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Karen Olsen

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Everything posted by Karen Olsen

  1. This is exactly what we did!! Had our new one (purchased on capital) up and running with all QA completed. Then we moved the blood to that refrigerator. And then moved the older refrigerators in. Permformed all QA on those and then separated the blood out as prior to the move. It really worked very slick! Yes, we performed all QA on all instruments after the move. I moved one workstation over ahead of time and had all QA done on D day. Then with blood in the refrigerator and a workstation up and going, I had one Tech move into new area with out even a hipcup! Went very smoothly! Good Luck!
  2. Saves lives!!!!! Not every facility can afford to implement the barcode/label system yet.
  3. Congrats and welcome to this wonderful website!!
  4. If I may respond to my own question.......Yes it is in the AABB manual under method 7.5.....and yes it is still required to perform upon receipt, repairs and periodically. We chose to interpret periodically as at least annually if not more frequent. So off I go to calibrate my new cell washer. Then the joy of validation!!!!!!!!!!!! Thanks for the help everyone!
  5. I'm looking for input on calibration of centrifuges for Transfusion Service. We have been performing calibrations to determine proper spin times for each of our centrifuges and cell washers annually. I just purchased a new cell washer and the manufacturer recomends using 20 sec. They don't say anything about calibrating to the proper spin time to achieve a 1+ reaction. I looked in AABB but did not find anything specific to this topic. Any opinions out there?
  6. We have been using the TEG at our facility for probably 10 years now. It has dramatically reduced the blood product usage on open heart cases. It is operated by a perfusionist in the OR. We have always wanted to duplicate the instrument in the Lab but that has not happened yet. Other surgical areas have studied the usefulness of this instument in their areas but it has not really taken off very well into any area other than OHS. (Mostly because they are unscheduled and the Perfusionist needs to be there to run the instrument) Matter of fact we had a really bad week in June a few years ago with tons of product going out. We couldn't figure out what was going on. Then later found out that the TEG had been out of service that week. (The lab is the last to know!) I swear by the TEG. We did many studies on the usefulness of the TEG back in 2001-2002. That was when we were trying to get a second unit in. The studies looked great but the second unit never has appeared! Some of the key points to it are that the physician has to trust the person reading the results! And then also the person interpreting the results needs to be well trained! The interpretation tells you exactly what products to give the patient or if there is still a bleeder that needs to be repaired. Personal opinion - for the patient's sake I think this instument is awesome!
  7. Wow- I was trying to get my thoughts together on this topic and there they all were written much more perfectly than I ever could have done on my own! Thank you for saying it so well! I miss the "feather in our cap" as someone put it - but the public has no idea or care that we are no longer AABB. I have not seen the quality of our BB diminish one bit for not having AABB inspections.
  8. I had a L&D nurse call me for Cord Blood results. I explained that I did not have any results for them because we had not received the specimens. She said she had sent them down and was sure we had them somewhere down here in the lab. I searched and searched with no luck. This same nurse called me back and said ' I just found the specemens under some papers up her at the Nurses station. So, can you just tell me the results, cause the Dr. is standing right here and wants them right now!" I told her we are good but not quite that good!!
  9. I'm no expert but from reading the standards I would say that for the return on a unit (of any type product) that has been out longer than 30 minutes you would have to be able to prove that the proper temperature had been maintained the entire time. Just my interpretation!!
  10. We crossmatch two antigen negative units automatically for all surgical cases and call to inquire if the physician would like any units crossmatched when we call the positive antibody result, on all other cases. We adopted this protocol because there was usually more than one physician involved in surgical cases and they may not always agree on whether blood was necessary (like never).
  11. Donna, Thanks so much! After I posted this request I found out that my Hospital has created a great little web site with the MSDS on all of the items we order (linked to our purchasing records). How cool is that! Nice of them to get the word out and let me know that. Oh ya I work in the laboratory -how silly of me! Any way thanks for your help! I am sure that there will be items I can't find on the hospital site!
  12. HELP OK - I am having trouble remembering how I got on to the Immucor Gamma MSDS sheet site. I am thinking that I first saw it hyperlinked on this website somewhere, but when I do a search I can't seem to find it. I can't get to it from the Immucor Gamma website either. Can someone please help me remember?
