priority based on location. You should check to make sure carriers coming from the Blood Bank have the highest priority available.
- kaleigh and David Saikin
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On 10/18/2019 at 1:33 PM, Cliff said:
While I do believe you, sadly I would not be surprised.
I seriously doubt that I would be surprised either.
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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.
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On 9/5/2019 at 10:42 AM, Malcolm Needs said:
Baby Banker, there are hundreds of blood group antigens. You cannot match for the all, and studies in both the UK and USA have shown that, even using units from donors who have been tested at a molecular level, it gets more and more difficult, and more and more expensive, to match more than a few antigens. It follows the Law of Diminishing Returns.
As I say, I have some knowledge of hyperhaemolysis myself, and, as you quite correctly say, the best thing to do is to stop transfusions. However, as I said above, there are some situations in which this is clinically impossible, at which time, covering the patient with high dose IVIgG and methylprednisolone during transfusion is one of the very few options - and this would have to be done at other facilities, as well as your own, even if the family are silly enough to go elsewhere under such circumstances.
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.
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19 hours ago, Malcolm Needs said:
The point is that, if the sickle cell patient has multiple antibodies (particularly if they are in crisis, and need an exchange urgently), it is sometimes necessary for the clinicians to make a decision as to which antibodies are "safest to ignore", if not all antibodies can be covered with antigen negative blood. In such a situation, the V and VS antigens should be amongst those ignored (at least, according to the reactions recorded in the literature, such as the FactsBook and Daniels).
I am aware of the danger of hyperhaemolysis, being a co-author on a few papers on the subject, but, in the circumstances I describe, where completely compatible cannot be provided, and only "suitable blood" can be provided, it can be a choice between the patient possibly dying due to the lack of a transfusion, or giving blood under cover of high dose IvIgG and a steroid, such as methylprednisolone. The following paper may also be of interest to you - Win N, Almusawy M, Fitzgerald L, Hannah G, Bullock T. Prevention of hemolytic transfusion reactions with intravenous immunoglobulin prophylaxis in U- patients with anti-U. Transfusion, 2019; 59: 1916-1920. doi: 10.1111/trf.15230.
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.
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On 8/27/2019 at 7:17 AM, SMILLER said:
Except that if you know the patient has been transfused in the past, and now has anti-E, and you also know they are c antigen negative, it would be nice if you could avoid having them produce anti-c. You already would know that they are a responder, and for future transfusions (for, say, a chemo patient), it would be nice if you did not have to screen units for little c.
(Extended phenotyping of patients to avoid transfusing certain types of blood is indeed done for certain cases, such as Dara or sickle-cell patients.)
Scott
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.
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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.
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23 hours ago, David Saikin said:
3rd day at midnight; draw day is day 0.
We do exactly the same, excepting neonates and pre-surg patients.
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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.
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Is anyone aware of a pediatric institution which has a PBM program?
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On 4/22/2019 at 7:38 AM, Neil Blumberg said:
I agree that blood bank refrigerators in the OR (or anywhere else) are accidents waiting for a place to happen. We use a temperature monitored and controlled cooler system so that the blood for the patient in the OR is sitting right next to the anesthesiologist. Have had no mistransfusion accidents in the OR in the close to 40 years I've been here. In the hospital where I trained there was an OR refrigerator and we had mistransfusions every few months. Case closed.
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.
Blood Shortage
in Transfusion Services
Posted
We haven't had any significant shortages recently. I am in the southeast.