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David Saikin
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Posts posted by David Saikin
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I keep the panel sheet attached to the workup(s) . . . haven't had the nerve to cull any.
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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.
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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.
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I believe you can continue to use the same cells. The reference is Transfusion, vol 39, no.1, January, 1999. p12.
Good Luck
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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!
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John - I'm glad you responded. I tried, but could not come up with what sounded good. Nice job.
ds
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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.
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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.
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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.
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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.
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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.
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I would think you would have to give RhIg if you transfused Rh+ plts to a patient of this type.
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Of our routine reagents, we also only test anti-D with pos and neg cells. The ABO sera and cells are only tested for reactivity. Ag typing sera are tested vs pos (heterozygous hopefully) and neg cells each day of use. I have this standard marked as vague for my upcoming CAP event.
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We have a white board, but more to the point, the techs pass info back and forth as we have a 2 hr overlap of shifts.
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The DataCyte panel is produced in Switzerland, I believe. I use it. It has an interesting antigen configuration, but is a helpful adjunct to my Immucor panel. Olympus distributes it.
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We give leuko's to everyone. Do you all feel that they are considered CMV negative? I've seen other opinions.
Changing blood infusion tubing/filters
in Transfusion Services
Posted
Our protocol allows the tubing to be used for up to 4 hrs.