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May 2024 Challenge

estiner

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Everything posted by estiner

  1. estiner
    Drop the 30min rule and go simply by temperature guidelines (current best practice)
  2. estiner
    Yes, if used for patient testing, timers should be checked according to facility defined schedule. AABB Std. 3.5.
  3. estiner
    We do not allow such orders - we leave that responsibility up to the physician or the nurse.
  4. estiner
    I agree with Mary - it is the last chance to catch a serious error... I would not be comfortable with a non-tech doing this important task.
  5. estiner
    We type a second specimen from a different venipuncture or else give type 0 red cells if there is no historical blood type. We have been doing this for about 18 months and it works well - generally the only patients who cannot be redrawn are the pre-admits. We even redraw the ED patients if we cannot find a hematology specimen from a different venipuncture.
  6. estiner
    My Pharmacy also directed me not to send any immunoglobulin in the pneumatic tube system because it is listed on their nationally published list of unacceptable products to be sent in pneumatic tube systems. I would check on this very carefully if you do.
  7. estiner
    Add the courier fee to the product cost - you will end up with two products - or if you always incur a stat courier, then just one product will do. For example: PLTP is our code for a regular plateletpheresis, PLTPS is our code for one with a stat courier, PPLRIR is our code for irradiated but it includes the irradiation charge and the courier charge because we always have to get it from our supplier who is an hour away. The P codes will be the same for both but the charges will be different.
  8. estiner
    Has some regulation changed? ISBT told me that I can thaw FFP or FP24 and use within 24 hours without relabeling - only crossing out the expiration and writing in the new 24hr expiration date and time. Now, if I change to THAWED PLASMA, then I would have to relabel the unit.
  9. estiner
    Standard dose of Rhogam is 300 microgram which is 1500 I.U. We give this at 28 weeks and again post partum. And we have not seen any HDN indicated as a result.
  10. estiner
    Our ThermoSafe coolers use 3 frozen coolants and two refrigerated cool packs. They keep the temperature under 6 degrees for up to 8 hours.
  11. estiner
    Check AABB for crosswalk between the two checklists.
  12. estiner
    I am interested in the question about platelets - do you send platelets in the pneumatic tube as well? PFA specimens cannot be sent due to damage to the platelets so just curious.
  13. estiner
    Helmer are by far the best!!!! I have not had any luck with Revco, Puffer Hubbard or Jewett in the past 5-8 years.
  14. estiner
    To confirm the reactions could be due to interference with solid phase technology, we perform a major crossmatch with patient sera and unit - since there is no stroma in the well for crossmatches, any interference would not occur - so if crossmatch is compatible on the ECHO, screen is negative in LISS, then we report suspected interference.
  15. estiner
    Have you ever done a study to see if 20 min is adequate to make sure the unit does not reach the limit of 10 degrees? We did and were quite surprised how short of time a unit straight from the refrigerator took to get to 10 degrees.
  16. estiner

    Galelio-immucore

    estiner replied to amalki's topic in Equipment

    We have the ECHO and it is wonderful!! Very little downtime, faster than ProVue, smaller than the Tango, and very user friendly. We like it much better than manual gel which we used before. Immucor gives great support - much more so than what we got from Ortho.
  17. estiner
    According to FDA the temperature of the blood is the critical piece of information - not the time it has been out of the controlled temperature - for the blood to be acceptable back into inventory. The old rule of 30 minutes no longer applies - it now depends on whether the temperature has reached 10 degrees or not. If it reaches 10 degrees, then it cannot be put back into the regular inventory but it can still be transfused within the 4hr limit beginning with the initial issue. We quarantine the unit until nursing can use it and then discard if they cannot meet the 4hr limit. To decrease temperature problems, we insist that nursing take vitals before coming to get unit.
  18. estiner
    We do charge - it is our policy to do a second type if the patient has no history. We too use other specimens from a different venipuncture if available or else we issue only type 0 red cells or AB FFP.
  19. estiner
    Check the guidelines from the OB/GYN organization. The last time I checked, the antibody screen should be done within 7 days of the injection for the 28 dose.
  20. estiner
    We had lots of problems with the Sorvall cell washer and went with Helmer this time - absolutely love it with NO PROBLEMS!!
  21. estiner
    We place an armband on the patient for the pre-transfusion sample to be drawn and then it is removed and placed on the chart - It it verified and reattached at the time of admission. No additional sample is drawn unless the current armband does not match the sample information. This system works very well for us. Previously when we would send the patient home with an armband, it would not come back or if it did, it was not readable for our POCT testing instruments.
  22. estiner
    We do not specify a time - just take the temperature of the unit. Then our policy lfollows the one described by AMcCord. Less than 10 degrees and it is returned to inventory, greater than 10 degrees it is quarantined but can still be transfused within the 4-hr limit if possible. If not, then it is discarded. The 30-min rule does not assure that "all components have been maintained at the appropriate temperature" STD 5.18.3 (2). In Florida it takes about 15-17 minutes for a unit to reach 10 degrees - the limit by FDA.
  23. estiner
    We just had two horrendous weeks of using Selectogen Lot VS280 where we had 8 workups that turned out to be nonspecific junk (nonspecific <1+ reactions). When I called Ortho, they suggested doing a DAT on the screening cells to rule out contamination - both cells were negative. Then they admitted that they had several calls about cell #1 on that particular lot. Some but not all of our workups involved cell #1. When we got in the new lot VS284, suddenly the workups stopped because we were no longer getting the junk. The new formulated cells from Ortho have been a nightmare - trying to figure out if you have a true antibody or not. The Tango may be a good alternative.
  24. estiner
    I just checked with the AABB accreditation department and was referred to Std. 5.1.8A #25 which states that the expiration for thawed pooled cryoprecipitate is 4hrs. I even questioned the answer in reference to ambiguous statements on pages 202, 287 and a conflicting statement on page 294 of the 16th edition of Technical Manual. I was told that since the Technical Manual is guidance, the Standards rule.
  25. estiner
    To Donna - I just checked with both CAP and AABB accreditation departments and both agreed that the surveys for Elutions and Antibody Titers are not required but are available to fulfill the requirement that these procedures be assessed every 6 months. A much cheaper way is to use check cells to perform the elution procedure and repeat the titer with a second tech.
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