Eagle Eye

We had one about 25 years ago, it was great because it was fast.  it was terrible when a bag broke.  It truly cooked the plasma, it looked like scrambled eggs when you opened it and the smell was horrible.  I'll stick with the water bath.

My facility uses Helmers and we have racks manufactured by Astron Systems. They store units vertically in sets of two or four. You can fit 4 across the length of a Helmer fridge in 2 rows (so 8 racks of 4, 32 total). In the Helmers with a higher bulk of products, we have some sort of plastic/acrylic dividers that section of units. We also have longer/heavier plastic "sleeves" that go down the length of the shelf, and those fit ~15 bags and go three across. So, I guess we have a lot of options!
Intrigued to hear others!

 

Yes you need the internal thermometer because if the probe disconnects for any reason you wont be able to get a accurate temp
 

Manufacturers calibrate the electronics and provide the certificate on the assumption of power to the electronics (which are simple and robust). As you did not change the electronics when changing batteries (the power input) you do not need to conduct a performance check (calibration). Or to put it another way: You do not recalibrate equipment after a power cut or if you remove and replace a mains plug. 

Just curious but has anyone thought to ask the timer manufacturer their thoughts replacing batteries?  Personally I don't think I would be overly concerned with the need to calibrate a digital time simply because I changed the battery.
Also, "However, the batteries have all died prematurely."  What makes you think that the batteries died prematurely?  Did the manufacturer indicate that the batteries would last the calibrations period?  If they didn't want you to replace the batteries they would probably make them inaccessible.  
Just a couple of thoughts.

Ouch !

If your timers are digital I believe they are exempt from calibration due to the nature of digital timing.  They work until the batteries run out of charge.  The CAP requirement for timers does not apply to digital ones.  TRM.31900.  How could you calibrate a digital timer (compare it to the Naval clock?)

It sounds to me that your lab director is the kind of person who would want to measure the amount of oxygen and carbon dioxide in the air each time someone breathes, AND perform a Change Control at the same time.

David Saikin - I'm in charge of the Isensix monitoring system for the entire lab, histology, and microbiology so I review logs at least weekly plus get paged for every every 2nd level and 3rd level alarm (email for 1st level).  Staff know if they don't respond, even in the middle of the night, I will call them.  Plus our hospital made it a requirement for Joint Commission readiness to have a report of all alarms and accordance to responding to the alarms so I have to look at it at least monthly.  
 

We have all codes in safetrace. 
1) anyone has thought about billing code?
2) also order service table: this will be same as FFP, right?

As the vast majority of hospitals (and Reference Laboratories) in the UK use column agglutination technology and automation, it is almost impossible to perform a second ABO without either a second D type or wasting a column or more than one column.  But, my point was that, if a patient groups as O the first time, and A, B or AB the second time, then, it is obvious that either the first bleed or the second bleed was WBIT.  Why should it be assumed that, if the person types as group O the first time, that is both correct and that it is automatically safe to give group O blood?  If anyone does, I advise them to read the posts of Dr Neil Blumberg on ABO mismatched, but apparently compatible transfusions.

Sorry, but to my mind, these patients should also be typed twice.  Yes, they can be given group O blood (almost always safely), but what if it is a WBIT, and the D typing is wrong because of it, or an antibody is missed because the "real" patient is group O with, say, an anti-K, while the other patient bled is group O, with no antibodies present.  In addition, and incredibly rarely, what if the "real" patient is an Oh, while the patient bled is an ordinary group O.

Parent bag----original expiration unless seal was not intact, in other words you must check seal of all weld when using sterile connecting device.
Aliquot in syringe---follow manuf. guideline. Usually 24 hrs.

As long as idiots exist in the world, they will thwart any solid plan we put in place to mitigate their recklessness.

Quite a few, but not all, hospitals in the UK use this method.  It is fairly fool proof, but, sadly, not entirely idiot proof.

We allow specimens collected through SunQuest Collection Manager to be used as the single specimen, which we will then type two times.
Of course there can be many workarounds for other techniques.  Double signatures - just collect the specimen and ask a friend to sign it.  Specimens collected at different times - collect two at the same time - put different times on them.
I heard of a local facility that the second tube was coded and provided by the blood bank.  That sounded fairly fool proof. 
 

