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dcharland

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Everything posted by dcharland

  1. dcharland
    What is your promised Turn around Time for KBs? We have begun accepting KBs from outside hospitals who are demnding a 4hour TAT which is just about impossible especially on night shift.
  2. dcharland
    Thank you all for your posts. What I have seen after transfusing these antibody units, is the passively aquired antibody showing up in the patient's next antibody screen. Now the patient's antibody screen is postive, requiring antibody identification, IgG crossmatches, unit antigen typing etc. etc. This is an additional cost to the patient which I struggle with ethically. How do explain this to the patient and the physician? Not to mention the additional workload for the blood bank?
  3. dcharland
    My supplier wants to provide us with donor units from individuals whose plasma contains unexpected anitbodies. I do not want to accept these units. What are other institutions experience with these types of units?
  4. dcharland
    Presently we make 100cc aliquots (in a bag with 2 syringes attached) in a cooler for many of our NICU babies who go to the OR (mostly G.I. type surgery). We have about 75% wastage on these aliquots. The aliquots are returned from the OR unused and expire within 24hours. To reduce wastage we would like to propose to anesthesia that they take a whole unit of blood that has been irradiated and the blood bank will send chatermed syringes along with the unit. If the baby needs blood, anesthesia can spike the unit and draw the aliquot into the Chatermed syringe. If the unit is not used it can be returned and then used for an adult and thus not wasted. Our dilemma is what about labelling the syringes? We cannot count on anethesia labeling if the unit is spiked and we don't want to label an empty syringe. Anybody out there solved this problem?
  5. dcharland
    We use 5 day plasma for all patients (except hemophiliacs). Factor VIII and Factor V are reduced but are still at suffient levels to help maintain hemostasis. See "Serial measurement of clotting factors in thawed plasma stored for 5 days" Katharine A. Downes in Transfusion Volume 41, issue 4, pages 570-570. Published online 4/21/2002. We are a level 1 trauma center. Good Luck!
  6. dcharland
    Thanks for the info, we keep 2 A's and 2 O's and I don't think that is enough. It's so helpful to see what other places are doing.
  7. dcharland
    Do you have AB plasma thawed in case of a Massive transfusion Porotocl being activated?
  8. dcharland
    Anyone out there have a manual washing procedure for 1/2 apheresis platelet? This comes up rarely but more than once for us... Mom has an anti-PLA1 platelet anitbody and donates a platelet for her baby. We need to wash away that antibody before transfusion. We are concerned volume reduction isn't good enough. We use the COBE for washing whole units of rbcs and platelets normally.
  9. dcharland
    Has anyone had experience transfusing an IgA deficient patient with anti-IgA antibodies >1000U (and anti-c) with RBCs? I understand deglycerolized rbcs are first choice and then second choice is washed (X2) RBCs. Is deglycerolizing really necessary?
  10. dcharland
    I would also like a copy of both audits, we are revising ours too!
  11. dcharland
    When we have weak reactions with Panel A and Panel B without a good answer to what the antibody is, we take an immucor panel and make a .8% diltuions of the cells and run that and typically we will get stronger reactions. We don't send out because the ARC in Baltimore uses tubes.
  12. dcharland
    Thanks Shelly, this is exactly how our neonatologists practice, more concerned with donor exposure...
  13. dcharland
    That would be great if you would share your SOP! My email is debra.charland@inova.org
  14. dcharland
    We have a large cardiac surgery program for both adult and pediatric patients. Currently we use blood <7 days old for our pediatrics that go on bypass during surgery. Once the child is out of surgery we drop the < 7day requirement. Also, children on ecmo get <7day old RBCs always. We do not do this for Adult cardiac patients but I'm sure we'll hear about the article from the surgeons soon!
  15. dcharland
    Presently we assign an infant a unit of RBCs, sterile dock with chatermed syringes and take aliquots off the unit until its used up. Is there anyone out there that has a cutoff date for using these units? 2 weeks, 10 days inorder to give these infants fresher units? I am not advocating fresh <7 days old for all infants but isn't it better to give these premie's blood that isn't at the end of it's life? We have had a couple of premie's recently that had problems with potasiums going up after transfusion and one baby the bili shot up after transfusion.
  16. dcharland
    At what age do you allow ABO incompatible Apheresis Single Donor Platelets? Presently we use 10 years as the cut off, all children under 10 must receive ABO compatible, if it's not available we wash(!) the Platelet. We don't want to start concentrating and removing the plasma. However, if someone out there has a procedure could you share it?
  17. dcharland
    We switch to the patients type as soon as we get it. We tried having a second specimen drawn for new patients. And what you said happened to us, nurses were drawing 2 samples and pocketing the second one in case we needed a second blood type. We stopped that process and started using the typenex band system and require just one specimen. As far as switching the patient if the type is RH neg, if it's a male and is actively bleeding we will keep him on O pos until the crisis stops. After that we will go to Rh negative units for the 1-2 unit at a time transfusions.
  18. dcharland
    Can you send me your neonatal protocol too? I would so appreciate it. @debra.charland@inova.org Thanks!
  19. dcharland
    How are others handling CAP TRM43850 "Are methods adequate to ensure removal of almost all of the plasma when washing RBC's?" Dip stick for protien?
  20. dcharland
    How do you all keep up with ecmo baby blood product requests? We are new at this and we had a baby this weekend requiring 120cc's at a time in syringes. Presetnly our syringes expire in 4 hours so we don't make them up ahead of time.
  21. dcharland
    We have a second tech do a "label check" and document (initial) on our sterile docking log sheet that the check was done. The tech checks the aliqout label against the "mother" bag.
  22. dcharland
    We use CPDA1 Group O Rh mactched, leukoreduced, irradiated, cmv-, HBS- RBC's for our NICU < 4 month old babies. We make syringes for each aliquot and irradiate the aliquot. The syringe outdates in 4 hours. We keep the baby on that unit until it expires. We just started ECMO here for our peds patients and the new surgeon doesn't care about the anticoagulant, so we have just started using Adsol for only our open heart babies even if they are the less than 4 months. We hope to eventually switch all the NICU babies to Adsol. We do not use the cord blood to many mislabelled specimens. We draw a bullet for the ABORH, Dat and Antibody screen. Antigen neg units if the Mom has an antibody.
  23. dcharland
    Did you get any responses?I am also interested.
  24. dcharland
    Did you get any benchmarks? I'm looking for the same thing, we are trying to come up with cardiac surgery transfusion criteria.
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