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AMcCord

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AMcCord last won the day on February 21

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About AMcCord

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  • Birthday May 8

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  • Location
    Nebraska
  • Occupation
    Blood Bank Section Supervisor

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  1. I've been searching unsuccessfully for benchmarks for blood use in Level 3 trauma centers. Specifically, I interested in: 1) The amount of wasted blood products related to MTP and emergency release in that setting. 2) The use of liquid plasma, never frozen vs thawed plasma - does the use of liquid plasma reduce waste? 3) What ratio do you see for RBC/plasma use? 4) What percentage of your MTP/emergency release patients are transferred? (which naturally limits the amount of blood used)
  2. Ours go to the floor in a bag that is zipped closed and locked with a FinalCheck lock. The bag has a biohazard symbol on it. The empty bag/infusion set goes back in the bag for disposal. Before we used the lock system, our units went to the floor w/o a bag. I do like the idea of a closed bag because of the potential mess if a bag is dropped and broken. Another thing I'm waiting to be questioned/cited for is having patient identifiers visible on the bag as it goes to the floor. I encourage staff to turn the patient ID tag to face the unit. Anyone had issues with that?
  3. We specify special requirements as part of our blood checkout process as well.
  4. The Credo coolers are very good - pricey, but good. Used by the military under pretty rough conditions. We use them to send blood products to our cancer center. Yes, definitely call them. Once you get hooked up with a sales rep, you can do business by email.
  5. We get platelets from our blood supplier in their heavily insulated shipping boxes with 4 conditioned gel packs and we still get chilly platelets at least a couple of times each winter. I think the key is in how the shipping box/cooler is handled. Require your courier/shipper to keep your cooler inside a warm place, not in an unheated warehouse or the back of an unheated truck. And I wish you luck.
  6. The package insert for fetal bleed screens has a list of references. Can you ask your hospital library or education department to acquire those articles for you?
  7. Excellent advice from the previous 2 posters.
  8. But if the donor was previously tested for any other patient and that patient was charged, you can't charge the current patient for antigen typing that particular unit.
  9. We use a commercial QC kit. The positive control is a blend of Rh antibodies that will give a positive reaction with all three screen cells. You could make something like that by spiking a negative plasma sample with anti-D and anti-c. For a negative control, we use a patient sample that was testing in the previous 2-3 days and was found to be non-reactive (negative antibody screen).
  10. I used to be competent in Hemo/Coag/UA/Serology, but as things got busier and more complicated in Blood Bank, I dropped out.
  11. We use the FinalCheck band system and it works 'outside of' BPAM. The unit of blood is issued in a tough plastic bag w/ a ziplock top. There is a 'padlock' on the bag that prevents it from being opened (the ziplock can't be opened). The combination to the lock is 4 alpha characters on the FinalCheck armband that the patient is wearing. This is the first step in the ID process at the patient bedside. (We still use 2 person ID for transfusions.) If the lock won't open, there is a problem and the BPAM ID process doesn't proceed until Blood Bank has investigated and solved the problem. If the lock will open, then BPAM ID and the transfusion proceeds. That is how their policy for transfusion is written. Their policy also says that the alpha code is not to be recorded anywhere in Epic or on paper towels or on the back of someone's hand. The bags are not cut open. We do not have a problem with bags being cut open - has not happened once in the several years we've used the system - because that action is subject to serious disciplinary action because it is considered blatant disregard for patient safety. Human behavior says that cheating the system is always possible, but we've had really great cooperation from nursing staff because enough of them realize the advantage of the bands/locks for patient safety. They self-police very well. . . And our phlebs are really good confidential informants .
  12. My experience is that it takes 3-4 months for a newbie generalist, esp an MLT, to be 'competent'. This does not include special procedures such as elution, adsorption, etc.,, though it does include antibody ID (1-2 antibodies). They are not going to be comfortable until they've been working about a year. Unfortunately, I can't give you a reference to show to management to support that. Interesting project for an SBB candidate?
  13. I've used 9 segments from an Rh neg unit plus 1 segment from an Rh pos unit with about 6-8 drops of anti-D. Let that concoction incubate at 37 C for 15 or 20 minutes. I washed the sample once or twice to remove some of the anti-D, then handed it off to the student. When they followed our SOP, the sample worked just fine. I'm sure you could do something similar w/ different antisera, but I've never tried. I just needed to teach the method, not evaluate for a competency.
  14. Mable, if you can figure out a way to convince your providers to skip the O Pos moms, let me know! Our OB/Gyn practice is OK with not doing the O Pos moms (and they delivery 90+% of the babies here), the pediatricians are Ok with it. Our problem is one family practice provider and he's not budging. We offered to make it an optional order - he wants it, he can order it, but that didn't work either.
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