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April 2024 Challenge

Ensis01

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Everything posted by Ensis01

  1. Ensis01
    Not sure if this response is too late. After your new hires receive 6 weeks training and pass the test are they then expected to be competent in your blood Bank? What exactly are they expected to be able to deal with? My opinion (and experience in a similar setting) is that you have trained your new hires in the theory of your Blood Bank; the next 3 (probably more) months will/should provide practical training in how to use those skills in practice, increasing complexity and especially under pressure.
  2. Ensis01
    I just answered this question. My Score PASS
  3. Ensis01
    Then we do not QC new panels aside from visual inspection and any insert changes. Apart from damage in transit it seems any in-house validation is FAR less than the manufacturer must do.
  4. Ensis01
    We don't but I assume that as we use panels for antisera QC it by default QCs the panel.
  5. Ensis01
    One reason (maybe) is that if you are AABB accredited the Reference lab you use MAY change what they are required to reprove from the results you provide, which would reduce cost.
  6. Ensis01
    I wholeheartedly agree with all the above comments for you to determine the surgeons expectations. One other thing we found VERY useful was asking if the patient has had prior heart surgeries, i.e. how much scar tissue was on/around the heart. We found that the more scar tissue the patient had the more products, especially RBC, would be needed.
  7. Ensis01
    I can just imagine the conversations you may have if a patient comes to you after being titered at a different hospital and an 8 fold increase is the result
  8. Ensis01
    I was told, by a very senior tech, that this convention began pre-automation when instances where an anti-E was identified but occasionally weakly reacting anti-c was missed. This resulted in a change in hospital policy so when the patient has an anti-E and is c= give E=,C= units. I then assume this practice spread as techs gained seniority and moved to different hospitals. The improved reagents, panel cells and especially automated methods over the last few decades, plus increased pressure with time and costs may either make this policy redundant or (remain) implemented based on your patient population and experience. Thoughts anyone
  9. Ensis01
    I just answered this question. My Score FAIL
  10. Ensis01
    My understanding and experience of thermal amplitude testing is to identify a cold autoantibody and determine if it is clinically significant or primarily just a nuisance. I have never been involved in cold autoantibody titers; can someone explain its purpose please.
  11. Ensis01
    The LIS has to have all the different product codes you may use entered so it can log and track them in your inventory. Discuss with your supplier as you will probably never see most potential products (it is a REALLY long list). The Dr however should only be able to see the basics RBC, platelet, plasma, cryo and be able to add extra requirements like LR, irradiated, washed etc. I suggest having special products like washed, platelet crossmatchs in a sub menu (or at least harder to get at).
  12. Ensis01
    Considering how often inpatients get stuck I am not sure they would notice the 2nd check especially if appropriate CBC tubes are looked for and used.
  13. Ensis01
    Upright: so you can read the unit number plus the segments can be kept tidy to avoid getting tangled with each other, and observe hemolysis.
  14. Ensis01
    I just answered this question. My Score FAIL
  15. Ensis01
    Did you test the eluate against DAT negative patient cells?
  16. Ensis01
    They should have, or create a policy to replace/reattach the armband. Get your pathologist and QA involved.
  17. Ensis01
    My main concern would be the cold ambient temp in the OR.
  18. Ensis01
    I would say it depends; if you need to do extra testing to resolve a discrepancy that is billable. if the instrument did not give a result due to QC failure (due to a hemolized sample for example) and you used tube then not billable. It should however be noted that I do not do billing.
  19. Ensis01
    My experience is that When a patient is being transferred from another facility with cross matched RBC or other products; infusion should have started by the time they leave the ambulance. Products not being infused are discarded unless they have correct transfer paperwork, I.e. for antigen neg units. Crossmatching process begins again. To put it another way if you know the patient is coming; the other facility Dr. Orders enough products to cover the journey. If the patient is a hard work-up get all information and transfer antigen negative units. If worked up at a reference lab: Reference labs have a form that will allow transfer of results though receiving facility do not always accept these results.
  20. Ensis01
    Try 4 drops plasma and incubate for 30 min at RT, include an auto control.
  21. Ensis01
    That seems wrong on several levels, or is it me?
  22. Ensis01
    So when you find the discrepancy, do you test for weak D and if that resolves the discrepancy add a comment and move on?
  23. Ensis01
    Get the lab director to talk to the pathologist to determine if the photos are to help techs identify a skiptocite or if the photos are for review.
  24. Ensis01
    Either CAP or AABB provide a Titer for intra (and inter) lab comparisons.
  25. Ensis01
    Do you get many inquirys about about discrepant results from hospitals/Dr offices that only do IS?
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