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Sonya Martinez

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    Blood Bank Coordinator

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  1. Sonya Martinez

    AS vs CPDA-1 with Peds MTP

    We are also a free standing children's hospital with a level 1 trauma. Last year we changed our MTP to weight based because there was way too much wastage for the smaller patients. We are currently in the process of switching from CPDA to AS3 for all our neonates and transfusion >20cc/kg on patients < 1 year old. We will be 100% AS3 (but can still use CPD, CP2D and CPDA1 if available) by mid December (if everything works out as planned). I attached a couple of abstracts and a really nice Power Point we used to get neonatology to agree to the switch. Hope this helps. http://www.haabb.org/images/04_The_Use_of_Red_Cell_Additive_Solutions_and_Special_Attributes_in_Neonatal_Patients.pdf AS3 pediatric cardiac surgery.pdf AS-3 SurveyAbstract 2015.pdf
  2. Sonya Martinez

    Temperature Indicator for RBC Units

    We switched from Safe-T-Vues to BT10s earlier this year and they are much better. With the safe-t-vues we had problems with both nursing and blood bank staff placing their thumb or finger over the indicator and making it turn when in actuality the blood temp didn't change. The BT10s are room temp storage, stick better, and don't have the issue with activating if someone puts there finger over it. We've also found during our validation the BT10s are a lot more accurate and turn right at 10C where the safe-t-vues were activating at 11 or 12C. Plus the BT10s are cheaper for us.
  3. Sonya Martinez

    Sterile Tube Welder (Connecting Device) Recommendations?

    We had a Terumo SCD 312 a few years back that never gave us any problems until one day it just flat stopped working and couldn't be fixed. I had been talking to Fresenius about the ComboDock but we have limited space and it was too big for our area. We ended up with the Terumo TSCDII because they were the only ones to get us a same day quote and had the equipment to us in 2 days plus they let us return the 6 boxes of wafers we had from the previous version and gave us out money back (minus 25% stocking fee). Working at a children's hospital we have to have a sterile docker so for us fast was what we needed. With the Terumo TSCD you have a clear catch bin for the used wafers so it's easy to tell when you need to empty it. I was watching a youtube video on the Genesis TCD and it looks more complicated than the Terumo. You have to load a wafer every time and your tubing has to be longer. Here's the link to the video: The only problem we've had is during a emergency generator load test one night it revered back to the LED screen being in German instead of English but the user's guide has a really good troubleshooting guide and I was able to fix it in about 5 minutes. I don't like the way you change cassettes though. It's not as easy to change them as the older SCD 312 model. Here's a video on the Terumo: Hope this helps!
  4. Sonya Martinez

    Repeat Antibody Investigations

    Our policy is if the patient is transfused they get a new ABID every 3 days but if the patient is not transfused we will only do the ABID if they are going to be transfused or every 7 days which ever comes first. Being at a children's hospital we don't get a lot of antibodies and most of them are WAA from our oncology/hematology kids. Plus we don't have the staff to complete the WAA workups ourselves and they get sent to a reference lab. So if they are just keeping a current TSCR but are not planning on transfusing (usually they give medication instead of transfusing these WAA kids) we only send out the ABID if they want blood for a procedure or something. We also keep the kids on the same unit and/or donor as long as possible. That's the nice thing about kids. For those kids with other than WAA we do a new ABID with every sample. For neonates (passive antibodies) we do a new ABID when we run out of specimen to crossmatch new units which happens rarely.
  5. Sonya Martinez

    Charging for washed, irradiated, leuko-reduced platelets

    No you charge for the product, then each process. So the HCPCS for leukoreduced platelets, washed is P9035 just like non-washed but you have 2 procedures codes in your CDM to include a larger charge for the washing then you add the irradiation using CPT 86945. For example a regular platelet unit is procedure code 63877 and is priced at $450 but when it's washed the procedure code is 68309 and you charge $611. We have our computer system built so that if the product code is washed then it charges the procedure code for the $611 but if it's not washed it charges $450. Unfortunately there's only a P code for washed RBCs.
  6. Sonya Martinez

    5 months with all positive tests!

    Along with anti-P1 you might want to look at the possibility of polyagglutination (if you are using human derived antisera not monoclonal) especially if the patient has bacterial infection which can cause T, Tk, Th, Tx, acquired B, and/or VA polyagglutination. There are also inherited and nonmicrobial associated polyagglutination as well. I would try testing with washed patient cells and donor plasma. The Blood Bank Guy has a good blog on it: http://bbguy.blogspot.com/2011/03/perils-of-polyagglutination.html Either way you will most likely have to send this testing out if you are not in an immunohematology reference lab.
  7. The Circular of Information (9/22/16) states "no medications or solutions may be added to or infused through the same tubing simultaneously with blood or blood components with the exception of 0.9% sodium chloride." When you transfusion whole blood or reconstituted whole blood for exchange you are creating a new product or medication. Since blood and blood products are considered biologic medication our hospital only transfuses one unit at time. However, if the patient has multiple lines which our traumas usually do then you can infuse multiple products just not through the same line. The other problem is if the patient has a reaction how are you going to tell which product is being transfused at the time of the reaction? Of course this is the same problem we see when patient's are placed on ECMO and both the RBC and FFP are placed in the circuit together.
  8. Sonya Martinez

    CAP survey data entry

    If you are using internet explorer 11 you must have it in compatibility mode for it to work for the CAP website. Also I have found that Mozilla Foxfire works better than IE11 for this website.
  9. Sonya Martinez

    Bacterial Testing - Apheresis Platelets

    FDA has this scheduled in their talks this month to move from guidance to regulation. This is the first topic on their agenda. But there is rumor out there that because this will raise the price for both the patient and the hospitals they may leave it at guidance until the healthcare issues are resolved. (Trying very hard to be PC). However, since it's a patient care issue no one really knows. We are moving forward to bring testing in house. All whole blood derived and apheresis platelets (including PAS) will be required to be tested once every 24 hours at a minimum on days 4 and 5. You can also use the PGD testing to extend the outdates to 6 and 7 days (with new product codes). Verax is the only FDA approved kit for doing PGD testing. We will be getting in our supplies and equipment by the end of March for validation in April-ish.

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