heathervaught
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Everything posted by heathervaught
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You can determine a Return on Investment for the equipment -- How much does it cost to have irradiation performed by an outside supplier? Divide the cost for the equipment by the cost per irradiation and you can determine how many units you have to irradiate yourself before the irradiator is "paid off". Then, you can determine how many units per year you would have to irradiate to "pay" for the service agreement. If you can't justify that, then you should look at having your blood irradiated by your supplier. Good luck!
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You can also test a pool of leukoreduced platelets using the BacT/ALERT. We don't make random platelets, but I'm sure that a bioMerieux representative would be glad to help you. -
In order for a unit to be considered leukocyte reduced, there may be up to 5 million white blood cells remaining in the product. There is no filter (that I know of) that can claim to remove 100% of leukocytes. In GVHD, it is the T lymphocyte that is of interest. In theory, it only takes one T cell to replicate and cause GVHD. The reason that radiation is used is to bind the DNA of the residual leukocytes, rendering them incapable of replicating in the new host. Freezing does not reduce the risk of graft vs host disease. We use X-ray irradiation at our facility, and given the requirements for housing a Gamma-cell irradiator, I would imagine that many facilities who are purchasing a new irradiator will purchase one with an X-ray source.
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All new ASCP certifications have a 3-year expiration date. During the 3rd year, you are required to submit a dodument listing 36 continuing education credits/hours, and your certification will be renewed. http://www.ascp.org/pdf/CMPBooklet.aspx
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It sounds like you should have a policy or procedure document for handling name changes; I don't see any reason to handle Jane Smith --> Jane Jones any differently from a patient who goes from John Doe in the emergency room to whatever his real name is.
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I have seen some "blood-safe" type refrigerators, where the blood bank would stock with units that are ready for multiple patients, then place the blood in the refrigerator. The refrigerator is programmed to know which units are for which patients. When one needs blood, the patient identifiers are entered into the refrigerator and it dispenses the correct unit of blood. I'm sure that they are pricey, but I would try to justify the cost compared to the costs incurred by the hospital if a patient is transfused with the wrong unit of blood.
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Grasping at straws...but could she have a very weakly expressed acquired B antigen that allowed some of the anti-B to adsorb onto the cells?
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We are a big fan of Helmer products. They do have a small "undercounter" refrigerator with a chart recorder. There is an option for casters. http://www.helmerinc.com/iB105.aspx I don't know how easily they roll around, or how long they would maintain temperature whilst unplugged. They are based out of Indiana, so I don't know how easy it would be to get a demo out in California...but you can always ask.
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We use a Mettler Toledo BBA-422, and it has this functionality.
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I believe that Raytek was purchased by Fluke. The thermometer says on the side "Fluke 63 IR Thermometer". And yes, we love them! I think that they work very well.
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We use a Raytek.
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Positive antibody screen post transfusion
heathervaught replied to jillyenrenee's topic in Transfusion Services
You can confirm anti-G specificity by adsorbing your serum onto "dC" red cells, eluting, and then testing the eluate against "Dc" cells (or the other way around). If the eluate reacts with the second cells, you have anti-G . -
Incomplete WB collection....?? cont--d..
heathervaught replied to geekay's topic in Donor Services and Donor Recruitment
The volume of anticoagulant and additive provided in the collection bag is designed to collect the "targeted" collection volume +/- 10%. The filters are also validated for the "+/- 10%" as well. In a 500 mL collection container, the acceptable volume is 450 to 550 mL. In a 450 mL collection container, the acceptable volume is 405 to 495 mL. I would suspect that an undercollection would not adversly impact the removal of leukocytes from the product, but I would fear that the volume of blood that is retained by the filter would cause excessive product loss. With an overcollection, you risk clotting due to the improper blood/anticoagluant ratio and premature red cell death due to not enough additive. -
Good luck!!!
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Thanks Malcom :-). That is my 8-month old son, Austin. I need to get a picture with him and his (almost) 4-year old sister, Ashley, together.
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Maybe CLIA???
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I think L106 means "SBB exam", but I listed my resources in my original post, too. Good luck if you choose to self-study!
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Yes, I think that it boils down to: was the unit issued in error? If you are intentionally releasing a unit using a method that does not involve a computer, then you have built checks and balances into the manual system to ensure that the component is acceptable for release. In this case, you have not made an error. If you fail to use the computer system when that is your primary method for issuing components, then you circumvent all of the checks and balances that are built into the system. I don't claim to be an expert on the FDA, but if the question is does this have the potential to harm the patient, you have to answer that it absolutely does.
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jkdmendoza, You do not need to calculate RBC recoveryf or the procedure you described above. You have taken whole blood, spun in a centrifuge, then removed plasma. Except for a miniscule number of RBCs that are lost in the plasma, you have retained virtually 100% of the initial RBC content. The "<80%" target for CPDA-1 RBCs referrs to the hematocrit of the final product. If you then take the CPDA-1 RBC component and pass through a leukorerduction filter, then you would calculate the RBC recovery using the formula you described.
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Reference lab workups
heathervaught replied to keisterkid's topic in Immunohematology Reference Laboratories
Our Reference Lab implemented Gel a few years ago for many of the reasons discussed here - when the customer performs their initial workup in Gel (however far they may go with it), we want to be able to continue the workup in Gel. They will often use other media too, in order to help describe the reactivity of any antibodies present, but I think if the customer uses Gel, they will at least start their extended workup that way. -
Rh immune globulin is made from pooled human plasma - not monoclonal. So presumably, it is a blend of specificities. If she is genetically weak D, then she can pass the gene on to her child. If the father does not pass a RHD gene to the child, then the "weak" gene from the mom is the only expression of D that the child has inherited. So presumably, the child's D expression should be identical to the mom's, and mom would not make anti-D. I suppose that it is also possible that the father passed along a "weak D" gene to the child...then the child would have two D expressions and then would potentially have a different epitope than the mom, which could prompt her to make anti-D. I vote for give the prophylaxis. It seems that the benefits would outweigh the risks.
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The ports already have a tamper-evident seal around them. I'm not sure that would accomplish anything...
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heavy exercise before donation
heathervaught replied to sona's topic in Donor Services and Donor Recruitment
Good point David, but we stopped doing ALT testing in 2004...I would venture to guess that not many donor centers continued with the testing after it was no longer required. -
Table top sealer for component manucaturing
heathervaught replied to DFields's topic in Donor Services and Donor Recruitment
We like the Sebra Omni, but have experience with Terumo's new model and find it to be acceptable, too. We have one Sarstedt and one Genesis multi-head sealer, and find those to be excellent when making segments on RBCs. -
I am told that they use a robust cooler, but not the Golden Hour cooler. No temperature indicators are placed in/on the units themselves. If the blood arrives at the receiving hospital and is not used, then the receiving hospital (same parent company owns the hospital and the helicopter service) checks the temp and places into inventory if acceptable, then provides fresh units for the hangar.