Eagle Eye

We do the same except few tests where we read and record results directly in computer. It depends on your computer system. I believe cerner is not easy when it comes to document antigen typing results. You have no choice but to document results on paper and then enter in computer as cerner doesn't allow to enter partial results. eg. once you enter IS results for rh typing and the result is negative you incubate it for 5-10 minutes then you will read again and enter result in computer. Cerner doesn't allow that all typing results must be entered same time that is why we need paper.
Some of the computer system allows enteries at different time so you can enter IS and after 10 minutes go back and enter RT result.
 
& also your STATE and CAP regulations must be checked before getting rid of any paper documentation.

I want to understand your question here.
If you are talking about second cycle, then it will be same amount of plasma you started with isn't it? If had 20 drops of plasma and 20 drops of cells in first cycle, you would transfer same plasma over to second aliquot of the red cells!

Eagle Eye you are correct in that it depends on the state. In NJ APNs can order blood products independently, but PAs require co-signature by the physician.

I totally agree...Our cerner is quiet old but when I became in charge, I made so many changes to make it the full proof system. that is almost 15 years into the system... 
there were so many simple thing we could have used it but were not used eventhough we had someone from BB validated the system. & it all depends on how opended minded you are to the change .....the crew we had were there for 20-30 years and grew up with paper & pen so they were reluctant to any change.....it was very difficult for our director when he brought in Gel system back in 2000...Now we have automation and the system which we validated the way we want and which is the best for the patient...

At or facility they used to keep the segment at the time of issue but we have very busy OR...some time we were running out of segments and we had too many bags to worry about so the practice was changed almost 10 years ago...
We pull out two segments at the time of receiving the unit in our inventory.
Why two? Incase patient has delayed reaction and we use the segments for the workup and for any reason if we are not able to complete the workup and need to send it out to ref. lab....Yes we had that happened at our place that is why we pull out two segments and keep them for two months. we have bags labeled for each day and the box label for a month. On 1st October we will discard July box...

At or facility they used to keep the segment at the time of issue but we have very busy OR...some time we were running out of segments and we had too many bags to worry about so the practice was changed almost 10 years ago...
We pull out two segments at the time of receiving the unit in our inventory.
Why two? Incase patient has delayed reaction and we use the segments for the workup and for any reason if we are not able to complete the workup and need to send it out to ref. lab....Yes we had that happened at our place that is why we pull out two segments and keep them for two months. we have bags labeled for each day and the box label for a month. On 1st October we will discard July box...

we do not do eluate for the positive DAT on cord if it is due to ABO incompatibility and mother's antibody screen is negative.
We do an eluate if CORD DAT is positive and mother has positive screen.
We also do an eluate when CORD DAT is positive & there is no ABO incompatibility & mother has negative antibody screen and mother doesn't have history of antibody........We had a case like that almost 10 years ago where I was new tech and the DAT was very weak positive, I repeated it for my supervisor and my supervisor also repeated it before sending out to reference lab.........The ID was anti-Goa. Subsequently father was tested and father tested Goa+.

21 CFR 606.121
( The label provided by the collecting facility and the initial processing facility must not be removed, altered, or obscured, except that the label may be altered to indicate the proper name of the product, with any appropriate modifiers and attributes, and other information required to identify accurately the contents of a container after blood components considered finished products have been prepared.
 
What we do for things like thawed plasma:  print off the full face label, cut out the product name/expiration date, and relabel over those sections only so that the information is updated and machine-readable.

agree with both of you. Issuing is the last thing we release our techs. on.

I agree with Malcolm. We do a final check of pretransfusion testing and transfusion orders at the time of issue as a final barrier to mistransfusion, if someone wasn't trained and competency assessed on a number of areas they wouldn't be able to issue blood products. If someone only rarely logged in donor units, I wouldn't trust them not to make a mistake - we see enough simple errors as it is. As far as logging in specimens, we don't even let the specimen processors from the stat lab do that. Maybe we're just paranoid, but I like paranoid.

we do the same...take O positive donor segment(or you can also use O Pos patient) and add anti-D.
2-3 segment and add 2 drops of anti-D...increase it accordingly...Should work.

The list of cleared BECS (Blood Establishment Computer Software), including those for transfusion safety management can be found on FDA's website at:
 
http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/SubstantiallyEquivalent510kDeviceInformation/ucm134987.htm
 

Cliff,
   The site looks great. I can not change the profile pic yet! Lots of new options...we can change display name that is really great!!
Big Thank you to cliff...

Hello Malcolm,
         Please do not give more work to Cliff! If you have a cell phone you can play games on FB!!!   :)        

Hello Malcolm,
         Please do not give more work to Cliff! If you have a cell phone you can play games on FB!!!   :)