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David Saikin

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Everything posted by David Saikin

  1. David Saikin
    I think that your new tech needs to follow your protocol. You do have a protocol, yes? If you do, then you must have a reason for having it . . . the tech needs to comply. Or - you can do it your new tech's way. By allowing this current process to continue, you are sending conflicting and possibly confusing information to your Medical staff.
  2. David Saikin
    The fetal bleed screen will usually be macroscopically positive on these weak D pts. There is no alternative but to screen for fetal hgb in order to detect fetal-maternal hemmorhage. You could do a weak D test . . . if positive do you give RhIg?
  3. David Saikin
    Why do so many organizations want a "massive transfusion" protocol. I don't have one either, but, since we do immediate spin xm's (for the most part), it seems to satisfy that need.
  4. David Saikin
    We type the same sample twice for possible transfusion candidates if there is no previous history. We toyed with the 2 specimen concept for a few weeks . . . problems we encountered were: ED pt gone somewhere else in the meantime, OR patient drawn preop now in the OR, outpatient now gone home. Yes, there are ways around all of these. I assume that everyone is hot on this wagon due to CAP 35150(?) or JCAHO recommendations . . . Bite my tongue, but, are we drawing extra specs for other lab orders (whose results may also endanger the pt's life)? I'm not talking about a redraw to confirm an unexpected or panic value result.
  5. David Saikin
    Our protocol allows the tubing to be used for up to 4 hrs.
  6. David Saikin
    I keep the panel sheet attached to the workup(s) . . . haven't had the nerve to cull any.
  7. David Saikin
    Just an addendum to my reply months ago (and I should have posted this with that). The BEST Blood Banker I have ever worked with is an MLT. I learned so much from this tech . . . she is the best.
  8. David Saikin
    If you are not going to make cryo, then you can either waste the extra bag or you could use triples instead of quads. I use Terumo bags, but only doubles, since I only do autologous.
  9. David Saikin
    I believe you can continue to use the same cells. The reference is Transfusion, vol 39, no.1, January, 1999. p12. Good Luck
  10. David Saikin
    I believe that I should not have said DAT in the previous response, rather the autoantibody. If it is too strong (>2+), I could not absorb it completely.
  11. David Saikin
    I use it since it is a lot easier. However, if the DAT is stronger than 2+ I find it to be ineffective. Strong DATs require the tried-and-true version. I use the procedure as outlined in a past edition of TRANSFUSION. Sorry, I don't have the reference available at home.
  12. David Saikin
    Yeah, I agree, I like running the auto ct, esp when all my techs are generalists. It saves time over the phone. So far "they" haven't forced me to give it up. I may be going to one of the alternate technologies, so it may pass in the near future too, alas.
  13. David Saikin
    Is gel really worth all this? Is the increased sensitivity so important? Are people switching to gel because of Ortho "scare" tactics? If it is so good, why are some of these comments so lengthy? I know some institutions in my area are concerned because they find "something" in gel, but cannot get it identified . . . are these clinically significant? These are purely rhetorical questions from a non-believer. Don't give me the line that you can look at the work of your off-shift staff.
  14. David Saikin
    Some folks do and some folks don't. It can be helpful when dealing with a recently transfused patient. I'm sure others have opinions on the utility of such.
  15. David Saikin
    Yes . . . and you can do a cryopoor plasma too. First you are going to make your packed cell, with a "soft" spin - (you'll have to figure out the best speed and time for all products). Express the platelet rich plasma into the platelet bag and sever the pc from the quads. "Hard" spin the platelets and express the plasma into one of the quads (remember to leave enough residual plasma on the plt conc) and sever the plt conc bag. You may now freeze and then thaw the plasma to make cryo and a cryopoor plasma product. The Technical Manual should be able to provide more succinct directions.
  16. David Saikin
    We do a clerical check, compare pre and post specimens for evidence of hemolysis, urine dipstick for blood with microscopic if positive, and pre and post DAT.
  17. David Saikin
    Our OR wanted us to perform the same function. My Medical Director adamantly refused. In most places I have assessed, the surgical suite maintains their own tissues - from ordering to storage, complete with records. Only rarely have I seen the blood bank as the repository for such.
  18. David Saikin
    I have been a blood banker over 30 yrs . . . it has never been policy to perform routine DATs on donor units in any facility I have worked at (from 40 beds to 700+). What a waste of resources!
  19. David Saikin
    John - I'm glad you responded. I tried, but could not come up with what sounded good. Nice job. ds
  20. David Saikin
    If the tube is FDA approved for blood bank use, why do extra validation? If you have validated EDTA tubes previously, my feelings are make the switch. It will be difficult to validate all your circumstances, notably +DATs. So, will you not use them for that or what, if you haven't validated that aspect of testing? Valdiation is for something that is totally new, not variations on a theme.
  21. David Saikin
    I concur with everyone that this situation was handled appropriately. Wherever I worked and used a BBID# the policy was - no number, uncrossmatched O's . . . no exceptions. One question I would like to see addressed is "What was the patient ID doing under the bed?" The biggest problem with BB ID bands (and even hospital ID bands) is that they get cut off.
  22. David Saikin
    Most places that I assess/inspect use some type of pump. First off, it must be FDA approved for delivering red cells. The manufacturer provides directions for maintenance. It is usually up to the BME people to configure some type of validation that the product does what it says.
  23. David Saikin
    While we usually perform the testing (absc) on the day of collection, our policy states that it must be performed within 3 days of collection. We may save the specimen for up to 7 days if no transfusions/pregnancy within the past 3 months.
  24. David Saikin
    Our OB docs were very amenable to this change. We gave them the new standard and the AAbb Q&A. The Medical staff made the change in procedure contingent on the approval of the OB's, as it would really only impact that group.
  25. David Saikin
    I would think you would have to give RhIg if you transfused Rh+ plts to a patient of this type.
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