[BloodBankTalk: Correct Blood Bank Nomenclature]

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[BloodBankTalk: Correct Blood Bank Nomenclature]

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[Unit Labels]

Do y'all use any particular brand of adhesive labels, specifically 4x4 ISBTs, that manage to survive through the "sweat"/condensation of temp. fluctuations?

It seems the labels we currently use have problems properly sticking to our RBC products when it comes to moisture (especially during the summertime). Wiping with gauze or a towel doesn't seem to completely solve the problem.

Interestingly enough, it seems the units we order from the Red Cross have labels that stick fairly well, and even hold on to additional modification labels placed over the existing labels.

Or, is this basically one of those seemingly meaningless, yet daunting, problems that don't have a fix?

[labeling units with historical antigen typing]

Antigens confirmed using licensed anti-sera are printed on the unit label. Any additional tested with unlicensed sera come with a separate tie tag that lists the more uncommon antigens that may have possibly been tested. Any historical donor antigen neg. also get a different tag, but normally we still confirm. antigen type for the ones we need.

[Solid Phase Dependent Antibodies]

I've seen a similar issue with gel, in that you have sprinkled agglutination within the two-cell screen that ends up resulting negative later on with tube. The lab has been attributing these weak pos in gel to be of little significance until proven positive in a tube two-cell screen. Judging by the comments on this thread, that thinking seems problematic .

We currently do not have gel wells to test specific antibodies, although I know C,E,K gel cards exist and perhaps will be used in the future. Before we came up with the sequential tube testing, some samples would get an initial panel (based on tech discretion). Sometimes a 0+, 1+ screen would result in a specific allo on an 11-cell panel, and sometimes it would all be negative.

Interesting reads here.

[High Risk transfusion form]

To answer simply, option #3. However, normally we have documentation filled out to express the intentional deviation from procedure that denotes it was per MD approval. These sort of things end up becoming a larger discussion between the transfusion medicine doctors and the pt care team, and then the lab is notified one way or the other. If the MD selects specific products to use, those products and Unit Numbers are also documented.

[Blood unit retypes]

Just from a safety standpoint, receiving products transported from an outside facility should be retyped, regardless if that outside facility is in your "network."

For example, even if a historical donor donating at a regular frequency gives red blood cells directly to Hospital B, the unit itself is still retyped at that given point and before transfusion.

[2nd ABO]

At my clinic, in cases where the first drawn tube on a no hx patient was not properly electronically collected, then a second sample is required. We use Sunquest and Collection Manager to track that. Oftentimes, the nurses and phlebs tend to argue why a second sample is needed, so they don't really know ahead of time to draw two tubes and stealthily send the second tube later.

I'm not sure the workflow of the phlebs and their side of the software and whether they ID the patient at the time of electronic entry and draw. However, when you cannot verify confidently that a sample was collected and verified by a tech at the time of draw, a second sample is ordered and sent at a later time.

[Non cellular component transfusion and historical ABO/Rh]

4 hours ago, SMILLER said:

Of course.  There is no link between a previous admission and a current one that is reliable enough to allow for transfusion of any product without at least confirming the ABO/Rh.  We have even had a few patients who have been admitted with a friend or relative's ID in order to piggy-back on insurance!

Scott

How often does this issue come up, and do you only recognize it when the typing is discrepant?

[Non cellular component transfusion and historical ABO/Rh]

Non-RBC products can rely on a historical type on file.

If there isn't a type on file, that's when you would require an indated specimen to test for issue (otherwise you would have to consider emergency releasing).

[Red Cell Storage Position]

Do racks even exist that allow units to be laid flat? Without any sort of holder, I feel like they could easily slide off each other, off shelves, and rub condensation onto other labels; overall make it fairly difficult to leaf through.

[Communication between shifts]

A log sheet is the most simplistic form of cross-communication that is fairly effective as long as all staff participate. Where I'm at, anything that takes longer than a sentence to verbally explain is usually followed up by someone saying: "write it on the shift report."

It really only has to be in a box/table format, nothing outlandish. Can include spots for bleeders, expiring products, inventory, special instructions, etc.