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April 2024 Challenge

Ensis01

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Everything posted by Ensis01

  1. Ensis01
    If you are screening unknown units in your inventory then a second confirmatory test on that unit is strongly advised. If you receive labeled antigen negative units from your reference lab then believe their process and the label. Retesting because a tech does not trust someone else’s work due to “comfort” seems to be a waste of time and money.
  2. Ensis01
    I seemed to use a bad example to show why I think front and back type ABO resolution is important.
  3. Ensis01
    My experience has always been that blood products given during an MTP were a stop gap while the cause(s)of the bleed were dealt with, continuing for as long as it takes. As described above this can involve a huge number of products. What situations during a MTP can cause more harm than good?
  4. Ensis01
    I am in the resolve the Backtype at a minimum of once for every patient. I have had two Bombay phenotype patients in labs I have worked in.
  5. Ensis01
    Four drops of plasma to resolve back type ABO discrepancies (with an auto control) has been part of procedures in all places I have worked. My concern is that your techs are using a technique that is not part of your labs procedures. WRT ISXM: if you resolve the backtype using 4’C (RT) incubation do your procedures require you to do the ISXM at 4’C (RT)?
  6. Ensis01
    I just answered this question. My Score PASS  
  7. Ensis01
    For many hospitals; once an anti-M is identified, at any phase, M neg units are required. This is usually due to reluctance, or inability to over-ride the BB LIS especially if the BB is primarily staffed by generalists.
  8. Ensis01
    To my understanding: if you are referring to PAS (PR) platelets, which are being, or have been phased in by blood suppliers; then give any ABO type as 60-70% of plasma has been replaced with crystalloid nutrient media. The pathogen reduction (PR) negates the CMV and irradiated necessity. Other BB may have a different policy though platelet availability may give you no choice.
  9. Ensis01
    Medical directors REVIEW policies every two years to ensure they are current and appropriate then sign, which is evidence of review. Staff read and sign when changes have been made.
  10. Ensis01
    I have frequently seen Rh discrepancies like this with hospital hoppers. If we have (or can get) last hospital history one phone call resolves issue (plus weak D test). However We have had problems when the patient is adamant they are Rh pos (or neg) and we report the other. This has caused long delays for patients to get or accept the explanations and give consent (or re-consent) to be transfused. The added tech time for these situations can be frustrating on occasion.
  11. Ensis01
    Use manufacture instructions as your starting point; but review and subsequently increase or decrease requirements as appropriate to your lab.
  12. Ensis01
    Keep paper long enough to ensure correctly billed from supplier.
  13. Ensis01
    If the candidate has commercial lab experience running HPLC or LC/MS/MS they will have direct transferable skills and experience with following SOPs/procedures, running QC and tight deadlines. So they would definitely be trainable. However you would have to teach them everything BB as BetnaSBB described above. Do you have the time for that commitment?
  14. Ensis01
    Do you think it too passive aggressive to ask if you are required to QC ALL the low and high incident antigens on the panel especially those that you have no antisera for (or the cells to QC that antisera)? You could also ask them if and how you should QC the antigen variants on each panel!
  15. Ensis01
    Have you ever found anything unexpected and clinically significant?
  16. Ensis01
    With respect to RBCs. If the patient has unidentified antibodies (as the title states) then NO. If you have identified the antibodies but can not confirm the patient’s antigens (as your question states) and the AHG crossmatch is compatible with units negative for the antigens that the patient has antibodies to then yes, though there are some/many possible caveats. Hope that is not too convoluted. It would help us if you give more details. Can you please explain what you mean by filters as in this context it is a little concerning to me.
  17. Ensis01
    I just answered this question. My Score FAIL  
  18. Ensis01
    I just answered this question. My Score PASS  
  19. Ensis01
    Does acquiring more good blood banking staff count?
  20. Ensis01
    How is the tap water? You could get a water filter to remove any/most of the mineral content
  21. Ensis01
    What is your pathologist’s opinion? I mean there is a point where a unit’s volume is unlikely to achieve the desired effect. Nurses are also going to raise concern with your physicians if the volume differences are large.
  22. Ensis01
    It maybe that you need to ask the flip side of the question; at what volume will the hospitals you supply no longer accept the unit (or at least begin to express concerns)?
  23. Ensis01
    It sounds like you are giving emergent uncrossmatched units, with an extra layer. So I would keep your current process. The only thing I would check that may be relevant is the point the patients get registered to your hospital. If they are on route to your hospital before the blood is given I would regard them as your patient, like a GSW walk in to the ER.
  24. Ensis01
    I just answered this question. My Score FAIL  
  25. Ensis01
    With staff shortages there is, or at least seems to be, a push to hurry and skimp on training. This usually results in huge amounts of stress due to feeling (and appearing) ignorant, slow, unprepared etc., which in turn causes them to quit. If trained correctly, the stress moves to the existing staff, who may be better able to deal with it as they can see the medium and long term benefits. Or not! A difficult cycle to break. Sorry for the side bar / rant. To the OP; as jayinsat said; if you auto print, call the station where the label prints to provide an explanation.
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