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Sonya Martinez

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    Blood Bank Coordinator

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  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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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