Hello,
 
Is anyone out there using low titer group O Whole blood for patients?  We are on track to use it for trauma patients in the near future.  Any information you can share about your process would be extremely helpful. 
A couple questions I have right now:
Can you run Whole blood through a blood warmer/rapid infuser? Seems like a no-brainer since it will be used for trauma patients, but you don't run platelets through a blood warmer, and that's one of the pluses of Whole blood is that there are activated platelets present. 
How do you cross match Whole blood? I vaguely remember learning about Whole blood crossmatches in school, but we were told we would never use Whole blood in real life   do you XM the patient's plasma with the donor cells, the the donor plasma with the patient cells?  Since it will all be group O blood, wouldn't we expect the plasma to be incompatible with out of group RBCs, even I found it is low titer? Is there any benefit to the crossmatch if we know it will be incompatible, and we know low titer group O is safe for non-group O patients?
Can we expect discrepancies in the reverse blood type of non-group O patients if blood is collected after Whole blood has been given? How much Whole blood before we can expect a discrepancy?
Can you switch to type specific packed RBCs after giving Whole blood? I understand that  bleeding patient will be bleeding out the anti-A and Anti-B from the group O plasma, but what happens Hohenzollern the patient stops bleeding, still has Whole blood in circulation Andy then you give type specific blood that will be hanging out with those antibodies for the next few weeks/months? Should we expect hemolysis? 
What limits did you set on the use of Whole blood? Only for certain diagnoses (just trauma? What about other massive bleeding like GI bleed, ruptured/perforated AAAs, post partum hemorrhage?)? Only in certain areas of hospital (just in ED/OR)? Is there an age limit/range? Is there a weight/size range/limit (specifically is it ok for smaller people)? Not available for people with specific conditions (CHF)?
How did you educate medical/clinical staff? Any good resources you are willing to share?
Any issues encountered in Transfusion Services (BECS? Tech training/understanding? Things you wished you'd have known when you started using Whole blood or lessons learned along the way?)
What is the max number of low titer group O whole blood units you will give a patient? 
How much do you maintain in inventory? How much is used vs. wasted? 
If you are willing to share any processes or procedures, it would be greatly appreciated!  Thank you!
 

I've put off weighing in on this topic for as long as I can.  I really hate impossible "shall have" rules and regulations.  First you would need to know/calculate the body mass/blood volume of the patient.  Then you would need know the level of activity of the incompatible ABO antibodies in each unit of plasma going into that patient.  Then you would need to know the volume they are bleeding it back out.  All this to give you an accurate estimate of the volume of incompatible plasma you could "safely" give one specific patient.  I'm sure I've left out a factor or two but you get the gist of what I'm saying.  My minor level of OCD really whats me to do it right if I'm going to do it at all.  I had a non-technical lab director (BA in business) throw me out of his office for trying to explain why the request for certain data by a VP was not only impossible to accurately provide but was a stupid, worthless waste of time.  
This is one of those times where you and your lab director will have to make something up based on your best guess and basic instincts because there is no one size fits all answer to this.

and you would - I hope - transfuse with group A, so if you wrongly called it a group A, rather than an AB, it would actually be better for the patient.  I know of at least one case where an ABel was transfused with group AB blood and died as a result of a transfusion reaction.
And if this is a donor, the amount of B antigen present MIGHT cause a minor reaction if transfused to a group A patient but would not do any serious harm.  An what percentage of those weak reactions with B cells will actually be caused by this phenotype anyway?  Probably less than patients having antibodies against LFAs that are not picked up in the antibody screen and who have a minor reaction due to the incredible bad luck of receiving a unit of blood that just happens to have the antigen
 

I can relate to that! I can log in to my work desktop from home, so sometimes I ask them to fax a copy of what they are doing to my work email (secure!) and I can see what they've documented. Once we're up with our new blood bank system, I'll be able to access that as well. That can be an enormous help sometimes with the ones who don't communicate well.

Agree 100% Anna!

Yes, that's true, Malcolm.  On the other hand, if you test with 2 different monoclonal anti-A reagents (and an anti-AB for good measure - a real one not an A+B) and they all come up 4+, I think it's fairly safe to say that the patient is a group A.  I think that giving group O blood in this case is both wasteful of group O blood (unless you are swimming in it) and overkill

No. You do not require FDA registration for thawed plasma. Thawed plasma is not FDA licensed product. 
You do not need variance anymore  for converting FFP to Thawed plasma and give 5 days shelf life .

No. You do not require FDA registration for thawed plasma. Thawed plasma is not FDA licensed product. 
You do not need variance anymore  for converting FFP to Thawed plasma and give 5 days shelf life .

I had never heard of it but it sounds like a great idea to me.  Wish I had thought of it!