DHarts

If all units are the SAME blood type, you can label with same ABO/Rh. Example: Pooling of 4 A POS platelets, use A POS to label pooled product. The ABO/Rh pooled barcodes are available when units of different ABO and/or different Rh types are pooled. Using one of these "pooled" codes replaces using a separate barcode label for each blood group contained in the pool. Please be aware that the barcode H0 (Pooled ABO, Rh not specified) is only used for Cryoprecipitate. The Intended use for pooled ABO/Rh barcodes is "not specified."

Using pre-printed labels can indeed be complicated and there are many considerations. First you need to consider if the size of your syringes can accommodate a full face label. If so, you will need to order base labels with your supplier name, address, and FDA reg. number. You will also need three identical copies of the DIN barcode. Check to be sure your supplier will be attaching these to the parent units in the quantity you need. If you can limit the number of different product codes that you will be using for neonates, I would focus on ordering only those product codes that you know you always have in inventory. It sounds as if you always have E0311 available. You did not mention if you used an irradiated product for neonates and whether or not you irradiated on site. This will determine the correct product code. E0311 is not an irradiated product, so be sure you have the correct code of the parent unit. Once that is determined you can order product code labels as Mabel described above, A0, B0, Aa, and Ab. If you only use O Negative, then you only need to order one ABO/Rh type label. If not, you will need to order all ABO/Rh types you will be using. You are not required to have a barcoded Expiration Date/Time label so that can be hand written. CMV negative labels are also available. Incidently E0291, mentioned in your post is not an leuko reduced product. Hope this helps. Dawn

Hi Terri, We use 4 random donor platelets as our standard order for adult pools. I am not exactly sure how that was derived but it had something to do with the average platelet concentration per bag. I can tell you that we use Apheresis platelets, random donor pools, and 5 day pre-pooled (bacterial tested) interchangably when platelet transfusion of whole blood platelets are ordered. The Blood Bank uses their discretion which product is issued based on availability. On average, the patients platelet count will be raised by 50-70 thousand by each standard platelet transfusion. Dawn

Does anyone have an update on where ARC is going with ISBT. I just spoke to one supplier today and they claim they still don't know when the conversion to ISBT will take place. Last I knew, they had an AABB variance until January 2009. This date is soon approaching. Will ARC's variance be extended? Dawn

Okay, I will throw my hat in the ring! Has the patient received an Immune globulin injection??? Check the medical record. I have seen this in the past numerous times. Dawn

John, I'm not sure what you mean by "dealing" with CMVN. For ISBT, you can simply scan the CMVN barcode when you enter units into inventory. This will put the CMVN attribute on units as they go in. Be sure however to have both the 1aaaa and the N0008 CMVN barcodes defined in your system. Your digitrax printer may only have the 1aaaa defined depending what version of software you are using. You can add the other if needed. I assume you are placing a CMVN special need on patients who require it as well. Dawn

To cut down use of more common antisera like K, C, E, FYa etc, we use patient serum to screen units if antibody is strong enough to do so. We perform an IgG crossmatch first and only antigen test the crossmatch compatible units. In most cases we can cut the number of units antigen typed by at least half. Dawn

I was first to answer poll!! The truth is, I am not live on ISBT yet. I just help others get ready for ISBT. In a perfect world, I would divide product (changing to "open" code unless sterile docked) making parent unit A0 and each division B0, C0, etc. If I divide a second time, lets say unit A0 is to be divided in syringes, A0 would remain as such as long as it has volume. Each syringe pulled from A0 would then become Aa, Ab, Ac, etc. Most computer systems can not do this in one fell swoop if they can do it at all. Some have to develop work arounds whereas first you modifiy the unit from a 'closed' to an 'open' system, then divide the 'open' code. Other systems are still caught up in appending the DIN instead of creating divisions in the product code. And then there are still others who can not make more than 2 divisions at a time.

Here is the path I think you are looking for: E4519-Deglycerolized RED BLOOD CELLS|None/XX/refg|Open|ResLeu:<5log6 -->>> modification Irradiate -->>> E4521-Deglycerolized RED BLOOD CELLS|None/XX/refg|Open|Irradiated|ResLeu:<5log6 Hope this helps Dawn

Please share the fix to change the default to "V." I would love to change that.

