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Jennifer Castle

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    Medical Technologist/Blood Bank Supervisor

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  1. We use a separate BB wristband, perform electronic crossmatch, and require a second draw on patients for whom we have no type history. (We may also use a separate draw, ie. CBC if available). Last year, a patient was registered incorrectly (same name, different date of birth - so all bands, charts and labels were incorrect). It was caught by the phlebotomist performing that second draw. If I had ever questioned our process, I certainly did not look back after that near miss. We have to remember that patient identification IS the number one safety goal, because everything stems from that.
  2. I respectfully disagree. The CAP standard you cite is for the initial type. Any other time CAP mentions type confirmation (ie. TRM.30575, and TRM.4670) they state ABO only. Jenny
  3. We have a 19 yr. pregnant female, front type Apos, back type 1+ A1cells and 4+ Bcells. (in gel) No history available. Tube test with A1 cellls=1+; A2 cells=0; two different O cells=0; and B cells=0. Anti A1 Lectin = 1+ Antibody screen negative Results the same with different lot A1 cells. Strength increases with cold incubation. Crossmatch in IgG at 37 degrees with patient plasma and A1cells is 1+. (in gel) We are having the patient re-drawn for confirmation, but do I call this weak A subgroup if all results confirm? Clinically significant? Transfuse O cells? Or could this be pregnancy related?
  4. We save 2 segments and get bags returned only if transfusion reaction. We briefly discussed getting the bags back after a off-site clinic had a delayed reaction (patient reported to ER later), but logistically, seemed like a bit of a nightmare.
  5. To the floors, units that are not in coolers. Also to our outpatient cancer center in another building, which do go in coolers, but are called for when they are ready to hang.
  6. We use the Blood Temp 10 for transport, not for storage. The standard for transport is 1-10.
  7. Check out Blood Temp 10, PDC Healthcare. We've been happy with them since switching over from HemoTemp. (No activation required)
  8. Agree with AMcCord, we recently had this occur and FDA stated that unless the death can be directly linked to the transfusion, we do not need to report. We did investigate as a potential reaction, and our Medical Director reviewed the chart and wrote up a conclusion that indicated that the transfusion reaction was not likely. In case it's reviewed, we did our homework.
  9. An MD at Trauma mtg stated that he understood that the anticoagulants used in Frozen Plasma collection were a reason that the INR reversal with FP is difficult to achieve. I had never heard this, just wondering if anyone else has?
  10. We require BB notification, and after prelim investigation, the Lab Medical Director makes the call whether it's ok to continue for hives/itching, and whether additional units may be given. Hives category gets a clerical check and all other "Transfusion Reaction Symptoms" (as defined by AABB) require disconnection of unit and are worked up as reactions. The patient's MD does not make the call. We have a separate transfusion reaction categories for: 1) hives, itching 2) potential bacterial contamination and 3) everything else.
  11. We run the panel with diluted anti-sera (Currently Anti-Fya at 1:500 dilution). I am assuming that you are testing the cell viability, and that the panel will perform as expected. We test before the old lot expires.
  12. It's my understanding that the manufacturer of the unit must label the unit for Zika testing as long as it remains an investigational test. We collect donor units and must label each one with the Zika comment. If you are only the end user and the unit is already labeled with the Zika comment, I don't know that you have to log that comment into your system, unless you re-print the label. (as with thawed plasma).
  13. email me at jcastle@ajh.org, I will share ours.
  14. It's for WBC. We don't have flow cytometry so we are using the Hemacytometer method. Trying to get away from this if possible.
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