David Saikin

Nursing would not believe me when I told them that their transfusion documentation was running about 50% complete. Finally, I sent all the deficient paperwork to the Nursing Admin. They got up to about 90% but then fell back into non-compliance. After a change in Nursing Admin, a new Medical Director of the Lab and constant haranguing and meetings we are now consistently at ~95% compliance. We had to give a little also. Instead of vitals q 30 minutes after the 15 min initial vital set, we now do 15 minutes and hourly. Still have a hard time getting them call a reaction workup for increased temps . . . but definitely improving otherwise.

If the blood is going to stay in the cooler until transfused - it is storage. (1-6C for storage) If the blood is taken to the room and stored "elsewhere" that is transport. (1-10C: temp while blood is in transport mode) If the blood is not in a cooler and taken to the patient's room - that is transfusion

We always added some saline when pooling cryo. A moot point nowadays.

Thawed plasma is a new product. If you make it you should be registered.

My medical director determined that we would call a 1+ rx (w gel anti-D) Rh Negative. There are folks that call a 3+ rx w gel Rh Negative.

correct

Most rbcs in the USA are leukoreduced and AS rbcs. The residual plasma in these units is very minimal. I cannot remember ever washing rbcs for neonate/preemie transfusion, starting in 1972. (before AS or leukoreduced rbcs)

since your institution considers blood/components "medication" do you get paid what a pharmacist gets paid? If u are using 2 or more lines for transfusion how would u know which product causes a reaction? Rhetorical questions.

The AABB Tech Manual states that only 0.9% saline may be added when transfusing blood or blood components. I do not see a problem running plasma and rbcs together - see my comment above.

While I appreciate this sentiment, my reality for apheresed plts is that I only receive group A or O - depending on what is there and pending outdates at the supplier. As a small institution (24 beds) I do not have the capability for washing plts (though I have in the past at larger, tertiary care places). Aside from myself - all the techs are generalists who would rather not do BB if they had a choice ( though for the most part they do excellently). I guess the larger institutions get dibs on the ABO identical plts - not so for us little guys whose usage is random and rare.

I know large institutions that use an immediate spin titer of 51 or less. Whether this is a titer or dilution I cannot say. The medical director there told me that it is a titer.

Immediate spin xm; we try not to draw a 2nd sample. We use BloodLocs (which are considered barrier protection).

years ago all we had was warm saline or ether. We used warm saline on cord bloods with +DATs.

Have you contacted your vendor? They might be able to provide a starting point.

We use AS-1 red cells w CPD as the anticoagulant.