SusanM

Do any of these (or is there somewhere else) give actual benchmarks? Like we expect to a rate of 1%, etc... Expected values vs. over/under reporting? Thanks!

We have a couple Clay Adams that are antiques, but still work great! :-) When we had to purchase new, we got the Helmer Heittech models and have had no real issues with them.

as long as the Smith band stayed on the patient, the tube is labeled Smith and the blood would be tagged with Smith, you can call the patient anything you want. It is similar to banding a "Doe" patient. I would have used it (provided the original band was still there). We always call the RN and attempt to explain the situation... and generally the band is removed by some "helpful" person so the crossmatch is then repeated with the current band.... but we try...

We use the same guidelines for allo, auto, directed. It's easier to have one set of rules & if you "shortcut" based on the autologous status of the unit, you are assuming there were no lableling errors... probably slim chance, but possible...

The way i understood it, BioRad actually owns the gel patent. BioRad's contracts with Ortho will or already have expired and since BioRad aquired BioTest, they are not going to allow a competing company (Ortho) sell "their" products... Nevermind, i see too late that it was already better explained above!

We also only use Leukoreduced O neg RBC. They are only washed & irradiated for exchange transfusions.

Love it, Malcolm!

We've been using Bio-Rad (Biotest) ABO/Rh for a while. It is just fine compared to the others (Ortho/Immucor). We're in the process of setting up our new Tango. Slowly, i am switching everything to them, save the few gel things we'll have to get from Ortho (for now, i assume those will come from Bio-Rad eventually, too). We will be doing gel as back-up. The prices are better and the reps (actually eveyone i have met associated to the company) are wonderful.

Pharmacy handles albumin, IVIG, and all factors!!! :-) Was such a relief to hand that (the factors) off... Last i heard our docs wanted Factor VII here, but i don't know if they ever got their way... BB does do the RhIG. S.

Just wondering: If the manufacturer has a process, why would it not be recommended? On the flip side, why would the manufacturer then tell you not to use it 'routinely'? (What constitutes 'routinely'?) I have wondered this same thing (converting from 0.8 to 3), but we have just kept a set of 3% around for the Anti-Gel's. Daily diluting of screen cells was never an option-- too busy. There are also some people that are Anti-Ortho's-- they don't react in gel when using Immucor (diluted) cells... There's always somebody who doesn't like something!

not being a hematologist so i don't really know, but i always assumed CBC was "complete blood count"

We occasionally receive units with other antibodies, as was stated earlier the majority are anti D or C,D. We do not wash them. We do try not to use them on 'repeat customers' as we have had cases where the antibody can then be detected in the recipient. But we have not had any other problems in giving them.

Our cords are tested on the day shift, so they are done the day after delivery if it's after noon and the specimen from mom is then collected later that day or the next AM with other labs (depending on how big a hurry she is to leave or how early we get them done). I can't imagine the screams (from both techs and the floors) if we attempted to type baby and get mom drawn as soon as 1 hour after birth!

Too true... and that guy retired. Now i've got a fresh young quiet one (and i'm not that old, if i do say so myself...) whose toes i'm trying to not crush, or at least only slightly mash.

Thanks for the replies... the 'problem' i have is with an outpatient MFM clinic that does amnios... they've been storing and dispensing their own RhIG and now we are 'taking it over' for them. We require a blood draw for all RhIG orders and add testing as needed. (An Rh-if not already done during that admission, a screen-if not rec'd previous RhIG last 4 months, and a fetal screen-if >24 weeks gestation) THe MFM clinic thinks all that is unnecessary and we are looking to increase revenue. I haven't found anyone that dispenses RhIG with out some kind of testing, although i can't find specific rules of what MUST be done, other than CAP's requirement of a fetal screen after delivery. I think what we do is a good system and should be done that way.

We are looking at updating procedures for administering RhIG... and i am interested in other's perceptions of how things must be done. Some general questions are listed below, but a general explanation works as well. Do you require a blood specimen for ALL RhIG work-ups? Do you require any testing on any/all RhIG recipients? (aside from the well known FCS after delivery... but what about in other situations-- like for early pg bleeding or amnios or the standard 28 week dose...) Do you accept historical test results for Rh/antibody screen for determination if patient requires RhIG? Who is responsible for keeping/monitoring the use of RhIG? Do you have different procedures for inpatient/outpatients? Thanks in advance... Susan

Our reactions were both gasping for air and chills. One became cyanotic. I totally agree that information SHOULD be on the package insert. No one should have to learn it "the hard way"!

When we had the reactions, it was because the RN gave all doses (i think 6 and 10) at once IV. The manufacturer determined that it was too much at once and we now issue only 1 syringe at a time and if multiple doses are needed they are issued no less than 2 hours apart. They can be given either IV or IM. Since doing it this way, no problems.

We have not had any issues since implementing the manufacturer's recommendation that we issue multiple vials 2 hours apart. I have not seen any other documentation on this.

What do you use for baby platelets? Random or pheresis? How much do you transfuse and what size hospital? Thanks!

I apologize if this has been discussed before, i didn't have time to read through a lot of stuff.... How do people deal with platelets and infants??? I am referring to the CAP TRM.40740 Is there a policy to limit the administration of ABO-incompatible donor plasma in platelets given to infants? The note goes on to suggest removing the plasma and resuspending them in saline or albumin. In an ideal world, we would use ABO specific random platelets. We are the only hospital that uses randoms from our supplier, so they don't always have the right group available. We went to asking them to 'wash' nongroup specific, but have met with some serious resistance to doing that. I don't think it's a good product anyway.... Is anyone willing to share their experiences? Susan

We QC the Diluent 2 daily, making a 0.8% suspension of DAT pos and DAT neg cells. We only QC poly and anti-comp when used, and for the anti-comp we have complement control cells. Susan

We have been using it and did have 2 incidents where moms had a large bleed during delivery and we had to issue multiple doses and they had reactions to Rhophylac. With all other products we had no problems issuing multiple doses at the same time... After reporting back to ZLB, it was determined that if multiple doses are need, each vial must be issued 2 hours apart. Susan

We were told the same... that when the bubble is gone it is merely a case of "aggresive pippetting" and the tech should try to back off a bit. Susan

Me, too please... {removed by admin} Thanks! Susan