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David Saikin

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Everything posted by David Saikin

  1. 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.
  2. 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.
  3. The most I've ever given postpartum is 7. C section delivery with a great deal of placental manipulation.
  4. 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)
  5. 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.
  6. 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.
  7. 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.
  8. 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).
  9. 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.
  10. That's what I've been doing also. Thanks for the response.
  11. A patient who has been treated w anti-CD38 is no longer having that treatment. Antibody screen is now negative. Is it prudent to continue K typing? Thanks in advance.
  12. No, we did type him as a B and gave him a few B plasmas. However, they wanted blood on the 4th day after admission and that is when we found the unagglutinated cells (which were O Neg).
  13. You change the alarm setting on your refrigerator to alarm just before 2C (2.2 - or whatever you are comfortable with). It doesn't make a difference if you say your refrig never gets to 1C. Even if you have the charts to prove it. If you cannot be warned of an impending out-of-compliance temp you are not in compliance.
  14. I've had scenario a few times in the past. Someone will always come and label an unlabeled tube. I tell them it broke in the centrifute.
  15. Just curious - doesn't your staff have to look at the product they are releasing for transfusion? Did that patient get both of those units or was the 2nd one also given to a O Neg?
  16. We took our old (>20Yrs) ultra centrifuge out of retirement.
  17. I've never saved pickup slips more than a day (have not used one in years). Inventory and blood orders to blood center: never saved Shipping documents/transfers: 10 yrs
  18. years ago my boss got all of us blood bank techs assigned to the same salary scale as the pharmacists (since blood is considered a drug by the FDA). Once again the lab folks were peeved but no one wanted to work in BB. Tertiary care, Very busy.
  19. What do you need to validate? Is it a manual station? Is it a new test system for you? Or just a new workstation?
  20. The inspector should not be uncomfortable w the way you are doing it. It is perfectly acceptable to have KB done in Heme and RhIg distributed by Blood Bank. If for some reason you get cited -it is also acceptable to rebut. I would just say that this is the way it is done. There is no standard that says the BB has to perform or read KBs, just that there has to be a mechanism to determine the dose of RhIg. Would the inspector have a problem if you numerated using flow? That's not usually done in BB either. Never be afraid to stand up for your operation. There are inspectors/assessors who should not be performing those tasks. Worse case scenario is that you would have to comply.
  21. I agree w the consensus. You have to be able to look up patients during a down time event (scheduled or unscheduled). When I had a BBIS we would make backup cards and only update if the original info had changed (+absc, abid,)
  22. You have to change your refrigerator alarm settings to activate at 2.2C (or whatever you choose). It doesn't matter that your refrigerator never gets too cold; if you are going to store reagents (and RhIg) in a BB refrig, it has to be able to alert you when then temp is out of prescribed range.
  23. If you store blood in the coolers when they get to their destination,they cannot be considered transport (if blood stays in them wherever you send them and no matter what your consideration is). This per the FDA. If you are CAP and/or AABB your assessor/inspector should remind you of this.
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