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cswickard last won the day on August 15

cswickard had the most liked content!

About cswickard

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    Seasoned poster
  • Birthday 04/17/1953

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  • Location
    Las Cruces,NM
  • Occupation
    Transfusion Service Supervisor

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  1. I will try here or message me your email and i will send it that way. https://pstat-live-media.s3.amazonaws.com/pdf_cache/policy/5813043/b3d2aae0-704c-4ada-9bd2-dad644dffb48/TS-045 Lookback-Recall- Withdrawal Notifications of Transfusion to Recipients.pdf this will only last for 30 days Been a while since we updated this too, but it has gotten us through these lookbacks/withdrawals for a long time.
  2. We Modify (Meditech) ours the first time for 24 hours (to the minute) as FFP thawed and then - if not used - extend for 3 more days until midnight as Thawed Plasma. That way we never exceed the 5 "days" allowed for the product.
  3. Are you asking about which labels can be placed on the bag and which have to be on the base label?? Some irradiation indicator tags - both Rad-Sure and Rad-Control - have a type of adhesive that can touch the actual bag. Both can go above or below the base label (or at least that is what I have always been told). Most little labels/stickers, like the original Irradiation label in this thread, do not have this type of approved adhesive and are not allowed to be placed directly on the bag. You have to find somewhere to stick it on the base label without covering anything else up.
  4. The really important point is that they enter their data into the computer directly from the test media or instrument printout (in our case). No results from memory or their own interpretation of the results (i.e. "it was an O Pos - I'll just make it an O pos"). That is the real battle.
  5. I forgot - you also have to have a documented training program for all users and establish competency with the irradiator functions and any computer work (relabeling, etc. ) that will need doing on all irradiated units. You have to at least REGISTER with the FDA (if in the USA) because irradiation is considered a manufacturing step and that makes you a producer.... (YEAH!! - such fun)
  6. We have a Best Theratronics Raycell X-Ray Irradiator. We have the paperwork from the technician that installed or repaired the unit - they do extensive testing and verification of the dose delivered. We send a test shot phantom (contract with MD Anderson's Radiation Dosimetry Services (RDS@MDAnderson.org) (713-745-8999) twice a year to document the dose delivered. We would have to have a test shot after any repair too. You would have to have a documented test shot with documentation of the dose delivered to start operating. Every time we get a new lot # of indicator tags, I run new tags from each box against tags from the current lot number, to check for duplicate functionality. We are FDA inspected - they have never asked for anything else. Ask your manufacturer - they should have some suggestions too.
  7. Yeah - sorry - I was just assuming it wasn't an obvious problem like that. When nothing else makes sense and the baby is still in trouble - that is when you are thinking about that rare antibody.
  8. You should also just check with your blood distribution center. They should be able to supply you with some empty bags. If you do not need an ongoing supply, they should be able to help with what you would need for validations - primary and ongoing. We store our "phantoms" in the frig and I have had them for years now.
  9. We do an eluate only if the Dr orders one, and we haven't had that in years. We only do the cord bloods of O and all Rh neg moms anyway. An O mom with a B baby can frequently be seen to have a more aggressive HDN - but usually treated just with Bili lights and hydration, occasionally they also don't let the mom breastfeed. Any ABO HDN eluate workup really doesn't yield anymore useful information than you already know - Mom's are usually O and the babys are A or B - DAT mystery solved. On the rare clinically significant antibody - try to find whatever it is mom has and phenotype the baby (if possible) if the DAT is positive - might be worth sending out if you can't do any of that. Do you have to send out AB Titers if they are monitoring the pregnancies? Do you usually know in advance, the moms with positive antibody screens or do you get little prenatal work? That might effect what you need to do. On the very rare(!): Dad has a rare antigen and mom has the corresponding antibody - good luck even remembering that if shows up. The only real way to work one of those up is to have specimens for Mom and Dad and crossmatch Mom with Dad's cells. If Mom had a negative antibody screen (frequently) but is incompatible with Dad and the baby - send that out for information to use on the next pregnancy - if there will be one. Otherwise - the current infant will have to be dealt with as well as possible - Bili lights, hydration, maybe exchange transfusion with units compatible with Mom's specimen. That is what we would do.
  10. mostly 72 hours, but if we can get some history - will extend until midnight of 3rd day.
  11. A - to find out the specifics of the problem - personnel may not talk in front of supervisor, so this needs to be done 1st. B - to get the other side of the story - if there is one. Don't spring a meeting on the supervisor with other personnel present without discussing problem 1st. 3 - to work things out - if possible.
  12. There has been the occasional OR RN who has had to crawl under the table and access the wristband under the drapes! The Cardiac OR team has learned to get their BB pick-up cards ready in advance.
  13. It might be that today's philosophy could be stated as: "I have to give one unit - but I don't need to give two." We are seeing some REALLY low hemoglobins around here, but the Docs have adjust nicely to giving fewer units.
  14. That's usually true Malcolm. But in the world we live in with these pesky patients doing their "own" thing you just never can say never. We had a anti-Lea the other day that we didn't even see with solid phase (almost never do/ detects IgG dependent Abs)) and didn't see it with immediate spin XMs either (should have picked up IgM), and then the pt HATED a unit - nasty transfusion reaction. Went looking for a low frequency antibody, but found the anti-Lea and it was reacting 4+ only with AHG tubes - so was it IgM (no I.S,. reaction) or IgG (no solid phase reaction)???. Go figure. That one sent us back to the textbooks. Immucor had just put out a Self-Check with an anti-Lea. The discussion paperwork gave us a good idea of what the patient had been doing - but it makes absolutes seem like a distant memory in this field sometimes. Happy 4th to all of you that are in the states! Everyone else - have a nice day.
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