David Saikin

We use started within 15 minutes of release. Our experience is that after 15 minutes, rbc temps are too high to return to inventory. We do the same as far as if Nursing wants to return but will continue the infusion as soon as they fix "whatever",i.e., keep the unit on the floor.

That is not unique to north of the border

We used to have sign in our BB: The Buck Stops Here. Of course someone altered the posters to "The Buick stops here". My boss was pissed off about that. The concept being that if you have a system of multiple checks and balances you better make sure the first one works. I have seen this concept evidenced too many times in my career. People get complacent.

All the talk about statistics is great but in the real world you never know: I once screened over 30 units for K. All were positive. As I was the night guy, the day folks were laughing until they got the same results. All we could figure is the blood center was screening for K and shunted all the +s to a shelf which we received in bulk. I've also screened for Fya in past. Once i screened 4 units and found 2. The next time I had to screen 16 and the last 2 were negative. As I said, the stats look good but reality is sometimes a bit different.

me too

having been a manual gel user for years I am switching to solid phase in the next few weeks (ECHO 2.0). I like the fact that it's pretty much hands off once on the instrument. I wanted to get away from gel as I've experienced many of the same discrepancies as with tubes. I expect this will have its own vagaries however it is a step up for my staff. Also the price was right for a refurbished unit.

The most I've ever given postpartum is 7. C section delivery with a great deal of placental manipulation.

She also may have made it after delivery (I expect you did no T&S for the delivery admission, as you have not mentioned that you did)

we require at a minimum the person picking up blood has the patient's MR#. Ideally, they will also bring the crossmatch result and can verify the component being released. Only requirement is patient MR# for p/u.

That's why folks use 'fresh' units and also why irradiated blood gets a shorter outdate than the original (unless the current outdate is less than what you would change it to.

IPDM?

I am working on a system in which the MD documents the need for uncrossmatched product in the medical record. It still takes a phone call but i'm trying to get rid of the paper chase which follows.

Tubes without enhancement is what I have always used. I don't care for the CAP method as it is actually a 1:3 serial dilution vs the 1:2 which has classically been used. (maybe it's ok because the "new" method is read microscopically vs macro read for the classic method).

I agree John. We would informally file the info but never act on it. The only thing I would consider is an antibody ID from one of the teaching hospitals, and even then as a guide, but I would have to respect their id. We also will not accept a specimen not obtained by our organization. We will only accept ambulance specimens if we have a history on the patient. No history, new sample.

That's what I've been doing also. Thanks for the response.