  13. I also agree with Malcom on the dosage issue-that is why I stated in my post that at the end of the day you still have to use your brain. If you have had to use heterozygous cells to rule out you want to be sure that you are not missing a dosing antibody. And yes there are certain antibodies that you would never rule out using heterozygous cells. That is why we get paid the big bucks - right??!!
  14. We used to provide this service exactly as you described above. We would have them go by our P&P and have to prove competency which was tricky at times. Now there are some new regulations in place that do not allow nursing to perform transfusions without a physician accessible so we no longer provide this service. Our blood centers can no longer perform therapeutic phlebotomies for this same reason. They are all performed in a hospital setting now.
  15. We use one homozygous or if absolutely necessary two heterozygous to rule out. Then 3 positives and 3 negatives reacting as expected to rule in. Of course you always have to look at the whole picture and use your brainpower to see if you can figure anything out when things are not clear cut. Which seems to be happening more and more often these days!
  16. Does anyone have any information on the original question - water vs. glycerol solution?
  17. The key wording in the CLIA reg is that you have to have an AA or AS to work unsupervised. Obviously there are also State regulations that if more stringent would superseed this. Many facilities either do not read the fine print of the CLIA reg or choose to use that as a reason for not allowing MLT's to work alone in especially BB but somtimes any Dept. Their reasoning is usally based on the fact that they have been burnt by doing such. Unfortunately the whole group gets a bad rap because of one bad apple! I am disappointed that your instructor in your program did not fully explain the differences in the education requirements and job opportunities. I am a little confused about your situation since in a later post you state that you have a BS degree - is it in a science field? If so maybe you would qualify to take the ASCP exam and could be a full fledged MT(CLS) and not have to worry about all of this! Hang in there - there is a career path for you - you just have to find your way through! Good Luck!
  18. We perform a T&S on all Moms prior to delivery. We have a lot of patients with very little to no prenatal care and very incomplete prenatal records. We have had several instances of incorrect blood types in the patient history. We also have the policy in place of setting up two units on Surgical or OB patient's with antibodies- this can be a real pain but often the Mom has already delivered by the time we identify the antibody and the Physician will say all is well and they do not need the 2 units set up-YES!! Another problem we have is women using each others identification - so a current blood type and screen is always helpful at the time of delivery to determine necessity of RhIG and DAT requirements for baby. As for the passive anti-D issue-we report them out as an anti-D possibly due to RhIG.
  19. We use Safe-T-Vue's on blood that is issued in a cooler so we can be sure that the proper temp was maintained the entire time the units were out of our control. We then remove the Safe-T-Vue as soon as the unit is returned to us before we place it back in our monitored refrigerator- because we too have had issues with them turning red while in the refrigerator- leaving you with the question - what now??!! We also are having a lot of trouble with our current box. They turn as soon as we put them on. We have to keep trying new ones til we get one to work. Once we do we don't seem to have any issues with them staying white in the cooler. We are very careful when placing them on - I believe they are just defective somehow.
  20. We require two people to identify our patients for Transfusion specimen collection. They do not have to be BB staff. We have a detailed 45-60 minute training session for Transfusion collection required by all staff (phleb, nursing, dial,etc) taught by me (BB supv). This has been very effective. We also hand label tubes (UGH) -this has been VERY effective at eliminating misidentification errors.
  21. Yes, our current policy states " as quickly as the patient can tolerate". That was why I posted this question in the first place- it just doesn't seem fair to Nursing to leave it so vague. If they ask we tell them 30-60 minutes as long as the patient can tolerate that rate. But if they don't ask I imagine they transfuse at the same rate as packed cells. I also would rather give them a rate rather than just an overall time for transfusion. I do not have the 16th edition. Still on the 15th edition. IT does not give any specifics for the products. Does the 16th edition give a more specific recommendation for products? Thanks everyone for all your help!
  22. I am looking for recommeded infusion rates for Blood Products using an IV pump. Particularly FFP, PLP and Cryo. Does anyone have any suggestions where I might look for this. I have seen it recently but for the life of me can not remember where and of course now I need it. I am in the process of reviewing our hospital wide transfusion protocol. In other words I need references not just opinions. Thank you so much in advance for your help!
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