heathervaught

We do about 5000-6000 components per year between red cells and platelets.

it sounds like you have a pretty good feel for the risks and benefits of each method. Our x-Ray cycle time is about 6 minutes, and do not require all of the security measures associated with cesium and cobalt. I'm going to knock very hard on the nearest piece of wood and whisper very quietly that is has been a while since we have had any equipment failures that have resulted in instrument downtime. I have 2 devices, which I think helps reduce some of the wear and tear on each machine. Just a side note, Cliff has recommended using discretion when discussing blood product irradiation on these forums, as they may be observed and monitored for potential security risks...

Very good point. Just as not all RBC units are created equal, neither are all "adult" patients. The lab MD should be able to help draft a policy for issuing partial units based on the size of the patient.

Dr. Gary Moroff has published articles on the effects of temperature and lack of agitation on in vitro markers of platelet function. Here are the ones that I could quickly find in Transfusion: http://onlinelibrary.wiley.com/doi/10.1046/j.1537-2995.1990.30590296375.x/abstract http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2008.01690.x/abstract http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2006.00756.x/abstract http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2010.02869.x/abstract

Hi everyone, I'm helping a SBB student to spread the word - they are doing some research as part of their "capstone" project. Please take a few minutes to complete this survey: https://survey.utmb.edu/TakeSurvey.aspx?SurveyID=llL2388 Thank you!!!!!!!

If you use a bedside leukoreduction filter, what type of quality control testing do you perform?

Oh, I have seen many RBCs break when dropped on the floor. It usually happens when they land flat on their front/back after falling off a counter or a cart. The RBCs will burst along the seam and splatter across a room.

I would recommend a manual calculation, which should be fairly easy to do. Aliquot Anticoagulant = (Aliquot volume/Original product volume) x Original Anticoagulant Volume So if making a 20 mL aliquot from an original product containint 200 mL and 15 mL anticoagulant: Aliquot Anticoagulant = (20/200) x 15 = 1.5 mL -Heather

Hi everyone, I am posting a question on behalf of one of my customers in the hopes that you all might be able to help me :-)!. *~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~ We had a CRNA use blood tubing after a transfusion had ended for LR and meds. I have never encountered blood tubing being used for anything other than blood, and can't find anything specific in the standards, except for Std 5.26.9 about addition of drugs or other additives to blood. It seems like very bad practice to me. ~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~ Any advice that you can give would be great. -Heather

I'll cast a vote for Helmer, too!

Any facility that returns blood products to the blood center is now considered a "supplier" to that blood center and therefore must be qualified. How the blood center chooses to do that is at their discretion. They do have a vested interested in determining what your massive transfusion protocol is - it impacts the blood center's collection goals and targets and their ability to meet your needs for the duration of your contract. You would be surprised at the number of facilities that are still just now rolling out MTPs, or expanding them to new departments (i.e. from ED to L&D). These potential changes in blood product consumption are not always communicated back to the blood center, which in the end could mean that a patient who really needs blood doesn't have it.

The definitions are spelled out in the US Industry Consensus Standard (Version 2.0.0, November 2005), which can be found at http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM079159.pdf DESIGNATED: A unit collected from a donor called by the collecting facility to privide (a) product(s) to be used by a specific recipient in some future therapeutic procedure (for example, HLA-compatible). DIRECTED: A unit collected from a donor who presents to the collecting facility at the request of another person intending to provide (a) product(s) to be used by that person in some future therapeutic procedure.

We use heating pads under the donor's arm plus blankets at the donor's request. I usually ask for 2 blankets at the beginning of the procedure. I've heard that our Director of Blood Collections would like to move to the XXL towels (aka Bath Sheets) that are placed in a towel warmer.

The ASCP publishes an annual report with examination and certification statistics. http://www.ascp.org/Board-of-Certification/Procedures-and-Reports#tabs-3. I'm not sure when the 2011 report will be published, though.

We use hard-sided gel packs that are frozen before use. They are placed in the coolers when the mobile leaves the main site with a plastic divider so that the blood does not come in direct contact with the frozen surface. Of course, you will need to validate whatever method you use.

