[Transfusion of DAT+ units safety?]

Main practical issue from a transfusion perspective is a positive IAT XM.
If RBC given via electronic issue you would be unlikely to ever know the unit was DAT positive. 

[Patient hx]

I once got a pre-surgery form where the patient initialed “never been transfused”. Our facility had given 5 RBC (over a two week period) three months previously. 

[BloodBankTalk: Can China’s large population help alleviate blood shortages?]

I just answered this question.

• My Score
  PASS

 

[BloodBankTalk: Is there a standardized age limit for elderly donors?]

I just answered this question.

• My Score
  PASS

 

[BloodBankTalk: Clinical Aspects of Transfusion Reactions]

I just answered this question.

• My Score
  PASS

 

[BloodBankTalk: Clinical Aspects of Transfusion Reactions]

I just answered this question.

• My Score
  PASS

 

[Incompatible Blood]

On 4/19/2023 at 3:26 PM, exlimey said:

I agree with all the previous comments. You cannot manage a transfusion reaction in a patient who has died from lack of blood.

Agreed. I would however like to add the caveat that some physicians do not understand the risks associated with antibody history and uncrossmatched blood, so getting a pathologist involved to ensure the situation is truly life/death. 

[Patient hx]

12 minutes ago, Malcolm Needs said:

Believe me when I say that you are lucky!  

Had a lot of hospitals saying patient has a Vel when they should have said V

[Patient hx]

I have never encountered a patient that says they have antibodies unless they have a card. 

[Antibody Testing Report Terminology]

For an antibody screen “Neg” or “Negative” has been historically used. This may have been heavily influenced by DOS based computer systems that had very limited memory so “Neg” made sense.
Reporting a SCREEN as negative seems logical to me, however a work-up requires more detail as Malcom’s described above. 

[Antibody identification art or science]

I do think that one sentence makes for a good philosophical discussion

[Same Day Survery ABO Confirmation process]

On 3/21/2023 at 9:43 AM, MAGNUM said:

 

sounds like fraudulent documentation

It is. They get two write-ups for their efforts. 

[Nursing verifications done at bedside before transfusion]

We vertically audit ten transfusions a month, reflecting different departments and floors. We ticked each criteria box as it was done correctly. If missed or done incorrectly another box was ticked and we educated the RN. The form was signed by us and RN. The BB kept a copy and original went to the RN supervisor. Not sure what they did with it. Not ideal system but showed us willing. 

[Same Day Survery ABO Confirmation process]

I suggest discussing this with the powers to be, QA, and any committee involved in transfusions, budgets, unnecessary, wrong collections etc. Present your concerns and suggestions and if you are overruled you have evidence of your due diligence.

While I see arguments for both sides; finding the most efficient and safe process that everyone can agree with is the important concern. If this means extra draws, cost and BB time so be it. 

Biggest risk maybe drawing two tubes at the same time (one draw) and writing different times (two separate draws)!!

[BloodBankTalk: Are statistics available on blood donations worldwide?]

I just answered this question.

• My Score
  PASS

 

["Critical values"]

How are the phone numbers checked to ensure correct information goes to right patient?

[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. 

[Preop Specimen]

To my understanding the process of having to sign a document made the patient think and take the questions seriously. Obtaining and documenting accurate information is the objective.

[Preop Specimen]

Fill out and sign form during sample collection. Phlebotomist is responsible the form is filled out. Patient label goes in box, patient ticks boxes to transfusion and pregnant questions with yes / no option, signs at bottom. Form goes to BB and is then scanned into record. 

[Antigen Charges]

My understanding is the antigen charge(s) are applied for the ordered number of units crossmatched. If keep ahead: then charge subsequent units that are issued. 
This keeps a consistent process. Especially if the units have to come from the reference lab. 
Usually in-house screening for units have no additional charge. 
I do not know the documentation reference though I am sure others will. 

[Retirement planning advice]

Part time / guest lecturer at your nearest Med Tech school?

[Documentation of Visual Inspection at Issue with Remote Refrigerators]

How often do you check / restock the fridge? As that could be your documented inspection. 

[BloodBankTalk: Is blood from previously pregnant donors safe?]

I just answered this question.

• My Score
  PASS

 

[Repeat of donor Antigen typing]

6 hours ago, Byfaith said:

In our case it would be not totally trusting your own work and asking a second tech to double check with a new segment.

The policy at all places I have worked; to find antigen negative units in our inventory requires testing two different segments sequentially (not parallel). First segment is a screen and second is confirmation. 

[Repeat of donor Antigen typing]

3 hours ago, exlimey said:

why are in-coming Red Cell Units re-typed for ABO/Rh ?

And....go......

To quote my first BB manager “first rule of BB; get the ABO right, last rule of BB; get the ABO right. “