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srichar3 last won the day on January 15

srichar3 had the most liked content!

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    Blood Bank Manager

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  1. In the UK the MHRA who are the UK equivalent of the FDA licence all blood facilities and hospital blood banks. One area they are very big on is change control. I just wondered how much the AABB focus on this area as at the moment our laboratory does not have a specific documented process for change control. Thanks
  2. Yes and this is what I've gone with, think its the easiest all round and the way I'm used to working. Thanks
  3. Annual Management Review meeting. Although AABB just refer to it as scheduled management review in the standards, I've only ever know them to be done annually unless AABB expect more frequent?
  4. I wish, if I was I could make it 100 times better than what we have, its been designed by people who have clearly no concept of blood bank.
  5. If AABB accredited is there a minimum expectation from the AABB as to the Blood Bank topics discussed at the AMR? We have our AMR coming up shortly and are also starting our accreditation process with the AABB. I want to ensure we have covered all bases. Thanks
  6. I am working on implementing a new blood bank system which has a very poor Crossmatch/Blood issue process, I'm looking for some examples to give to our IT department as to how other systems manage this process because I think they think I'm wanting something that is top level functionality when I see it as a basic requirement. Please can you give a brief outline of your LIS Crossmatch/Issue processes for me. Thanks
  7. When you say you have them all listed, do you mean you have them listed as individual product codes, I'e the product description but under one main category heading? or you have a category for each class or product. For example a category for packed RBC's with all the possible product's within this description, then a separate category for apheresis RBC's with all the possible products listed under this category, a seperate category for irradiated RBC's with all the possible products listed under this, then a different category for apeheresis irradiated RBC's and so on so forth, rather than just calling them all PRBC's then listing the individual product descriptions under the one category for PRBC's. If you say the Dr's only see the 4 main category's this implies all PRBC's individual codes are listed together under the one main PRBC category? This is the way I'm used to it been. Thanks
  8. I'm in the process of setting up a new LIS for our lab, the current settings in the system have 100's of component categories for example, Packed Red Cell's, Packed Red Cell's Leuko Depleted, Packed Red Cells Irradiated and so on all as individual categories. In the UK we always used to just used to stick to 4 main categories, PRBC, FFP, CRYO, PLT'S and some times Whole Blood if it was ever used. My issue with having lots of different categories is that all of these are presented to the Dr's at the time of ordering and they are unlikely to understand all the different product categories and know which one they should be selecting etc, so my gut instinct is to stick to the major types of product as the specific product type is in the description anyway defined by product code and there is little benefit to each one having its own category. Just curious what the usual setup is in the US? As we are going for AABB accreditation I want to set it up in a way that they would expect to see it. Thanks
  9. In the past we always used to test the second group with just a forward group but when the requirement for 2 samples came out in 2012 most labs changed to doing two full's groups on the first 2 samples, then forward only on any subsequent samples. 4.3.1. ABO grouping. i. A full ABO group comprises a forward group and a reverse group; the forward group should be performed using monoclonal anti-A and anti-B blood grouping reagents, and the reverse group using A1 and B reagent red cells. ii. A full group must be performed on all samples from first time patients, with the exception of neonates, where the reverse group is unlikely to be helpful, as any ABO antibodies are likely to be maternal in origin. iii. Consideration can be given to omitting the reverse group on subsequent samples, where secure, fully interfaced automation is used and a risk assessment has been undertaken to ensure that the forward group is not compromised. The risk assessment should include the possibility that the first sample may have been taken from the wrong patient, an event estimated to occur at a rate of 1:2000 samples (Dzik et al., 2003; Murphy et al., 2004). iv. The following should apply before consideration is given to omitting the reverse group: • There should be no manual intervention or manual editing of results; • The current cell group must be identical with the historical record; • There must be at least one valid historical record where testing included a reverse group. The historical group should have been performed in a fully automated system, in control of the LIMS or analyser, with nomanual edits; however, further aspects of validity should be locally defined, with consideration given to where and when the group was performed and recorded. v. The risks involved with omitting the reverse group decrease with the number of matching historical records. Where there is only one historical record, the first sample could have been taken from the wrong patient, and a grouping anomaly in the subsequent sample could be overlooked without a reverse group, e.g. mixed field reactions (potentially indicating an ABO incompatible transfusion) are sometimes not detected or are misinterpreted.
  10. I think the point is in an emergency situation where you don't have time to either get the second sample or if you have the second sample and have identified a discrepancy then you should use group O until it is resolved. What other option do you have? If it is not an emergency then of cause a third sample would be required to resolve where the error occurred as well as looking at any other patients on the same ward bled at a similar time to see if there are any other patients involved in the mix up. But I agree with your point that it should be all patients that have a second sample, we required 2 samples regardless of their blood groups.
  11. Current UK guidelines stipulate "Unless secure electronic patient identification systems are in place, a second sample should be requested for confirmation of the ABO group of a first time patient prior to transfusion, where this does not impede the delivery of urgent red cells or other components." As per the recommendation only ABO type is required to be repeated, repeat antibody screen is not required. In any case of urgent blood request group O blood is usually used if the 2nd sample is not available. When this recommendation came in in 2012 it did cause a lot of discussions regarding the increased use of group O blood at the time.
  12. When we did plasma exchange and had a single SAHARA we used to have to start thawing overnight to get it ready in advance, they claim 6 bag capacity but in reality I found it was hard to fit 6 in. One site I worked at that was a major trauma center and did heart and lung transplants and ECMO had 2 for this reason.
  13. I have used the Sarstedt SAHARA III for many years and they are very good, with regards to limitations I am not aware of any as such, they use dry heat to thaw the plasma and I don't ever remember one breaking down in the 3 different labs I have used them in. Maintenance is limited to wiping down the unit every week and cleaning out when you get a burst bag but they have a tray in the bottom to catch any leakage, I would take one any day over any water bath options. My current lab has an Helmer, I find it very slow compared to the SAHARA.
  14. Are BPL still going? I gave up on them in the end, so many supply issues over the years, the only real advantage of BPL over the other suppliers was the fact they did a 250iu then they stopped producing that to concentrate on the 500 and 1500's. Plus the fact it was a lot cheaper than the CSL product.
  15. Worth noting not all preparations can be given IV, it depends on the filtration methods used. One of the main suppliers in the UK (BPL) could only be used IM, Rhophylac by CSL Behring can be administered IV.
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