REN_NH

Does anyone use the Optix Gel card reader with their Ortho Workstation? If so, what are the pros and cons?

Years ago we had a transplant team come from a larger hospital to harvest from a brain dead donor. We were 4 hours away from them and 3 hours away from ARC. As the sole overnight Lab worker in a rural hospital, I had to give many units to keep his organs alive, which included STAT taxi's, etc. The transplant team said to me "tell the Lab they are doing great". I said "consider it done, I am the only one here". It was the worst night shift, Blood Bank-wise I have ever had in my 32 years due to it being all on paper then. I would expect that the Transplant procurement team could bring their own box of blood along with their ECHMO -like device nowadays. Isn't the "patient" now in their hands once considered a donor? This should be reviewed by some committee along with AABB, etc., and regulations made to absolve the hospitals of any liability.

I did come across one article where the author recommended changing guidelines for the use of Lactated Ringers in transfusion but only in times of "Rapid Infusion" such as during trauma. I would suspect there would be too many clots in the tubing otherwise. I would imagine there needs to be much more study on this with specific guidelines created. I work in a small hospital and like that it is black and white to NOT use the Lactate Ringers. With the Blood Bank being responsible for all transfusions, I wouldn't want to be a part of a situation where someone used a solution when it was not indicated that resulted in a bad outcome. I'll embrace change when the Circular says otherwise What articles has the OR read and offered? Is the surgeon previously military? Just wondering where they saw that Lactated Ringers has been used....

The triangle file is the same thing. We just called it the "file" but I needed to make it more clear for the post. My father-in-law had the same tool when we cleaned out his garage and it brought back memories. I worked with a woman old enough to have performed pregnancy tests using frogs and you guessed it... rabbits! She was my partner on weekends, she the Lab elder and me the Lab baby. It was awesome to hear her stories!

We used a "Machinist File" to cut glass crit tubes back in the day for baby Bilis. You can get them for less than $10 at Grangier or other suppliers.

Does anyone have EMR ID's for the new cold stored platelets to build the product in Meditech? I have sent a task to Meditech and am getting ghosted when asking for an update on this. Surely we are not the first to build this product in BBK?

Found this conclusion statement online from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016247/ Chemical and Microbiological Changes of Expired Platelet Concentrate Chemical and Microbiological Changes of Expired Platelet Concentrate Nora Y Hakami, 1 Abdulrahman M Al-Ahdal, 1 , 2 Afnan J Al-Sulami, 3 Httan M Alabbadi, 3 Mamdouh M Sindi, 4 Kholoud A Gholam, 3 Maiman M Bayuomi, 3 and Talal Qadah 1 Author information Article notes Copyright and License information PMC Disclaimer "Platelet concentrate, among other blood components, is considered an inventory management challenge due to its short shelf life. This study showed that extending platelet concentrate storage is possible for up to seven days without any chemical or microbial changes. Extending storage time for platelet concentrate will save money, increase availability, and save more patients. Further studies are required to evaluate platelet function during expiry time and to assess the stability of platelet morphology and function. It is recommended that platelet concentrate storage time be extended to day seven after obtaining approval from the medical director in case of shortages or high demands. However, further studies must confirm these findings and determine the most effective strategies for improving platelet concentrate quality. Additionally, it would be ideal to investigate the clinical implications of these findings."

Women's Services has the patient sign a "Consent for the Administration of Blood Products" upon admission and this covers the RhoGAM as well.

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We are using this workstation also. I was not aware of a new one. I use a similar setup, but with an infrared probe/gun wire, to perform verifications every 6 months (operator's manual says "as needed"). Other than that it is just the daily green light check for temp.

We document that the light is indeed green, indicating that the factory set temperature is OK, on our Daily Temperatures and Checks form as a check mark each day for the "MTS Incubator Status Light Green?". We also check the RPM's daily and record on the same form.

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Does anyone have a flowchart for the workup of cold-reactive antibodies? I'm a Generalist using GEL BT, and GEL anti-IgG with tube IS XM and feedback on this is much appreciated as I am also working on updating policies.

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Do you mean you have a "Manual" called Job Aides that you upload the PDFs in or is it elsewhere in MediaLab?

Resurrecting this thread to ask what document control systems are being used out there? I would love to scan in many items to store electronically (i.e. temperature charts, etc.). Are people scanning to a facilities specific drive or something else? We use MediaLab for policies and competency assessments.

Luckily we have already been using the new workstations when I came across this. I had kept the incubator portion only of the older model like yours for back-up, and went back to using our smaller footprint, yet old, tube incubator block (can't imagine that relic is cleared either!). Once I saw that the old station was no longer FDA cleared, etc., I ordered a new tube incubator block. I am very curious to see if the old incubator can still be used (would love to still keep as back-up) since we always check and document the temperature.

In our 25 bed critical access hospital, uncrossmatched blood orders are always verbal to the Blood Bank and all LIS entries are made by the Blood Bank Tech thereafter. If the patient is registered (true name or John Doe), we perform the Emergency Release Routine in Meditech (otherwise we resort to paper back up procedures). This routine assigns the unit to the patient, and allows us to choose whether or not to add to a specimen in use or create a new specimen order. This same screen documents the issue of the unit to the patient. An Issue/Transfusion card prints and is attached to the unit. A Practitioner's request for uncrossmatched blood form is filled out. The unit is delivered to the care area by the Tech but not handed to the nurse until a provider signs the request form. A nurse can sign but the provider must countersign when time permits. This form is immediately brought back to the Lab and additional units can be added to it need be. The completed form, after review, is scanned into the EMR. The form has space for communicating any antibody history or other special transfusion requirements.

Thank you all for your kind responses! Does anyone use Blood Warmers any more for cold agglutinins or is that reserved for MTP and pediatric transfusion to minimize hypothermia? We do retype our donor units and perform a second type on our patients, but as a workup for this specific case, I think repeating again to remove all doubt would be a good idea, especially since it may not have been the same tech performing the original testing as for the crossmatching. We use Meditech and have the capability to say "Least Incompatible" as a work around for the common not clinically significant cold Ab's. I would just have to include the specifics in our policy. We also do saline replacement. We are a small Critical Access hospital with the nearest ARC Reference Lab 3 hours away but I think the mini cold screen may be doable for us Generalists. Happy Holidays!

Let's assume all units are reacting the same way due to a cold antibody. What needs to be done to deem the units ABO type compatible?

If a patient's Immediate Spin Crossmatch is weakly positive (tube method), and the Antibody Screen and IgG Crossmatch (GEL) are negative, what is the next step to prove Blood Type compatibility? Advancing to pre-warmed method seems a waste of time since the GEL Crossmatch is already negative.