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AMcCord last won the day on April 20

AMcCord had the most liked content!


About AMcCord

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  • Birthday May 8

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    Blood Bank Section Supervisor

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  1. Temperature Monitoring

    There was a period of time it was so hot in our lab due to construction issues that a door to the main hallway had to be open or our chemistry analyzers wouldn't work. It was still tropical with the door open. We threatened to work naked, in view of everyone that passed by. We did get a couple of big fans after that until the problem could be resolved. As for monitoring temps, we do pretty much what Scott does.
  2. Bovine albumin reagents

    Who do you get your other reagents from...like anti-A, anti-B, etc.? I would assume that you would be able to order on line directly from the vendor/manufacturer of those reagents. Instead of albumin, I would recommend a switch to a low ionic strength solution (LISS, Lo-Ion, N-Hance are some of the name brands readily available in the US). Shorter incubation time and readily available from reagent suppliers.
  3. immufuge

    We use Hettich centrifuges also, but don't try to decant from the head. Our manual testing is minimal.
  4. Laboratory Massive Transfusion Protocol

    We have order sets available to providers, but will go into action with a phone call for MTP and emergency release. The order does need to be placed for that to happen. The patient comes first. CAP specifically says that blood products the patient needs should not be delayed so as to endanger that patient by sticking to paperwork rules. The orders do need to be placed as soon as it is feasible, but sometimes some of those orders are placed by lab. Our procedures spell that out. TRM.40770 Life-Threatening Situations Phase II Adequate policies and procedures have been established for the investigation and handling of life-threatening situations (such as the use of uncrossmatched blood or abbreviation of testing) that include the written authorization of a qualified physician. NOTE: Written policies and procedures must be available to expedite testing for transfusion in a life-threatening situation. If an institution's procedure allows abbreviated testing in massive transfusion situations, records should indicate that the procedure was followed. Records must include the authorization by a qualified physician. (If approved by the institution and recorded in the laboratory's procedures, the physician responsible for the transfusion service laboratory may accept this responsibility.) If an incompatibility is discovered on completion of an incomplete crossmatch, the responsible physician must be notified in a timely manner and this notification recorded. 29 of 85 Transfusion Medicine Checklist 08.21.2017 Red blood cells released before testing has been completed must be conspicuously labeled as uncrossmatched on the tag or label. Records of completion of compatibility testing for units released uncrossmatched must be maintained. Evidence of Compliance: ✓ Records of emergency release authorization by a qualified physician REFERENCES 1) Food and Drug Administration. Current good manufacturing practice for blood and blood components. Laboratory controls. Compatibility testing. Washington, DC: US Government Printing Office, 1999(Apr 1):[21CFR606.151] 2) ibid. Records and reports. Records. Washington, DC: US Government Printing Office, 1999(Apr 1):[21CFR606.160]
  5. Daily QC Requirement

    Performing a manual antibody screen, in addition to the temp, RPM and timer checks, would be checking your system (centrifuge/incubator/pipette) as well as reagents (strips). You could use 'serum' from the QC material you run on the ProVue for your positive control and inert patient plasma (previously tested & negative on the ProVue) for a negative control. As far as QC for the ID panel, that's a whole nother discussion. For tube testing, we run a weak antibody against an antigen positive and an antigen negative cell. That is not something we did when we were running gel, but that was more than 8 years ago and regulatory issues have changed since then.
  6. ABO/ Rh Testing- MTS gel vs. Tube

    To be honest, it's more about making inspectors happy.
  7. ABO/ Rh Testing- MTS gel vs. Tube

    Immucor now has a Weak D cell available. I've added it as a positive control. We get a w+ - 2+ positive reaction at IS, depending on the lot, and 2+ with AHG. It's a nice training tool as well.
  8. Daily QC Requirement

    I would say Yes - you are using a different platform to perform manual testing. The volume delivered by the pipette for the manual test should be verified by performing the test manually.
  9. Workflow for 2nd Blood Draws

    I believe that you cannot charge for the 2nd type. Cost of doing business.
  10. FDA 30 minute rule

    All the pretransfusion requirements are built into the electronic transfusion flowsheet, so they have a checklist that has to be completed. This is emphasized during orientation training and during their annual transfusion education. We suggested making them mandatory entries, however nursing service refused because 'that would be setting them up for failure' Oh well................The flowsheets are reviewed by someone on their end for completion, so there is follow up with the transfusionist. If there is a problem/product return, I review the flowsheet and chart. If there is something missing that should have been there prior to product checkout, we fill out an occurrence report which goes to the appropriate nursing manager and quality. This has improved compliance dramatically - not perfect, but very good.
  11. Automation Daily QC Documentation

    I recently learned that the Echo QC could be backed up onto one of our hospital's servers, instead of onto a disc. I'm going to check that out.
  12. Cooler Validation Question

    I use LogTags with probes. For a two unit red cell cooler, I validated with one unit left untouched, lid unopened for 24 hours. Then I put 2 units in, removed one at 2 hours and left the other in the cooler, lid not opened again, for a total of 24 hours. The coolers held temp below 6C for 24 hours for both trials. I did the same thing for our small platelet cooler. The idea was to mimic use for routine transfusion. Our policy when issuing blood products in these coolers is that the cooler must be returned within 8 hours, so temps are well within range...as long as they leave the lid closed unless removing product. I need to validate a couple of 6 unit coolers for mass transfusions and will follow a similar plan. Stack 6 units, the top and bottom units will have probes. After 20 minutes one unit will be removed from the middle of the stack and every 20 minutes thereafter another unit will be removed from the middle until 4 units are gone. Another 20 minutes and the bottom unit will come out, leaving the top unit in until 24 hours have passed. It will be interesting to see how long the temp will hold, but I'm betting 3-4 hours won't be a problem and that will work just fine for mass transfusion.
  13. We do have a process for PAT patients that sends them home with an ID card instead of a band on their wrist. Patients may not want to wear a bright red armband for days and even if they are willing to do that, sometimes the band doesn't survive the wear and tear of normal life. The PAT ID card has a sticker on it from their armband tail and the form they fill out when the specimen is collected has their signature. When they come in for surgery, they present the card, we ID them following our normal process and ask them to sign the card. We match the signature with the form they signed when drawn and band them with the armband we've held in blood bank. We do occasionally use this process for transfusions as well.