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cswickard last won the day on March 11 2017

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. Shortage of 0.9% saline for transfusions

    Our hospital did a good job of sequestering the available saline and saving it for specific uses last time this happened. Pharmacy kept track of it and did a good job keeping enough available for transfusion and other saline specific uses. They used some of the other solutions to replace saline use for reasons other than transfusion where they could. Maybe that would be a better/safer way to go?

    Yeah - those darker ones are sneaky...
  3. Thank you so much for this - very useful. (And for once.......we have the right reagent!!! - Go Immucor!)
  4. Blood Product Orders and Consents

    Nursing picks up their own "Transfusion Order" in the Nursing system (Meditech - I don't know what it looks like). Then they bring a copy of the signed consent form with them for every unit. It is cumbersome for the RNs to always find the consent form and photocopy it off (and we do suspend that in heavy use) but it has succeeded in getting us to and keeping us at 100% compliance with signed Transfusion Consents on the charts. The only exception to this is the O.R. (no easy access to photocopiers - they say) and an Emergency Release (where the DR has to sign for the blood). Each unit is confirmed by a 2 RN read and check, at this point.
  5. Emergency Release Labeling

    This is roughly what our current procedure is too. We call them Rapid ID packs, but they are only in our ER. I wonder if L&D would ever need them here? Have to check into that.... Just to hijack this thread farther - does anyone have an extensive Disaster Plan that covers both internal disasters, external disasters and (God help us all) Mass casualty events?? I have been trying to write something for quite a while - but everything seems to be just too little or too much. What do you put down on paper and does it ever help anyway? What do you practice/drill? We have 2 100 bed hospitals, two E.R.s (about 20 beds each), 2 college campuses, 4 High schools and a few dozens mid and elementary facilities. Our blood center is about 1 hour away. Can anyone share what they may have? Can anyone from Las Vegas, NV, USA share anything?? Can't imagine what your night was like at all.... Carolyn.swickard@lpnt.net Thanks for any help.
  6. Unit History in Meditech 6.x

    Our last Meditech revision was to 5.6.7 and there was no change to unit lookups. Meditech 6.whatever is a long way ahead of that, but I don't understand why they would change such a long-standing, NECESSARY part of the Blood Bank system. Please keep us informed on this subject if you discover this is a real change and not just a new version Glitch they have to fix before Go-live.
  7. Transfusion reaction protocol

    Also - examine your Joint Commission Standards if your Lab happens to be under Joint Commission accreditation. QSA .05.18.01 - section 2 and 3 state in part: 2. The requirement that suspected transfusion reaction-related adverse events are reported immediately to the laboratory, whether or not the physician responsible for the patient deems it necessary to report the event. 3. Policies and procedures for nursing services related to blood and blood component administration do not conflict with the laboratory's policies and procedures. That is fairly definitive about what they want to see and it differs from CAP. We had to change from " what does the physician want to do" to "we need the Transfusion Reaction Workup" if we hear about it at all. Curious as to what Hospital Joint standards say about the whole thing - I have never seen that set of standards. And most hospitals are accredited by Joint Commission, even if their Labs are not.
  8. Preparation of DTT for treating RBCs

    We purchased the HemoBioScience DTT - premade also. It worked very well in parallel testing and seemed to completely decrease the reaction of DARA with the treated cells. It is frozen and can be thawed up to 3 times (I think), but you will use it up before that as only 2 mls comes in each tube. Much faster than a send out. Gives you a clean screen and then you can just crossmatch treated K neg units. (barring the production of anti-k, that is!) Used a combination of the AABB procedure (recommendations and limitations) and the manufacturer's procedure to get a clean procedure that worked here. I can not get a file copy of our procedure from our system (Policy Stat) to this system but would be able to email a copy if anyone cares for it. If anyone notices a problem - please let me know. This was a scary stretch for us too.
  9. Tracking Transfusion Orders

    Have you considered getting your system programmed for electronic crossmatch/release). At your size - that could be your best option to have zero units tied up on your shelf in "crossmatch" status. It is a lot of work, but Cerner has the programming for it and it would be the best answer for you in the long run. Especially if you get any bigger or busier. Getting the Dr's to change their ordering patterns would be just as much work and wouldn't be the most efficient way to handle your overall problem - looking towards the future. Just an opinion......
  10. It would be so nice to have the luxury of giving, at least, ABO identical pltphs. We really don't have that here, we have too few pltphs to choose from in this region. And washed pltphs would have to cross state lines and our distribution system does not have them FDA licensed, so they don't get to come up here. But thank you for the information - we can simply try harder.
  11. Antibody Screen before Issuing RhIg

    We have a canned comment that says " Anti-D detected is presumed (you might want to make that "possibly" or something less) to be due to Rh immune globulin given...." and then we input whatever date is given to us from phone calls, computer searches, questions to the pt, etc. Some of my techs are now also putting in the source we receive the information from ("chart", "computer", RN's or clerk"s name, etc.) The computer puts the comment on the chart. hope this helps.
  12. febrile transfusion reaction

    Some of our cancer patients are transfused while febrile. They can go with a fever for days, so rarely, they have to transfuse in the face of the fever. Impossible to determine if they might have a febrile reactions on top of the fever. The RNs look for the rest of the signs and symptoms possible in transfusion reactions.
  13. Acceptable glass tubes for blood bank testing

    We use the Fisher Scientific borosilicate glass tube cat # 14-961-26. it does not have this statement anywhere on the individual box, the carton or the website catalog description. We also write on them with Sharpies. Anyway - what does that statement "For Research use only. Not for use in diagnostic procedures." even mean? What context/use does the manufacturer mean? Have you found anyone to ask?
  14. Antibody Screen before Issuing RhIg

    We always get or have an historical Blood Type and frequently get the (roughly) 28 week antibody screens from our outpatients, but we do not require the antibody screen results before giving antenatal RhIG. On any of the numerous(!) positive antibody screens on Rh Neg moms, we always have to call and ask about the last known RhIG injections. With an ECHO - you can detect RhIG for months. We almost always get a Type and Screen for all new admits on L&D too - almost all of them who are Rh Neg have a positive antibody screen for anti-D. Much of our Rhig is now given in the Dr's offices and clinics. In the ER, we have a computer reflex test that adds the Antibody screen to any ABORh ordered in the ER that comes out Rh Neg. This has worked out well for our OBs because otherwise, by the time they see the pt and ask for the antibody screen - it is positive from the RhIG given in ER. We went to the hospital OB committee and asked to do this (once we could get the computer programmed to guarantee it would happen) and they happily agreed.
  15. Repeat Testing for FFP and Plts

    If we have the pt's blood type in our computer records - that is what we use for pltph and FFP. We do not BB ID band for plasma - only RBCs. We are able to give type specific pltphs so rarely in this region anyway, this has worked for us. Of course - the Drs often order a Type and Screen or Type and Cross anyway when they want just plasma, so we frequently get a new specimen then. If we need a specimen for the Blood Type - it must be a new and unique (re-identified) draw from the pt - we will not share a prior Lab specimen for Blood Bank for an ABORh.