@MHC, we usually discard a product if the yield is below 1.5. Most of the time (and they a re rare), the lowest yields are due to procedures that are discontinued before the target due to donor reactions/incidents. Most of our products that are labeled with the Variable Yield codes are >2.5.

Yes, if you go to the Code of Federal Regulations, it is in the table under 610.53.c. http://www.gpo.gov/fdsys/pkg/CFR-2011-title21-vol7/xml/CFR-2011-title21-vol7-chapI-subchapF.xml [TABLE=class: GPOTABLE] [TR=class: ROW] [TD=class: ENT]3. Plasma[/TD] [TD=class: ENT]....[/TD] [TD=class: ENT][/TD] [TD=class: ENT]5 years from date of collection of source blood (−18 °C or colder).[/TD] [/TR] [/TABLE]

I doubt that you will find any requirement that a laboratory be a certain size, regardless of the type of facility that you serve. What is required by the CFR (a.k.a. cGMPs) and AABB standards is that you have adequate space for the activities performed. What your laboratory needs to do is a thorough assessment of your operations, identify and eliminate waste, create a map of your current and proposed value stream and your current and proposed "spaghetti" diagram. Then, find some paper with grids and lay out your new lab to scale. When properly performed, this process should take no less than 2-3 months. We have tackled this in many of our laboratories by contacting our local NIST Manufacturing Extension Partnership and requesting Lean training.

For those facilities that collect granulocytes - what value do you use for the specific gravity to convert the product weight to volume? Thanks!!!!

We use the following ISBT codes: E4643, E4644, E4645, and E4646. We label all of our platelets with the actual yield by using an additional label on the bag.

Here are some from my computer system. PLEASE verify these against the ICCBBA list. E5242: CP2D/AS3 E5243: CP2D/AS3 anticoagulant adjusted E5244: CPD/AS5 E5245: CPD/AS5 anticoagulant adjusted E5252: CPD - Irradiated E5253: CPD anticoagulant adjusted - Irradiated E5122: CPD/AS1 - Irradiated E5123: CPD/AS1 anticoagulant adjusted - Irradiated E5124: CP2D/AS3 - Irradiated E5125: CP2D/AS3 anticoagulant adjusted - Irradiated E5126: CPD/AS5 - Irradiated E5127: CPD/AS5 anticoagulant adjusted - Irradiated E5155: CPDA1 E5156: CPDA1 anticoagulant adjusted E5157: CPD/AS1 E5158: CPD/AS1 anticoagulant adjusted

We also do not do the self-exclusion card any more. Just like Cliff, our donors take a half-sheet of paper with post-donation instructions on food, hydration, physical activitiy, and the number that they should call if they don't feel well after their donation or if they decide that their donation should not be used.

I vote for the KISS principle whenever possible - if you try to make someone remember to request several different things, they will sometimes miss something. I would vote for giving the physician (or the nurse or clerk that is entering the orders for them) one place to order the workup, with the battery of tests ordered every time.

I passed the SBB without ever working in a reference laboratory (without working in a transfusion service, either...SBBs come from many paths, and mine is via Blood Center experience). Fortunately, I was able to work with a wonderful person in my reference lab who was willing to take me under her wing and make me work on the difficult samples (recently transfused, positive DAT, warm auto with underlying allos) until I got it right. And it was not about just knowing how to get the right answer, but why it was the right answer and why all of the other answers were wrong. I also used these forums while I was studying...even when I didn't respond to a post, I read everyone's answers and learned something from their experience (especially Malcom, who seems to have encountered just about everything). The research project is something that EVERYONE struggles with. I would recommend reading some articles in Transfusion to get a feel for the format (abstract, background, methods, results, discussion). In the front of the journal, they usually have at least one editorial that discusses an article, whawt other literature has to say about the subject, and what studies still need to be done to gather more information. Work with your program coordinator to identify potential topics, then work with your mentor to narrow them down to something that is relevant at your facility. Good luck!

We manufacture pre-storage pooled cryoprecipitate. In my eyes, pooling harnesses are a waste of time and money. We pool 5 units, and the bag that we use for final storage is one of the containers that was used to manufacture one of the "single" units of cryoprecipitate.