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AMcCord

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Everything posted by AMcCord

  1. AMcCord
    The Echo won't like a specimen w/ hemolysis at 3-4+ when graded. That's actually quite a lot of hemolysis, so the specimens we reject for hemolysis are few and far between. The majority of our hemolyzed specimens tend to come from IV starts collected by nurses - they are 'supposed' to be saving us time by collecting specimens that way.
  2. AMcCord
    Mabel - our patient is wearing a medical alert bracelet which says that she has the antibody. Not sure exactly what it says about transfusions as her provider dealt with the details. The patient (former nurse) and her husband are both very aware of what her problem is so are able to communicate effectively about her situation, which is very helpful. We were contacted by another facility not too long ago w/ questions about her as they were making plans for a surgical procedure - did we actually test for the antibody? (we did), symptoms of her reaction, etc. She is now, understandably, very reluctant to consent to transfusions.
  3. AMcCord
    Dr Blumberg - appreciate your input.
  4. AMcCord
    We've seen one of those patients with the antibody who had the severe anaphylactic reaction - impending sense of doom, etc., just like the books say. Fortunately the nurse was very attentive when the transfusion was started and caught it immediately. My advice is to instruct the nurses to watch very closely if she is transfused and make sure they know how to recognize a reaction if it occurs.
  5. AMcCord

    Unit Labels

    AMcCord replied to Ward_X's topic in Equipment

    We use hang tags that we have printed for us. They have a header with our facility logo and name/address and a big blank spot on the front to receive a 4 x 4 label printed from our BBIS. The back of the tag has info for recognition of transfusion reactions, response to transfusion reactions (in a nutshell), and blood product handling instructions. Works well and no stickers on unit face to cause problems.
  6. AMcCord
    Excellent point!
  7. AMcCord
    This is what we do. We are a smaller facility with an active Oncology treatment unit. We transfuse platelets and plasma with a type from the current admission.
  8. AMcCord
    I also had an elderly male like this. The first time he was transfused was the first time he had ever even been in the hospital.
  9. AMcCord
    I have my centrifuges set for a very soft brake - makes a big difference.
  10. AMcCord
    Keep it simple. Let them order red cells, just red cells. If they need irradiated or CMV neg or leukoreduced (assuming there is a choice at your facility) or whatever, let them select that option. In Epic they can be required to select a reason why they are ordering irradiated or CMV or whatever - the reasons should come out of institution policy. That way they are less likely to order inappropriate special attributes. Ditto for platelets and plasma products.
  11. AMcCord
    Epic/Orchard Harvest/SafeTrace Tx It has been challenging to get everything communicating, but once past that everything seems to be working well. We went live with SafeTrace in May, so stilling working on some bumps with billing and workflow.
  12. AMcCord
    We have also used the small Helmer incubator. It was very dependable over a lot of years. We have since upgraded to the next larger size.
  13. AMcCord
    We are Epic/Harvest/SafeTrace. Our cord blood specimen labels include the mother's name and MR# as well as baby name and MR#. Our facility is also using a naming convention for babies that includes mother's first name (Last Name, Mother'sFirstNameBaby's Sex - example: Jones, BeckyBoy). The names are awkward to look at, but do help connect mother/baby.
  14. AMcCord

    KB

    AMcCord replied to ESIZENSKY's topic in Transfusion Services

    We did them in Blood Bank until we started sending them out. I was not sad to see them go. I would also vote for Hemo.
  15. AMcCord
    My institution has an order set for a cord blood panel (ABO/Rh and DAT), which is ordered on all newborns whose mothers are type O and/or Rh negative. A blood type is ordered on all OB patients in labor so we have mom's type. If mom delivers before a type is done, we would get the cord blood order on the newborn based on the type in her H&P. When we do the type on mom post-delivery and she is Rh negative, we would make sure that we have received a cord blood specimen on baby. If necessary, we would contact the nursery to get orders for a blood type/DAT on a capillary specimen.
  16. AMcCord
    It is important to remember that inspectors are human and as John says, they can and do cite things because it's not how they do it. Don't take it personally. Their way may give you a good idea for improving your way. At the same time, don't be afraid to challenge a citation if you feel that you've met the intent of the standard and can prove it. I definitely don't recommend arguing with an FDA inspector - you are probably not going to win.
  17. AMcCord
    Yes, I imagine those centrifuges are still about the size of your average washing machine or bigger - not something I could find room for in our lab or our budget. When I first started in the lab business, won't say how long ago , we did pack some cells (and wash platelets) using floor centrifuges with big buckets in Micro. That would never fly now! Talk about the "yuck" factor!!! I haven't really investigated the WB option yet. I don't know if rotation would be an option or not. It isn't w/ 'liquid plasma, never frozen', so it might not be with WB. I suspect the WB product would be a special order situation. Will cross that bridge when/if I have to.
  18. AMcCord
    I can't speak for other labs, but our 'large' centrifuges are big countertop models for specimen processing and the rotors won't accept the large buckets we would need to centrifuge a unit of blood (and none of them are refrigerated). And quite frankly I wouldn't want to do it, even if I could, because of the contamination issue from processing specimens in that same centrifuge. I know we can sanitize, but yuck, just yuck.
  19. AMcCord
    Patients coming in to us with blood products are coming from much smaller facilities w/ limited capabilities and inventory. I send any units that are not hanging back to them with the ambulance that brought the patient. They need that unit much more than I do. If a provider here wants to infuse a unit that came with the patient, for whatever reason, that unit would have to meet shipping/transfer requirements, be inspected, processed and crossmatched prior to transfusion. I would enlist our pathologist on call for assistance if the provider wanted to give that unit straight out of the shipping container - our policy states that we would give uncrossmatched in that situation.
  20. AMcCord
    We do a shift huddle 10-15 minutes after shift change. The lead or responsible tech in each area notes important info on the huddle log and reports verbally at huddle - everyone (usually 7-10 techs at huddle) is expected to pause long enough listen unless they are dealing with an emergency/stat. The PM shift then huddles with the overnight techs (usually 6-7 at huddle). Overnights huddles w/ day shift. It is mandatory, but we've been doing it for 3 or 4 years now, so its automatic. It is effective as long as everyone plays by the rules.
  21. AMcCord
    That could include appropriate and expected patient test results fgr specific antisera that are non-reactive, if your SOP states that this is how you do your negative controls. Specifically anti-A, anti-B and Anti-A,B. It doesn't say what your negative control materials have to be.
  22. AMcCord
    Nursing policy says that they must take pre-transfusion vitals no more than 15 minutes prior to checking out the blood product, then repeat vitals at 15 min and at the end (<4 hrs). Most of our transfusions run 90-120 minutes.
  23. AMcCord
    We've passed several CLIA inspections within the past 10 years.
  24. AMcCord
    The FDA didn't have a problem with it when they were inspecting us.
  25. AMcCord
    Exactly! That said, I do currently choose to run positive and negative controls every day of use, though it's not required. Just anal that way I guess. Before that however, for quite a few years I had a statement in my SOP that said I was following manufacturer's recommendations for QC, did the pos and neg for anti-D, and I also never had a problem with inspections. The FDA and CAP had no issues with our QC.
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