Ensis01

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. 

If the model is discontinued and no parts are available for repairs, I'd say it has reached its 'end of life' - however I'll bet it will still work a long time after that before a part needs replaced (especially older, quality scopes). I can see 'end of life' for more complex or expensive equipment, but a microscope for blood bank is more of a minor equipment purchase. My 'new' scopes are student scopes that cost less than $500 and they work just fine for our purposes. 

They are AO's, then I am sure that they are still working. Why is your upper management trying to mess with a good thing?

Do you have a company come in to service them? If so, they might be able to help you.  It's possible that the company was bought out by a bigger one like Fisher Scientific. I am retired so I don't have contacts anymore.

Agreed, sounds like you're moving to a less secure option for whatever reasons, so in that case I say go low tech and put a physical lock on the fridge door. Helmer sells fridges that have built in electronic access control, but you can also drill right through the handle bit and get a combo lock put on it. No access unless they call BB for the combo..... there are definitely ways to secure this low cost, I've got experience with both of these options and they work just fine after the surgeons stop complaining about it.  

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. 

I know the feeling.  I once cross-matched for a patient who was a Jehovah's Witness who said that they had never been transfused.  The only trouble was that their serum/plasma contained one of the strongest anti-Fya's that I ever saw throughout my career!!!!!!!!

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. 

While it is infrequently referenced, universal leukoreduction is one strategy for minimizing pulmonary and cardiovascular adverse responses to transfusion (see attached).  When we instituted it in 2000 our rate of TRALI decreased by 80+ % and TACO decreased by 50%.  Probably mechanism is that white cells, DNA, histones and neutrophil extracellular traps (NETs) cause acute lung injury and inflammation when infused (good animal model data exist).  Thus the failure to implement universal leukoreduction in the USA during the last 23-25 years was a terrible and tragic mistake, and this fatal error persists to this day.
ULR TRALI TACO PMC version.pdf

Thanks Cliff.  From a VERY brief test, it looks like it.

This should be fixed now.

I just answered this question.

My Score PASS  

I just answered this question.

My Score PASS  

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

We send cards to physicians (for their patients, if they like)  because it is our responsibility to patients, not because it works well.
If anyone has better ideas, please share them. Obviously a national database would be best.
Doing absolutely nothing is not an option from our standpoint.

I worked at a site that sent cards. Never did any good. For all the work there was no benefit. As for the chip...pass.

Jason Bourne all over again!!

We don't issue cards to patients with antibodies. I've discussed it with several of our medical directors, but none of them have been very enthused. They feel that most of the cards will be lost, forgotten about, or the info won't get passed on to us. Based on our past experience, I can't make a strong case. Our current medical director is a believer in Med Alert bracelets for the scary stuff.
I've seen only a few cards, under the following scenarios:
A few times: nurse is checking out blood and says 'Oh, the patient showed me this card about an antibody or something. Did you need to see it?' YES, before you transfuse! Twice: nurse has started transfusion and calls Blood Bank - 'Mr XYZ showed me a card about an antibody or something today (or yesterday). Do you need to see it?' YES, STOP THE TRANSFUSION! and once, once only - as the patient was being admitted on the floor, the nurse called and said the patient had a card about transfusions - 'Do you want me to fax you a copy?' YES! Gold star for you! Sometimes I wish we could put a chip in the scruff of everybody's neck that had all that info loaded on it - allergies, antibodies, med history - wouldn't that be handy.

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. 

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. 

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. 

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. 

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. 

Just be aware that dry ice turns into a gas.  I presume your freezer is not fully airtight, but it could open rather violently depending on how tight it is sealed, and how long since the last time it was opened.

All, I am about to blow your mind....
Our plasma freezer is down and so is our backup. The freezer will not get colder than -18 C. I was preparing to move all the products into boxes with dry ice until I had a conversation with my 87 year old dad, a retired blood banker from University of Chicago. He said to me, do not take the plasma out of the freezer and put it in boxes, PUT THE DRY ICE IN THE FREEZER, IT IS THE BEST STORAGE BOX YOU HAVE!!!!
MIND=BLOWN!!!!
I did that. Our freezer is currently reading -25.1C and getting colder. Furthermore, the probes in the freezer continually monitor the temp in the freezer so you don't have to record temps every 4 hours, the chart is doing that for you!!!
Isn't that cool? That perfectly illustrates the difference between wisdom and knowledge there. I wish we could hire my dad.
I just had to share this here.
PS. Freezer is now at -26.4C.