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Sonya Martinez

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Sonya Martinez last won the day on October 7

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    Blood Bank Coordinator

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  1. We don't do IUT (we get them after they're born) but we wash red cells all the time. Our red cell override is set at 3 minutes but all other settings match ours. When's the last time the unit was primed and the RCD cleaned? Maybe there's a bubble in the line to the hydraulic fluid. You could also add a manual spin followed by super out after the program ends to ensure a majority the saline is removed. That's what we have as troubleshooting if the excess pressure light comes on or the lid will not open because the bag is overfull.
  2. I think this came from the AABB Primer for Blood Administration. We have it in our policy to check all vital signs 1 hour after transfusion and if it meets requirements of a transfusion reaction then they start the transfusion reaction workup. We put this added vital sign check after instituting the Hemovigilance Surveillance through the CDC (NHSN) after we started seeing a lot of hypotensive reactions and because being a children's hospital we see a lot of allergic reactions that aren't necessary happening during the transfusion but some times right after. It hasn't significatntly increase
  3. When we started using Epic we had to have the physicians change from ordering the nurse to transfuse over 4 hours to over 3.5 hours or 3 hours 45 minutes because of the way it's documented in the BPAM. We use the completion of the entire transfusion, blood and saline, as the end of the transfusion.
  4. David Saikin - I'm in charge of the Isensix monitoring system for the entire lab, histology, and microbiology so I review logs at least weekly plus get paged for every every 2nd level and 3rd level alarm (email for 1st level). Staff know if they don't respond, even in the middle of the night, I will call them. Plus our hospital made it a requirement for Joint Commission readiness to have a report of all alarms and accordance to responding to the alarms so I have to look at it at least monthly.
  5. DebbieL - THANK YOU!!! Now to figure out what they mean about temperature mapping during installation, after repairs or after moving the fridge in TRM.42600!!
  6. We received our CAP pre-inspection packet recently (version 06.04.2020) and I have a question. TRM.42750 states "All component storage units are equipped with an alarm system that is monitored 24 hours/day (in laboratory or remote) with alarm checks (for both low and high settings) performed according to the manufacturer's recommended intervals, or at least quarterly if not specified, with results recorded." Under notes it states "The laboratory must demonstrate that all components of the alarm setting (including chart/graph recordings) work as expected and that there is a process to ensure
  7. Malcolm Needs - Thanks so much for the quick response. There's no ethnicity on the patient yet but I doubt she is Japanese by her last names (very Hispanic). We are not planning on antigen typing the red cells for M at this point since it only showed up at immediate spin. We didn't do the workup on the mom so although the other BB said they ruled M out we don't know for sure if they use the 3/3 homozygous rule that we use. You are definitely correct about the M still possibly being IgG, I do realize, thanks for correcting me. It's been a very weird year, since last July when we had our fi
  8. We have a newborn (2 hour old when the sample was collected from the patient) term infant who's mom is confirmed to have anti-E and anti-c. Being a children's hospital we have specimens collected on all our patients and do not use the mother's sample. Our workup shows the anti-E but instead of the anti-c we have a confirmed cold anti-M that reacts in gel and only at RT in LISS (tube method) and shows dosage. We do 3 homozygous cells to rule in and out each antibody. We completed a back type on the patient just to see and the patient has a 4+ reaction with A cells and negative with B cells
  9. Yes we are having similar issues in San Diego. Being the only children's hospital between Mexico, Arizona boarder and Orange county we are doing a majority of all testing on children (even for Kaiser) plus we have contracts with multiple hospitals, the Navy and the county of SD and Riverside!! We are trying to hire staff but state of CA is a pain with licensure of CLS (generalist) vs molecular diagnostics (limited license that can only do human genetic testing - stupid since it exactly the same testing just on a virus). We're a small hospital lab and by Monday we're supposed to be able to r
  10. 86644 is the CPT code we use to charge for CMV seronegative cellular products.
  11. We have been on Epic with HCLL (now WellSky Transfusion) since 2013. I like HCLL and they have user groups just for those of with Epic integration. We're starting our 2nd upgrade to the newest WST 2020 version next week. Do not wait too long between upgrades. We do not see much of a delay (seconds) with out interfaced orders and results. Unfortunately we are not on the Epic BPAM (Blood Producat Administration Module) with the matching so we still have paper transfusion records to document our clerical checks. I really like their analytics software and it makes my monthly reporting easier
  12. Our IRL suggests we use LISS for crossmatching when we have a WAA. Most everything else we do is in gel because we don't get enough sample being a children's hospital. Also we do LISS antibody screens when we're dealing with an anti-M since kids get a lot of cold M antibodies. This way we can tell if it goes all the way through AHG and requires M neg products or if not then just LISS crossmatched red cells. When I changed to the N-HANCE it was the same time I changed our red cells for antibody screens so that made my validation simpler. We now do method to method correlation between gel a
  13. San Diego Blood Bank (SDBB) is our primary blood vendor an they sent out information just this morning that they are working on their process and it will require an approved eIND number for each patient and each order or an approved organizational IND which will cover all CCP requests moving forward. SDBB is starting with collections labeled with same product codes as frozen plasma products with a tie tag identifying them as CCP. I do have the CCP codes that were given to me by our software vendor, WellSky, so eventually I will build them (after I finish the added PAS platelet build and my n
  14. That seems over the top. What area of the country are you in?
  15. We require a second type no matter where the patient is. We rarely get push back even during an MTP or ECMO cannulation. We've been doing it this way for more than 15 years. We also don't require them to place an order or use Epic printed labels. We have them label with a demographics label on the lavender top and our processors know if they don't have an order they immediately bring it to the blood bank. Unfortunately working in a children's hospital we give a lot more O RBCs due to our patient population and the fact that we don't have the moms at all. We will also take a verbal secon
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