Mabel Adams

Definitely redos use more products, especially heart valve redos. I think there are some patients on plavix that get more platelets because of that but most that get platelets get them when they are coming off the pump as those above said. We don't have TEG or ROTEM so they just judge by how much oozing they see I think. Ours don't give a ton of products but they still want a couple of red cells in the OR a fair amount.

To the elution question: if the results of the test will never alter the patient's treatment, it is hard to justify having the policy to always do the test, even if the results are academically interesting to understand causes and what is really going on.

Does anyone have experience with the Stago Hemosonics Quantra Hemostasis analyzer? I'd love to know what questions to ask if they demo it.

At the recent AABB meeting San Antonio reported on their program with whole blood out on ambulances and helicopters. When the blood bags come in with the patient to their ED, they are sent to BB so they can be crossmatched after the fact. Here, we keep segments from the units that we provide to our medical transport partner so we can crossmatch those brought to our facility if serological XM is needed or if a reaction occurs. In TX they have two level 1 trauma centers and I think more than one supplier for the units so they have to try to solve it at the receiving site.

I guess you can triangulate the data by checking several record sources but I am not sure that anything, including our own EMR, is perfect. Expired patients are still in our BBIS, we just move their ABID records to the deceased folder for another few years before discarding them. You could certainly mix up two patients who live in your area and share both full names and DOB using something like BillionGraves.

What will you be using for the billing HCPCS code for liquid plasma? I don't see one in the latest CMS reimbursement list that I have.

Well, John, they are having big discussions about cold-stored platelets these days, but I think the reference above was to the first round rather than in the same cooler.

I think they made it so you can run fewer than 11 or 12 dilutions on the Vision now but initially, I didn't want to use up that many reagent cells for every titer because most are less than 8. We would have to notify a perinatologist in another city who consults on all of our antibody patients so we have not switched to gel. Maybe someday. Tube titrations are time-consuming and require technical skills that are getting weaker as fewer of our people have spent years doing tube testing.

The BBIS records should meet US regulations. Our BBIS could print a report of all antibodies if we closed and needed to give that to lawyers. We always do data conversions when we change BBIS vendors. Reviewing old panels and testing records is sometimes informative so we keep them and try to weed out those who have died. Familysearch.org has a records search function that may help. You have to create an account I think, but it is free. They also have a family tree search and usually won't publish a record on someone still living. The people in that tree will have records attached to them, that are probably even correct! They connect with Find-a-Grave and BillionGraves records too.

We supply blood to a helicopter service with a contract with our hospital system. We put Safe-T-Vue indicators on all of their units. They provide us a copy of their in-flight chart when they transfuse anyone not coming to our hospitals. If the patient doesn't come to us but has an account in our HIS, we create a bogus registration in our BBIS using a defined format account number. If they don't exist in our HIS, we create a complete registration manually in our BBIS using a defined format for MR# etc. Then we emergency issue the product in our BBIS and handle it just as we would those patients who expire before a specimen is drawn etc. We charge the helicopter service for the products which they include in their flat fee to the patient. We maintain the final disposition records for any lookbacks etc. If we got a market withdrawal or lookback, we would notify the helicopter company to follow up with the recipient. That duty is at least vaguely covered in our agreement with them, I believe. We tell the helicopter crew to return any unused products to us and not to leave them at the receiving hospital but this isn't perfect. We sometimes transfer products on paper to the receiving site if we can document handling sufficiently. It doesn't work easily if the receiving hospital doesn't use the same blood supplier.

https://www.youtube.com/watch?v=OGeHG_DbCdE&feature=youtu.be&fbclid=IwAR0I-pK1bARk0rtSsti-2axaWveg1efHGpOQxQDejfFgaJqXozTyOfYxRks I hope it is okay to share the link to this video here because I think it helps explain some of the complexity of blood types to patients who may come here with questions.

I once had a patient who did not show the same blood type as his historical record. We had to redraw him and repeat all testing which matched what we had on the sample from earlier that day. As Scott said, we could at least safely transfuse him but later we learned that he was registered under the record of a prior patient with the same name (different DOB) so then we had to separate all of the testing records from the prior patient and clean up the records. Much better than a mistransfusion but still not optimum. Nowadays the habit of asking the patient to verify ID verbally should have caught that before he even got his blood drawn but this was eons ago.

As Malcolm said, it is unfortunate that you were frightened. Because your anti-Coa will react with most of our test cells, you could be subject to panicky medical providers in the future too. (Sorry I implied above that being negative for the Coa antigen is common; Malcolm has stated that much more accurately.) If you are in the US, I would suggest that you contact the lab at any hospital you would likely use and ask to speak with the blood bank section. Provide them with information about your antibodies and ask them to formulate a plan for managing your anti-Coa should you need a transfusion, especially in an emergency. This will save time when they have to repeat your antibody identification workup. If they formulate a plan in advance they can probably keep it in your record in the blood bank so that it will be available when needed. If they are a small hospital, they should be able to discuss the plan with their reference lab or the medical director of their blood supplier to come up with something that works in your locale. These things always work best when blood bankers speak to blood bankers because, frankly, no other medical practitioner is taught all of this information in the detail that we are. My goal for you would be that a plan be created that provides you with the safest transfusion possible when transfusion is life-saving but that you avoid transfusion if possible to prevent you from making any more antibodies to other antigens that you lack. You are welcome to answer this post or message me on this group if you need help with talking to your local blood bankers or understanding what I am suggesting. Best plan of all will be to be too health to ever need a blood transfusion!

If by this you mean that you are negative for the antigens Kpa and Coa then that is of no more importance than if you have blue eyes. Antigens are structures that antibodies recognize and attach to. They could be on the flu virus in a vaccine or on a strep bacteria or on red blood cells. We in blood banking deal with those on red blood cells. Being negative for Kpa and Coa is just a genetic difference in your red blood cells and a very common one at that. If you have made antibodies to these antigens which you lack then that could cause some potential problems with your pregnancies or transfusions but they are manageable. Your children will not have any special risks in their pregnancies because of this.

In your case, all scanning would be correct so the technology won't save you. Thank heavens for phlebs also asking patient to verify ID. I've seen several registration errors that could have had negative downstream effects.