David Saikin

I don't know that there is a prescribed number of transfusions to review. Each institution determines what and how review is done. My hospital is very small. I review everything.

As an inspector I would be satisfied with this for compliance. It's always nice to see the RadSure label but I do not believe that it is required.

Cliff Those systems usually are able to provide printouts of temps; documenting aberrations/alarm checks can be done on-line. Somebody has to review them I would think.

I think missing the antibody screen depends why it was missed? Was it negative this time? Was that an error? If the pt has a hx of an antibody, ag negative rbcs should always be provided (regardless of the absc result). Since the unit was transfused without an ahgxm, without ag typing, Biological Product Deviation report is required.

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.