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David Saikin
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Posts posted by David Saikin
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If Lab is not performing this why are you responsible? Get a letter from Admin exculping you from responsibility.
Though I am not conversant w JCAHO in the lab. All they ever do here is ask about transfusions.
- John C. Staley, Ensis01 and simret
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14 minutes ago, jayinsat said:
Hi Malcolm,
What terminology is recommended in these situations? We have always used "least incompatible" in the states. I think, probably, the majority of our databases have that option listed besides "compatible" and "incompatible." What terminology should replace "least incompatible?"
We used and continue to use: INCOMPATIBLE.
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We always felt that least incompatible is like saying someone is a little pregnant . . .
- Yanxia, exlimey, Malcolm Needs and 2 others
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When using Immucor Solid Phase I have Rapid ID, Extend I (all Rh+ cells w 5-6 c neg and e neg cells), Extend II (all Rh neg cells w 1 Rh+)
3% panels: Immucor Panocell (10 cells + 1 rare cell).
Used to use Ortho 0.8% panel A and Panel B
BioRad has 3% and 0.6% panels
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We keep cords and placentas for 7 days post-delivery.
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I take units and place them in the refrigerator. Being an all paper BB, I fill out the paper forms and then compare w the actual units as the processing continues. I never have more than 6u out of the refrig at a time. My temperature study indicated that Leukoreduced rbcs reach 10C within 15 minutes of being out of the refrig so we make certain that they stay cold.
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On 12/23/2021 at 12:37 PM, John C. Staley said:
I'm sure many of you are delighted with Ortho. This is just my opinion on them and their equipment. It all started when the Ortho rep told me that if we didn't become an all Ortho Blood Bank we were extremely stupid. (I am paraphrasing but maintaining the gist of his words.)
Years ago the Ortho rep told me if I didn't buy anything he wasn't coming back. (I had requested prices which were never forthcoming). I told him good bye. Ortho called and told me he was their top salesman. I told them not to send him back.
- AMcCord, Sonya Martinez, Malcolm Needs and 2 others
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On 12/9/2021 at 8:34 AM, Neil Blumberg said:
I know there are some old dogmas that you should keep patients on group O once you've started. No data whatever to support that, practice some data suggesting it's harmful and it's obviously terrible for the supply of group O red cells.
this stems from "the old days" prior to AS rbcs due to the amount of residual plasma in the units. It is a moot point since the additive solution age began as residual plasma is negligble.
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Capture technology?
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i switched from manual tubes to manual gel about 12 years ago. This year I switched from manual gel to automated Capture (ECHO 2.0).
email me (dsaikin@lrhcares.org) or message me on this site.
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How you bill for it is up to you. I have 2 policies: Investigation and Advanced Workup. I've bundled the testing fees into each. Reimbursement is the purview of higher pay grades than mine.
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I am not aware of that also. Youdo have to validate any updates, upgrades, and after non-scheduled downtimes.
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3 hours ago, John C. Staley said:
That was my only experience with the glass as well.
Interestingly, I had an aunt who was a head nurse for quite a number of years in Albany NY. She told me they used to bleed donors into stainless steel bowls and wisk the fibrin out. She said they never had transfusion reactions.
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I got to draw a few in glass but never had to xm any that way (therapeutic phlebotomies).
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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.
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On 10/14/2021 at 9:07 AM, John C. Staley said:
As Joanne mentioned above, no system is fool proof and there are lots of creative, inventive fools to prove it. Keep your system as simple as possible which should minimize the need for creative people to find ways around it. Now to your question, does it actually help prevent problems? Probably a few but certainly not all! I've seen people become lax in their diligence when they assume they are protected by the system. They seem to assume that if they make a mistake someone down the line with catch it. This is something to be avoided if possible. The only way that I know of to prevent this type of mind set from developing is through education and convincing everyone involved in the process that their step is critical and by keeping it simple they will be more likely to perform their step as instructed.
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.
- Ensis01, Arno, John C. Staley and 2 others
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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.
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On 10/1/2021 at 4:33 PM, Malcolm Needs said:
I was thinking the same - and I have seen this scenario.
me too
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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.
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The most I've ever given postpartum is 7. C section delivery with a great deal of placental manipulation.
Reference lab do extra testing?
in Transfusion Services
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If I send an abid to my IRL, no matter what I have done, they do an: ABORh, Absc, Rh Phenotype, DAT, and finally ABID. If I order a titer of a specific antibody they do a type, abid, dat, rh pheno (if not on file), and finally the titer. I did lots of abids and other special tests only performing what the other hospitals wanted and nothing extraneous. If i needed a phenotype or DAT or anything else that completing the testing required, it was done.