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carolyn swickard

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Everything posted by carolyn swickard

  1. Currently we are just holding on to it. We can't relabel it ourselves for FFP use - not allowed. Our distribution center is not taking them back nor are they testing them. The units apparently belong to the govt agency that organized the whole program. We can choose to use them if our distributor can not supply a High-titer unit (in very short supply), but titer values have not been good in our region, so it wouldn't have a good chance of being a High titer unit with just a random pick from current CCP units (not tested).
  2. I saw a discussion once that said draw it as soon as you can post delivery (ours is at 1 hour) - but that drawing it is more important than the time of the draw. I think I remember that they discussed up to one week post delivery (sort of ridiculous to think about). I have never really seen a maximum time for drawing. Make sure your procedures allow for double checking RH neg mom's with Rh pos babies - make sure L&D has some checkpoints and that your techs have some checkpoints to make sure tubes get drawn and tests get done. Make sure the testing gets done and documented and the
  3. Oh - absolutely - I have enjoyed his help so much.
  4. Since we have both manual procedures and QC and automated procedures and QC, we have left our manual QC with just the recommended "positive" controls. Since the ECHO runs 3 QC reagents and winds up with a "positive" and a "negative" for all of the reagents (usually the same lot numbers in both sets) we thought that was enough. We are FDA and Joint Comm. and they have been happy so far.
  5. To answer the original question - we use "mi" and the computer interprets that as "positive" and we can choose our "weak positive" answer. Works for us. Yes ,we still read the occasional tube under the scope - still in the tube and rolling the tube. Everything else is on the Immucor ECHO - eliminates the problem! Weak DATs on cord bloods are sometimes found - never know how that works out for the infant. Reading Fetal Hgb Screens requires microscopic reading - you never see the positives in the optical aids (convex mirrors). We try to keep it to noticeable agglutination/clump
  6. No - we do not have that procedure and I do not anticipate adding it.
  7. TS- Dithiothreitol -DTT- Treatment of RBCs.pdfThis is our procedure for the HemoBioScience product. it will be open for 30 days only. (I think) Don't worry about thawing it too many times - there is only 2-4 mls in each tube, so it doesn't last for that many pts. We have just thawed ours at room temp. We wrote the procedure using both the HemoBioScience procedureand the one in the AABB Tech Manual. Best of luck
  8. Beyond any shadow of a doubt - personnel will always be the greatest challenge. Not enough, not well enough trained, will they follow the SOPs (in spite of the continuous Competency - truly a pain!), will they show up, will they get along with each other........... Be prepared for that challenge and take advice from a good manager, if you are blessed with one. Always consider that mistakes may stem from a misunderstanding of what is written in the procedure or the procedure might need a tweak to eliminate a "process" problem.. Approach mistakes from the point of view - "Is it a process
  9. I'm sorry - we still just have our employees sign the facesheet of the printed copies of the manuals they are responsible for. Everything is in Policy-Stat for us, but we also still have printed copies for downtimes (and the computer challenged!) - it is just easier than fighting with a computer system.
  10. CCP for covid-19-ccp-considerations-for-clinicians.pdf hope one of these will work for everyone.
  11. There is a recent Covid-19 document on the AABB website for Drs to see the current considerations and protocols for CCP. They recommend Group A or group B plasma for AB Covid-19 patients. Sort of like the use of Group A FFP for trauma pts. Vitalent (formerly United Blood Services) is letting us stock some CCP - it sure helps.
  12. Very nice reference. Nice to see a concise, clear - recent - rework of irradiation recommendations. Thanks.
  13. We have a question that the Drs (and myriad other "orderers") must answer on the RBC and PLTPH orders (Meditech Magic) in order to get Irradiated products. Originally the questions was just "Irradiate? Y/N" and we were happily (naively as it turns out) anticipating the Drs having greater control over their orders and getting it right more often - WHAT A JOKE! Since so many of the Drs do not deal with blood all that often and did not know really what irradiation was or what it was for - there were MANY wrong orders. We soon changed the Question box to also contain a statement "For Immuno-c
  14. I was also thinking about 'why not drop the unit retesting' after all of the donor centers went to computerized donor labeling/retesting and I hadn't seen a labeling error in years (you did use to see a very few go by) and then realized that with so many places going to computerized "compatible unit release" - the retesting done by the receiving facility is the only chance they get to check that the RBCs in the unit do indeed match the label on the bag. Without, at least, an Immediate Spin crossmatch check of the unit vs. the pt - there would be NO other physical check done if unit retesting
  15. We use these too. Sales from Global Sensors - almost too many to make sense of but we use a simple one Log Tag Trix 8. Software updates online - seems to work on Windows 7 at least. If the data logger is at RT - I can set the programming to wait 5 minutes before the 1st reading - that allows it to get to cooler temp. If the data logger is cold - yeah - they take a while to warm up. We store ours at RT, but it would be ok to store them at frig temps if you only use them in coolers. Otherwise you do have to let them equilibrate to RT, if used at that temp.
