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cswickard last won the day on May 17

cswickard had the most liked content!

About cswickard

  • Rank
    Seasoned poster
  • Birthday 04/17/1953

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  • Location
    Las Cruces,NM
  • Occupation
    Transfusion Service Supervisor

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  1. cswickard

    Suspected Transfusion Reactions

    Fantastic list - now all they need is TACO (Transfusion Related Circulatory Overload) and it's differential diagnosis from TRALI and they are set to go with current recommendations. Seems like there is an increased interest in TACO with regulatory agencies lately.
  2. Interesting idea to try to get the form electronically. We have fought for years to try and get the Admissions folks to get the patient into the computer in a timely manner so the whole hospital has access to pt. information and computer ordering. As we try and transition to a Level 4 trauma center (yes - I know - why bother? We already stabilize and ship), there have been improvements. But we just discovered we still - even if the pt. is in the computer - have problems getting the name in the Lab if we are not receiving orders. We currently have a handwritten Emergency release form - it might help us to have that changed to an electronic form so we get the order, the pt. name and the ordering Dr. - all at the same time. All Blood Bank orders could be entered there to keep the encounter together. For our MTP - the Blood Bank is doing all of the ordering, but an electronic order to start it might help us there too. We are currently counting on a verbal order, followed by the handwritten Emergency release form. We are currently starting our MTPs with 2 units O Neg, uncrossmatched RBCs and have had 2 encounters decline additional units after receiving only those 2 units. (Not complaining - just noting a trend!) Given the problems we are having getting the ER Drs to order Blood Bank correctly - I really don't know if adding even more orders for them to think about will help though. Thanks for the information.
  3. cswickard

    DTT for DARA - help!! :)

    DTT SOP.pdf This procedure is based on the HemoBioscience SOP and the AABB SOP. Works for us. Prior threads on this topic have indicated that the DTT treated cells will not last long, so we do this only at need.
  4. cswickard

    Gold Medal.

    You should be excited - a well deserved honor. Congratulations and well wishes from across the pond.
  5. Try the Blood Type setting for Emergency Issue Units prompts. It says you can define products, etc. We don't have ours set up that way, but will need to consider it for MTP/ Trauma.
  6. cswickard

    0.8 Surgiscreen, vial # 2 reactions

    Very interesting post - especially given that we are having current problems with Cell 2 also (R2R) with our Solid Phase RS3 strips on our ECHO. We received a new lot# of strips last week and are doing better - just odd that it is cell 2 in both types of systems.
  7. cswickard

    Group O Whole Blood, Low Titer

    Yes to not wanting to worry about WB, but some of this is talking about actual transfusions in the field where fresh (<14 days) WB would be very useful and much easier to deal with for a field team. I have also heard that some Trauma centers have a procedure where FFP and pRBCs and all get mixed together as they are being transfused(?!!?) I have no clue how that works, but seems like it would almost be safer to give a WB unit than that procedure?!? Fresh FFP with more functioning Coag factors logically seems better, but maybe a fresh WB has enough to keep things going. I can't see us managing this though - the WB inventory, even with returning it for Packed RBC production, would kill us. Most of our "traumas" to date have used fewer than 4 units. It will be interesting to follow this trend. By the way - does anyone know if the WB is Leukocyte reduced? If not, still having white cells onboard the unit would cause problems too. Especially with WC degradation over time before packing and filtering. Would NOT want to go back to that!
  8. Grifols is still doing our rare ones - through send outs from the United Blood Services, Tempe AZ IRL, but the price is now over $500. Also -- they prefer a tube that has not been opened (risking cross contamination) for other testing, including automated. Theirs seems to be a molecular test that leads to a RH Type decision (prediction?). I have not been able to charge our pts, but appreciate the new CPT code. Might get that to work, but the results take too long to get back for most of our outpt encounters. (about 1 week.)
  9. cswickard

    Group O Whole Blood, Low Titer

    "and cold-stored WB contains PLTs that appear to have equivalent or better hemostatic effect in both in vitro tests and in clinical trials, compared to PLTs that have been stored under conventional room temperature conditions." (quote) How long do the platelets in a WB unit last? Even 7-10 days still leaves half of the unit's lifetime without platelets. The rest of the benefits sound interesting - especially pre-hospital. We are not even close to having blood products in the field, but it is an interesting idea to work on. I wonder how this would change the Massive Transfusion Protocol" 1st response (usually a unit of pheresised platelets in 1st load)- if at all?
  10. cswickard

    Return of Plasma to the Blood Bank

    Plasma is hard to keep track of just by temperature alone. If you are in a hurry - there is a good chance the plasma is going to be warmer that 1-6C when it leaves the Blood Bank to start with. Even in a separate cooler, that means the temperature monitoring tabs won't work and there is no way to know what happens to the plasma that way. Data loggers wouldn't work either. Difficult situation. We will only accept plasma back if it is cold and in it's own cooler and will only keep it for 24 hours. We do not extend FFP (any type) that was issued and returned into a Thawed Plasma product either.
  11. cswickard

    Blood Transportation to Floors

    Coolers (Credo line) for more than one unit or across the parking lot, and by hand for single units. Tried clear bags for awhile, and the nurses hated that because it was just one more plastic bag that had to be thrown out and added to our mountain of trash. We already use a ton of plastic bags (biohazard and plain) for our specimen transport. Our tube system is too small, fast and old to transport blood in.
  12. cswickard

    Benchmarking and Lean Expectation

    Dear God, you have my deepest sympathy. 1. Push the company to give details on their benchmark standards and where they come from. Chances are, you are not in the same boat. We had a similar problem here because our Micro and BB staffing for the weekends did not meet corporate standards (desires), but we were unable to cut staff because of the physical layout of our facility and the distance between the departments. 2. Your situation matches one hospital I know of, if you could contact them - University Medical Center, El Paso, TX. The Blood Bank is in the Main hospital and the main lab is way across the parking lot. They are a level 1 trauma center and a big surgical hospital, but the NICU is in a separate hospital next to them and did have it's own Blood Bank staff. 3. Do you have current FTE numbers that justify your current staffing? What is the difference in the "factors" in the staffing equations that are being used that lead to this new company coming up with their figures vs. your current FTE figures? Good luck. Patient safety arguments sometimes sway Administrations when nothing else will. If you can make a case for how dangerous it is for the staff of a Trauma center to be too little, too late - maybe it could help.
  13. cswickard


    Oh - we have a Credo set of coolers for our OR and floor use - they have worked very well for us. But darn-- it never even crossed my mind about taking the temps every 4 hours - now we are going to have to look at that. We seldom get units back, except from OR, and that is usually within 4 hours, but still....... Thanks for the heads up.
  14. cswickard


    I I thought the only reason we were driving ourselves crazy (in the US) trying to get everything down to 1-6C was because the FDA (at least) has determined that coolers moving blood around in the hospital are considered "storage" - not transport (1-10C). Have they changed their minds again - officially??

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