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Mabel Adams

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Mabel Adams last won the day on June 14

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About Mabel Adams

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    Seasoned poster
  • Birthday April 23

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  • Interests
    Gardening, miniatures, crafts
  • Biography
    An Oregonian that lived in Idaho for 25 years. Got my SBB in 1998. Moved back to Oregon in 2008.
  • Location
    Bend OR
  • Occupation
    Blood Bank Supervisor
  • Real Name
    Mabel Adams

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  1. Can you keep a thermometer on it to make sure proper temperature is maintained? Or validate that it is in range? Those old serology/RPR rockers used to have a motor that got hot in the middle so we had to put a rack on it to keep the platelets away from the motor (this was probably 30+ years ago).
  2. That's what we do with age 50 for women. A bit of confusion now with extended gender choices in Epic but we haven't got a way to identify MTF trans patients adequately. We don't change to type specific (other than matching Rh) until we have crossmatched blood but that is because of the fear that they will think uncrossmatched is always universal donor so don't think they need to check ID when they hang it. I keep hearing people express that thought. "What, you need patient ID for me to pick up blood in a massive transfusion?!?" "Yes, this is crossmatched blood." This is on a day when we had multiple MTPs underway. KISS principle here. Some exceptions include a young female A neg when we have used all of the O neg units.
  3. We don't worry about Hgb S in neonates except for exchange transfusions for which we request it. I've heard the same about the LR filters but don't have true evidence.
  4. I'm reactivating this topic because it has come up again. The AABB Guidelines quoted above are over 15 years old and the only reference in them that says not to use for platelets is to a specific blood warmer's operation manual. Does anyone know of any studies with modern rapid infusers like Belmont RI-2 and Level 1 regarding infusion of platelets and cryo? It seems like they should be safe and it really helps with the workflow to use them but we need evidence.
  5. Some of the success of WB may be due to the reduction in crystalloid rather than the whole blood itself. I look forward to more good studies being published.
  6. We are on Epic and that is one of the reasons that we have continued to use a separate blood bank banding system. Outpatient transfusions cause the same problems. Beyond that it matters greatly whether you have good institutional compliance with the electronic Epic ID scanning for inpatients. We also draw a second blood type confirmation tube on new patients. For small children we may just give them group O blood the first time but that is a quite rare event for us which would be quite common for you.
  7. We test any sample that meets the manufacturer's specimen requirements and ours are more than 24 hours. We even validated citrate tubes so we could use them for blood types. I'm comfortable with getting a second draw on only non-O patients because we also have a BB banding system and an electronic patient ID system. The problem is the rogue humans who decide to make end runs around the systems but with belts and suspenders and duct tape, I feel pretty confident. We are also lucky in that we do the prenatal testing for most of our OB patients. That's a point to consider in making the determination of how many specimens you will have to collect.
  8. And Admissions sometimes selects the wrong patient's record to admit--usually someone with the same name. You would hope that we have enough checks to catch this pretty quickly these days, but strange things happen.
  9. We have a pancreatic cancer patient who swears he has never been transfused and doesn't appear to have had major surgeries that require transfusion but who has an anti-Fyb. No evidence of a source of passive antibodies. Negative antibody screen elsewhere in recent months. Are there reports of naturally occurring anti-Fyb?
  10. Remember that the impact can be affected by A and B substance present in patients and donors. Of course, that also means more immune complexes formed.
  11. So you could pull off an aliquot of "packed cells" from it?
  12. We are doing pre-treatment antibody screens and sending out for full molecular typing. We started this before we were doing DTT treatment in house. We serologically K type them if we need to give blood before the molecular typing results are back. Now I am not so sure that the full typing is justified. It seems to us that those who need transfusion whilst on the drug often don't stay on the drug long-term. As mentioned above the majority of patients on it don't require transfusion. I'm not going to change policies right away but am interested in others' experience.
  13. I am revising our procedure for HLA-Matched platelets and reviewing literature so we can have an evidence-based policy. If you are a hospital without its own HLA lab, what approach do you take? Do you start with HLA antibody testing and give units compatible with the antibodies found and only HLA type the patient if they have a high percent reactive (PRA) or do you always start with HLA typing the patient? When do you order HPA antibody testing? Do you know of evidence to support your approach? It might also be helpful to know if you are across town from your HLA Lab and blood supplier or more remote. Thanks for any input.
  14. How do keep physicians engaged in your committees?
  15. I found this article fascinating.
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