  16. We have had a Helmer 4 well for years. We ONLY use bottled water (distilled/deionized) and change the water every month (unless there is a messy spill). We use the Helmer Cleanbath product (per instructions) after cleaning the unit and putting in the fresh bottled water. We use the specific bags sold by Helmer for their machine - sort of expensive, but I do not see how anything else would work right. Units thaw in 14-18 minutes and we recently used it to thaw 16 units for plasma exchange and were finished with the thawing within 1 hour. Easy to maintain and keep operating - very stable.
  17. As a smaller hospital with 2-4 MTPs a year anticipated - you might find it easier to go with smaller loads in the rotations. I will try attach our policy. Smaller loads let you respond faster - when you probably do not want to keep this stuff "ready to go" as a Level 1 trauma center has to. You also lose less when they stop the MTP, but you don't hear from them in time to stop thawing the FFP and/or Cryo pool. Massive Transfusion Protocol -MTP- - Blood Bank Procedure - Adult.pdf
  18. The important part being "w/o contrifugation" - don't centrifuge the 37C incubation tubes. Take them to wash without spinning them down or you risk false positives because PEG is so "sticky". Always wash at least 4 times if using cell washers or you risk check cell failure. PEG is a good enhancement medium and it is very sensitive, but it is "sticky". You probably already know this - just emphasizing it for other readers.
  19. Oh bless you - this is what Meditech does. We have to evaluate each "update" that comes along (several per year!!) and see if it affects Blood Bank programming. If it is largely associated with another module of Meditech (Admissions, Billing, etc.) - we can usually ignore it. If it involves the Lab or BBK modules, we have to do the specific testing recommended for the specific "fix", if available. Otherwise we have to figure out our own little testing plan. On top of this, we get the major upgrades every 4-5 years that require the entire module to be retested. The whole revision retest r
  20. I will try here or message me your email and i will send it that way. https://pstat-live-media.s3.amazonaws.com/pdf_cache/policy/5813043/b3d2aae0-704c-4ada-9bd2-dad644dffb48/TS-045 Lookback-Recall- Withdrawal Notifications of Transfusion to Recipients.pdf this will only last for 30 days Been a while since we updated this too, but it has gotten us through these lookbacks/withdrawals for a long time.
  21. We Modify (Meditech) ours the first time for 24 hours (to the minute) as FFP thawed and then - if not used - extend for 3 more days until midnight as Thawed Plasma. That way we never exceed the 5 "days" allowed for the product.
  22. Are you asking about which labels can be placed on the bag and which have to be on the base label?? Some irradiation indicator tags - both Rad-Sure and Rad-Control - have a type of adhesive that can touch the actual bag. Both can go above or below the base label (or at least that is what I have always been told). Most little labels/stickers, like the original Irradiation label in this thread, do not have this type of approved adhesive and are not allowed to be placed directly on the bag. You have to find somewhere to stick it on the base label without covering anything else up.
  23. The really important point is that they enter their data into the computer directly from the test media or instrument printout (in our case). No results from memory or their own interpretation of the results (i.e. "it was an O Pos - I'll just make it an O pos"). That is the real battle.
  24. I forgot - you also have to have a documented training program for all users and establish competency with the irradiator functions and any computer work (relabeling, etc. ) that will need doing on all irradiated units. You have to at least REGISTER with the FDA (if in the USA) because irradiation is considered a manufacturing step and that makes you a producer.... (YEAH!! - such fun)
  25. We have a Best Theratronics Raycell X-Ray Irradiator. We have the paperwork from the technician that installed or repaired the unit - they do extensive testing and verification of the dose delivered. We send a test shot phantom (contract with MD Anderson's Radiation Dosimetry Services (RDS@MDAnderson.org) (713-745-8999) twice a year to document the dose delivered. We would have to have a test shot after any repair too. You would have to have a documented test shot with documentation of the dose delivered to start operating. Every time we get a new lot # of indicator tags, I r
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