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Posts posted by MaryPDX
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This is correct. Verax is not licensed for PAS platelets.
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Our Zebra printers go through Hematrax print server (from Digi-Trax). We didn't have to do anything to adjust the size (it does that automatically). At least that's how I remember it. It's been awhile.
Next time I'm at work, I'll try and print out the configuration label. Hopefully it will help.
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We use the rad source x-ray irradiator as well. Allows you to irradiate 6 products at the same time. It takes 280 seconds to irradiate.
Even though you have to periodically replace the cathode ray tube, that 280 seconds never changes (unlike cesium based irradiators).
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We use electronic xm.
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On April 27, 2017 at 8:36 AM, mollyredone said:
Are you at OHSU?
Yes
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On April 10, 2017 at 5:37 AM, ANORRIS said:
We screen units for Kell only for those with Anti Kell and Sickle Cell recipients.
We do the same, plus thalesemia and Dara patients.
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On 4/7/2017 at 8:28 PM, Mabel Adams said:
Does the Grifols gel have as much of a tendency as Ortho's to have reagent cell lots that give tons of false positive antibody screens, especially as the cells age or you get to the dregs of the vials? We had done some testing of Grifols gel and felt that it might not pick up those false positives so much. We ended up with a Vision because of $ but I am interested in the experience of long-term Grifols users in this regard. Our last lot of Ortho screen cells was terrible for false positives.
We don't get the false positives with Grifols like we did with Ortho. IMHO
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Level 1 trauma center with large surgical, heme/onc and BMT programs. 20 min from supplier, 20 plts for stock (average)
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On March 30, 2017 at 4:33 PM, anapryz said:
At what point in time would you switch to type specific? Does it matter how many units of O were transfused before you go to ABO specific? Do you then perform an coombs crossmatch?
For red cells, we switch to ABO specific once we've processed a T&S (and a confirmation type on a second sample when not type O). We do that as long as we can (don't want to waste O cells on a non O if I don't have to).
If the patient is Rh neg, and we had been using Rh pos during the massive, we don't switch back to Rh neg until the massive situation is over.
- Ensis01 and Malcolm Needs
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12 hours ago, Dansket said:
Rarely
Same here.
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In Epic, there are 2 orders that need to be placed for inpatients, a prepare order and a transfuse order.
The prepare order tells us what they want and how much. The transfuse order tells us they want us to send the product (and it allows them to scan the product they're giving into Epic).
Both orders (as well as all test orders) print out on a network printer in the blood bank.
We have a pneumatic tube system, so the products get tubed to the proper location. For orders that need to be sent in a box of ice, we use our hospitals transporters.
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18 hours ago, mollyredone said:
We are still using the two part tractor feed slip with tags. We use the bottom part "unit ready slip" to tube to the floors to let them know the unit is ready. How do you notify the floor the unit is ready?
We use Epic and it updates when blood products are ready. It shows the kind of product, unit number and status (available for issue, issued, returned to stock, or transfused). The floor is required to look this up themselves.
We only contact the floors during system downtimes or if a location does not have epic access.
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Grifols wadiana and Erytra use windows 7.
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19 hours ago, MeganPLT said:
Great Post All! Just one concern - Brenda, your last post mentioned missing weak antibodies and I know no one method is perfect (it's my mantra), but can you give us an example of which ones are weak/missed that are showing in PeG? And when you say questionable screen - do you repeat screens that have a history of antibody or just when they give you an equivocal result?? I've seen where others have done that during a transition period between switching methods - until they get use to it!
And just since no one has mentioned it yet - we got a chance to look at the echo Lumena and have been fairly impressed with footprint and new and improve specificity (an issue solid phase has dealt with but seems to be getting better and hopefully much better on the Lumena!) and sensitivity has never been an issue for us with Echo.
PS - @MaryPDX Thanks for the heads up on the Eflexis, I hadn't heard about that analyzer yet; but just keep in mind anything available in Europe usually takes 2-4 additional years for US to approve (from what I've seen in the past) so I wouldn't wait around for it!
We didn't. We now have 2 Erytras. Had the first for about 1 1/2 years, the second we just got.
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11 hours ago, kate murphy said:
Univ of Texas, with the military, conducted a study a couple of years ago - PROPPR study - about the proper ratios of plasma/platelets to red cells in massive transfusions. Most trauma centers have adopted the guidelines.
Generally, ratios of 1:1 plasma:red cells or 1:2 plasma:red cells is now accepted. Platelets are counted in plasma products.
So when docs notify us they are activating the massive transfusion protocol, we issue 1:1 plasma:red cells. Kind of a simulated WB. Patients mostly do better, avoiding the edema and coagulopathies associated with massive transfusions. And overall mostly use less blood. Google PROPPR STUDY for more info.
Our facility was involved in the that study. As a result, in a massive the first box issued is 4RC and 4FFP (which we always have ready to go) thereafter it's 6RC 6FFP and 1u Platelets. We keep ahead with this until the massive is called off.
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Grifols TAS people were onsite to go through their validation of our Erytras. This is simply just making sure that the instrument is functioning properly (hardware and software). They had a book with the scripts they follow while our technical coordinator did the actual button pushing. As far as training goes, 2 of our people went to Grifols for training. They were responsible for completing the correlation studies and training the rest of the techs
Correlation takes longer and may involve your medical director (or the primary person responsible at your facility that makes the decision as to how many specimens need to be run make a test method valid.
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3 hours ago, Christiane said:
Thank you all for your feedbacks. ...and please keep them coming. I am listening.
One question though...am I to understand that most of you are giving O POsitive to males and females (>45 let's say) as the first set of units to be transfused, without even bothering with O neg ?
Correct. This is our protocol. Females <45, or whose age can't be determined (or if the sex is unknown) start with O neg red cells.
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From Grifols LinkedIn site:
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I know it's happened, but the number doesn't seem to be very high. (I'm going strictly on memory and not actual numbers).
The problem with that is, most of these type of people tend to be traumas, not the chronically transfused people you see often. Once they've been discharged, we may not see them again or it may be years later.
It may sound crass, but for it to be a problem, they need to survive the event which is causing them to bleed to death. Developing an antibody (ANY antibody) is the least of their problems.
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The blood type should appear mixed field if an Rh neg person receives Rh pos blood (the opposite is also true). If we've never typed the patient before, we consider them Rh neg until the type can be verified (contacting hospitals where the patients been recently, etc).
Our facility has used O Pos red cells for males and females >45 years of age for as long as I can remember.
Our department doesn't issue patient cards, at least not that I've ever seen.
RESt and DARA
in Immunohematology Reference Laboratories
Posted
The only way I'm aware of is DTT treating the screening cells used.