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Baby Banker

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  1. Haha
    Baby Banker got a reaction from Mabel Adams in Whole Blood Compatibility Testing   
    Bring back minor crossmatches?
  2. Sad
    Baby Banker got a reaction from John C. Staley in Whole Blood Compatibility Testing   
    Bring back minor crossmatches?
  3. Like
    Baby Banker got a reaction from John C. Staley in Dilute a RBC?   
    We do this occasionally, but we use plasma instead of saline.  We use the formula mentioned above.  We use RBCs diluted to a specific hematocrit when we have a patient who does not have the blood volume to safely prime an apheresis or dialysis circuit.  
  4. Like
    Baby Banker reacted to Neil Blumberg in Transfusing O positive RBCLR to O negative   
    This is why all transfusion services need experienced/trained physicians.   It's a clinical decision weighing the risks of not transfusing urgently vs. the risks of alloimmunization.  And the risks of not having Rh negative red cells for patients where such products provide important safety (girls and women <40-50; patients with anti-D). 
    Obviously the issues in alloimmunizing a male patient, particularly an older patient, are very different from a woman or girl with the potential for future pregnancy.  If not terrifically urgent, requires a discussion between the practitioner responsible for the patient and the transfusion service physician. I've certainly made decisions independently and only informed the patient's physician after the fact, when the maintenance of Rh negative red cell supply has been a priority.  Hard to write a procedure that covers all possibilities, so one would have to be broadly written, and probably kept it short on details, since these are so variable.
  5. Like
    Baby Banker reacted to Bet'naSBB in Transfusing O positive RBCLR to O negative   
    We have it written in our policies.....based on what our Medical Director wants.  He'd much rather transfuse Rhpos and the patient live than NOT transfuse and have them die.
    His philosophy is that we can deal with the anti-D later - (IF it develops - which it often does NOT).  There's nothing you can do with a dead patient.
    We transfuse OPos LTWB to ALL our adult (or >50kg) MTP trauma patients.  If an Rh neg patient is bleeding - but not MTP, our policies allow us to switch to Rh pos after a designated # of Rh neg units have been transfused to conserve Rh neg inventory.
  6. Like
    Baby Banker reacted to Malcolm Needs in Transfusing O positive RBCLR to O negative   
    Was the physician happy for his/her patient to expire if there was literally no group O, D Negative blood available, or, indeed, to condemn some other patient to death if, for example, they were exsanguinating and also had an anti-D???????

    RIDICULOUS!!!!!!!  NOT you, the physician.
  7. Like
    Baby Banker got a reaction from AMcCord in Cold stored platelets and a happy BBIS   
    Maybe you could make a Product Group for it.  I did that with Octaplas.

  8. Like
    Baby Banker reacted to Malcolm Needs in Patient hx   
    I would be wary of relying on enzyme-treated red cells, as a negative reaction could be due to the cognate antigen being denatured by the particular enzyme used.
  9. Like
    Baby Banker got a reaction from Kelly Guenthner in Antibody identification art or science   
    The answers are given at the end of each case study.
  10. Like
    Baby Banker got a reaction from applejw in Blood administration   
    Aliquots will warm even quicker than that due to their smaller mass.
  11. Like
    Baby Banker got a reaction from applejw in Antibody identification art or science   
    The answers are given at the end of each case study.
  12. Like
    Baby Banker got a reaction from John C. Staley in Blood administration   
    Are there still two ranges: one for storage and another for transport?  I've always thought that was ludicrous.
  13. Like
    Baby Banker reacted to Ensis01 in Emergency Issue / MTP   
    While I understand the convenience of making MTPs and emergency release a paperless process. I regard the physical signature a good reminder that issuing uncrossmatched blood must not be taken lightly. 
  14. Like
    Baby Banker got a reaction from John C. Staley in Aliquot bags and syringes   
    We send both syringes and bags through the tube system.  
    We have a special cap that we use for syringes for which it is obvious if someone has taken it off.  That is to prevent partially used syringes from being accepted back into stock.  
    That was an issue for all syringes, not just the ones sent through the tube.
     
  15. Like
    Baby Banker got a reaction from SbbPerson in Mismatch Kidney Transplants and Titers   
    That's still a significant number of A subgroup kidneys to give B patients.  
    Patients who are type B and need a kidney transplant usually have to wait years, and sometimes die because no type B kidney is available.
  16. Like
    Baby Banker reacted to exlimey in Mismatch Kidney Transplants and Titers   
    This is fascinating stuff. A lot of science, learned the very hard way, with a heavy dose of art. I don't envy those having to make these calls.
  17. Like
    Baby Banker got a reaction from David Saikin in Mismatch Kidney Transplants and Titers   
    I don't know what the titer is for incompatible kidney transplant, but for hearts they prefer less than 1:4, but there are other criteria as well.  If the patient is less than 12 months old, they don't worry as much about the titer.  
    I think they won't consider a patient who is over 2 years old.
    Again though, that is for hearts.
  18. Like
    Baby Banker got a reaction from exlimey in Mismatch Kidney Transplants and Titers   
    I don't know what the titer is for incompatible kidney transplant, but for hearts they prefer less than 1:4, but there are other criteria as well.  If the patient is less than 12 months old, they don't worry as much about the titer.  
    I think they won't consider a patient who is over 2 years old.
    Again though, that is for hearts.
  19. Like
    Baby Banker got a reaction from Ensis01 in Mismatch Kidney Transplants and Titers   
    That's still a significant number of A subgroup kidneys to give B patients.  
    Patients who are type B and need a kidney transplant usually have to wait years, and sometimes die because no type B kidney is available.
  20. Like
    Baby Banker got a reaction from exlimey in Mismatch Kidney Transplants and Titers   
    That's still a significant number of A subgroup kidneys to give B patients.  
    Patients who are type B and need a kidney transplant usually have to wait years, and sometimes die because no type B kidney is available.
  21. Like
    Baby Banker got a reaction from applejw in CAP ALL COMMON CHECKLIST COM.04250   
    That is, in large part, why we HAVE different methods.
  22. Like
    Baby Banker got a reaction from Malcolm Needs in CAP ALL COMMON CHECKLIST COM.04250   
    That is, in large part, why we HAVE different methods.
  23. Like
    Baby Banker reacted to DebbieL in Facility location on SOPs   
    My previous boss always said they had to come up with new rules to justify their jobs.
    When they can't find the "low hanging fruit" because we all try hard to do the right things and follow the rules, they start digging deeper and come up with stupid stuff. As long as they keep coming up with new rules, they keep their jobs. 
  24. Haha
    Baby Banker got a reaction from jnadeau in Facility location on SOPs   
    I could not agree more.  I believe that, if unchecked, some of the accrediting agencies will eventually regulate themselves into irrelevance. 
  25. Like
    Baby Banker got a reaction from Cliff in Facility location on SOPs   
    I could not agree more.  I believe that, if unchecked, some of the accrediting agencies will eventually regulate themselves into irrelevance. 
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