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HN327

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  • Gender
    Male
  • Location
    Chicago
  • Occupation
    MLS - Resource Coordinator

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  1. Same. Everyone who is not bound down is all going travel tech. Even our new hire is looking into it. It just a big gap with how much travel tech are getting, like almost double. Except no insurance and all the perks. So our FTE who are working, seeing travel tech making more than them for the same work are causing this crisis. One of my shift FTE went into travel tech and were getting paid 3.5k per week in Portland. Heard same crisis with travel nursing too.
  2. We perform electronic back up once per day. We also back up a simplify patient data in the last 24 days in an excel sheet once per shift daily. That is kind of scary if you do not have any type of access especially if the patient has a non-reactive antibody. But yeah, before every downtime, we would perform all our back up so that it is current as much as possible and can be access offline from 1-2 designated PC. The excel version is accessible from every PC.
  3. We use the Cobe 2991 as well for IUT. Your setting looks identical to our except we do not differentiate between Wash RBC and IUT Protocol. It was suggested once, but the terumo engineer and our medical director deems it was not necessary. We just use your Program 0 setting for our IUT washing. I think we also have about 100mL saline left over for Red cell washing. The only one that empty the saline bag is washing platelet with it two pre-dilution. How much volume was in your RBC and was 200mL pre-dilution complete? The donut also hold about a max volume of 600mL(I want to say it's more like 630 but I don't have the manual with me) Did you observe your Red Cell detector? Maybe it is stopping the superout too soon thus leaving more volume in the donut and the saline cannot complete fill for each cycle. Is waste line getting kink so it cannot superout? Can't think of anything else that may cause the issue.
  4. For inpatient transfusion, we need a Type&Screen that was performed at least once for the duration of the admission. Does not need to be current. For outpatient transfusion, we use historical Type&Screen with ABO verified on two separate draws. We use the bloodloc system so, as long as the patient has this code on their driver license/ID that matches our LIS, it is valid for transfusion until they lose it. Otherwise, a new T&S is needed.
  5. We keep 4 thawed A plasma at all time for emergent adult population transfusion. We use these for daily transfusion and replenish them with new batch immediately. They are not strictly for emergent need only. There is no limit to the # of plasma. Recently, we had a level 1 gsw and they used over 15+ emergent plasma so we provide as much as needed until they can send us a type&screen. If the patient end up typing as a B, we ask the careteam if they can wait 20-25min for the thawing. If they cannot wait, we will give them the A plasma regardless. Usually, they require more of RBC and can hold off on plasma but there were case that they transfuse B patient with group A. If there is no current sample or blood typing; for us, all emergency plasma dispense require provider to sign an Emergency Release form and return the form whenever possible. We will not stop them for getting plasma if there is no signature and often time we just tube the form along with the plasma. These product does get issue in the LIS for tracking purpose, otherwise it document on the Emergency Release form. The form does need to be sign within the shift or in a 24 hours period. There were case where the provider left and does not come sign the form days later and required our Medical Director intervention. We only need 1 signature and keep track of all emergent product they use. Provider does not have to sign a sheet for every product. We used to require signature on every sheet, and trust me, it require a lot of effort to track the provider down.
  6. We performed weak D testing regardless of the DAT result as long as the Rh control is negative. If the Rh control is positive, we would perform EGA treatment if the mom need Rhogam. Otherwise, we would request for heelstick or result as Rh indeterminate.
  7. Not sure what flying squad is but we have something similar at our hospital We call them Emergency Uncrossmatched RBC and have it located in the ED Trauma Bay and a few Surgical area. These units are stored in a constant temperature monitor system CimScan and also have a door alarm function that alert Blood Bank whenever it is open. RN are require to notified Blood Bank of any product usage and what blood type (O+ vs O=) based on gender. Like O= for female of child bearing age. If we do not receive any call within a few minute, we are require to call the charge RN to check in on the situation. Each of these prepared units have an Emergency Uncrossmatch allocation label along with a transfusion report form to chart the vital and and 2 FDA ply sheet that require the Physician signature acknowledging the risk/need for transfuse outweigh the risk of waiting for a type&screen completion. 1 sheet for patient chart and other sheet send back to Blood Bank for crossmatch later when T&S receive before sending it to medical director review.
  8. It definitely would be convenient to not have to retype. The whole process of receiving, saving and squeezing segment is quite time consuming. I usually do like 4 units per minute before any testing. Our blood bank can go through a hundred units everyday. We do not retype for licensed antigen typing from blood supplier... It was in discussion with our compliance last week that if a CAP/accredited transfusion service perform the typing, we do not necessary to retype during blood transfer. But those transfusion service had to be in our LIS system. While there have been no ABO discrepancy in all the thousands of unit I retype, there has been quite a few Rh discrepancy over the years. Especially for those weak D donor.
  9. Same thing happening in Chicago. We have 7 opening across all 3 shifts since this all started in March in our Blood Bank department for a level 1 trauma center. Other department is overrun too like molecular with all the covid testing and all their opening. Our max FTE is like 24 techs. And if any of our tech is in close contact to anyone with Covid, they cannot come back to work for 2 weeks with no symptom and negative testing. Luckily it only happen to 2-3 tech over the past 3 months. Everyone is really burnt out and we all easily pull like 20-40 hours OT weekly. They literally look like a zombie We manage to get a few temp agency and desperately in need for more but haven't gotten any. Agency contract is ending too and they not extending. Haven't gotten any new hire beside the batch pre-Covid and we are looking at a international one, pending on their work visa approval. And it is so busy everyday due to all the backlog surgery.
  10. We do not perform QC on our panel when they arrive and haven't gotten any issue with the inspection. We keep our expire panel of 10,16 and 20 cells for like 3-6 months to use for those rare rule in/out. Antigen typing is performed on selected cell that we trying to rule in/out for the specific antigen. Recently last year, we decide that panel expired within 1-3 months did not need to be antigen type but it is still a bit of a gray area. When in doubt, just antigen type for your peace of mind.
  11. For our procedure, we would perform a Cold Antibody Screen. If it is panreactive, then the patient is suspect to have a Cold Auto Antibody. We would only give electronic crossmatch. If it is selectively reactive, we would perform a cold panel to identify the cold antibody and give antigen negative for the clinically significant antibody. We used to do immediate spin crossmatch a few years back but it almost always positive due to the cold auto, which would reflex to full crossmatch. Our medical director changed the process.
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