It is my understanding that the Intended use code "0" is not being used in the United States. This has been an issue with HemaTrax for those who use the Stand Alone printer software. The default is "0" and you have to remember to change to V. The ABO/Rh barcode is the same for both non-specified and Volunteer, so either will work.

Most facilites that are interfaced with HemaTrax are using Intended Use "1" Autologous Use Only Biohazardous for Untested Auto units. Although it sounds misleading, wouldn't you consider any tissue or blood specimen biohazardous unless otherwise tested?

By ICCBBA standards, the product code for division does change if going from a "closed" to an "open" system. It only stays the same if using a sterile docking device. In both cases, the division characters would apply.

Does anyone know what the expiration of a Thawed Pooled Cryo unit would be if the frozen pool was prepared in a "closed" system? Open prepreparations would surely expire in 4 hours when thawed. But would that be extended to 6 hours if the Frozen Pooled Cryo was prepared by sterile procedure? ICCBBA defines a code for this product. I can't find a reference for this protocol.

The system I have seen this in is Meditech CS 5.5. Initially the system did not recognize the Intended Use characters. When the client called the vendor, they were able to populate the Donation Types into the system. I don't know if it is done in a DTS that is accessed by the client. However, now that it was "fixed" by Meditech, we are able to scan in Autologous and Directed units that are recognized as such from the bar code. Perhaps this is not a feature of Magic.

You may want to add that you will use a previously drawn hematology specimen ONLY if it follows Transfusion labeling protocol. (Identifiers, time, date, initials, etc)

In the newer versions of Meditech, the Intended Use characters should have been hard coded in the system and default in when you scan the unit. There should not be a need to create separate Meditech codes for Autologous, Directed, etc. If this is not happening in your system then you need to take this up with the vendor. It should have been loaded.

Your naming convention makes the most sense to me. And I whole heartedly agree with building very specific component preps. I'm sure your techs appreciate not having to go seaching for the appropriate code when they sit down at the stand alone to print the label.

Robin, For the Sunquest users that are defining their products with actual E codes, are they having any issues with the system confusing the code with a bar code scan? A previous poster who defined his products by using a leading E claimed he would get an error message when the code was entered but was able to blow through it. Any experience with this? Dawn

I am looking for the United Blood Service FDA Reg #'s. Are there any public copies out there?

Thank you Richard. I hope you have better luck than I getting information. It seems Sunquest has been vague at best as to when and how interfaced label printing will be implemented.

Richard, Interfaced with every system except Misys Blood Bank that is. Any word in the industry when that is going to happen? As user friendly as the Stand Alone is, it will still make re-labeling very cumbersome when blood products are needed in a hurry. Many Misys users are in the process of developing naming conventions for their ISBT bar coded products. Knowing exactly how interfaced printing will work within the application may guide them in how they are naming their codes now. In the current versions of Misys Blood Bank, the actual ISBT product code does not display anywhere in the application. Should users somehow be encoding the actual "E" numbers or will Misys change the way components are displayed?

Today I went to the radiologist office for three different procedures. Each tech asked me the same two questions. What is your last name? What is your birthdate? Oddly enough, there was not a sole looking over their shoulder to verify that they asked these questions. Needless to say, I was impressed. I would like to hear some strategies used in successful campaigns to educate nursing, medical, and phlebotomy staff on the importance of positive patient identification. It is working in some places. Anyone?

I'm not sure how it works in Cerner Classic. In Cerner Millennium you can divide the parent unit into divisions A0 and B0. A0 can have the syringe or pedi volume, and B0 can have the remainder volume. The parent unit now will have a volume of ZERO. The next split(s) will come from B0 to make Ba, Bb, etc.

My understanding is this: Split Products - the new product code would be the same as the original product but with the division characters appended, A0, B0, etc. Returns - If you return a product (ship out of inventory), your computer system should allow you to bring back in with current avalible status. I don't see why ISBT units would be any different than codabar in this case. Apheresis Units - Each bag will have a unique product code and should be defined in Cerner as such. Not to be confused with divided (split) products which will contain the division codes.