heathervaught

Dr. Pepper, it's no wonder you're a blood banker!  Search for the answer and never give up until you've found it.  Bravo!

No, Heather, it's why I can never get everything done at work!
Phil

Dr. Pepper, it's no wonder you're a blood banker!  Search for the answer and never give up until you've found it.  Bravo!

Dr. Pepper, it's no wonder you're a blood banker!  Search for the answer and never give up until you've found it.  Bravo!

That's what I was getting at.....but then, I got curious, and looked it up to see if it was actually true about water draining one way or the other. It turns out that in a perfect, static state of affairs, Coriolus forces can indeed cause the hemispheric effect, BUT in the real world those forces are vastly weaker than other influences at play and are overcome by variations in the shape and structure of drains and tubs, motion of the water in a basin caused by use or a slightly off center (which they all are) faucet filling it up, and so on. Hence it joins a long list of charming but untrue urban legends. There's an equatorial nation where, for a modest fee, you can see a toilet on the north side of the line flush in one direction and one on the south side flush the other. They're rigged.

They do fly but they spin around in the opposite direction.

I will occasionally get requests from a hospital to provide a divided red blood cell for a patient with congestive heart disease.  They transfuse one half over the allowed 4 hour window, then have an additional 4 hours to complete the second half.

I will occasionally get requests from a hospital to provide a divided red blood cell for a patient with congestive heart disease.  They transfuse one half over the allowed 4 hour window, then have an additional 4 hours to complete the second half.

I will occasionally get requests from a hospital to provide a divided red blood cell for a patient with congestive heart disease.  They transfuse one half over the allowed 4 hour window, then have an additional 4 hours to complete the second half.

I will occasionally get requests from a hospital to provide a divided red blood cell for a patient with congestive heart disease.  They transfuse one half over the allowed 4 hour window, then have an additional 4 hours to complete the second half.

John, thanks to the generosity of Cliff, who has allowed me to edit the photographs (a very brave move, considering my well-known disabilities with anything to do with computers!!!!!!), the photographs now have captions.
Thank you so much Cliff, and I hope I haven't crashed the site!

I'd eat the evidence Anna!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

NO!
Unless the lady has had a haemopoietic stem cell transplant of course!

A little late on this subject but I thought I would chime in anyway.  We suffered the same problem as you described a few years and 2 employers ago.  When trying to determine what to do about it we discovered that the nurses were being "required" to document the same information in multiple places.  This made no sense so I worked with a team from the nursing department and we came up with a system that only required the documentation in a single place and did away with the other locations.  An example is that they were being required to document vitals both in the patient's chart and on the transfusion record.  Obviously they were much more in tuned to documenting this info on the chart so we removed it from the transfusion record.  Any inspector who wanted to see the info was shown the chart.  Over the years I have discovered that simplifying a process usually enhanced it.  

Hi Amy,
We are the transfusion service for three hospitals in our area that don't have blood banks.  They follow our blood draw and patient identification requirements, send us the specimen and we perform the type and crossmatch and transfer the blood.  We have contracts spelling out exactly what is required of them, as well as us.   It is their responsibility to arrange for transport of both specimens and RC units.  Two hospitals send the specimen with couriers and someone from their facility will pick up the blood later, while another sends the sample with a hospital employee who then waits "in the Big City" for an hour (usually they shop!) while we get everything ready.  I have never been to any of their hospitals but they are required to send the transfusion paperwork back so I can review and make sure they are following policy for transfusion.  They also have protocol for how to what is needed for a transfusion reaction and we would work it up here.  We have been doing this for many years and no inspectors have questioned the process.  They just want to see the contracts and transfusion documentation.  We are a non-profit hospital.

But if I remember things like untinned coelacanths, I forget my phone number...

You all are officilally scaring me.  I am starting a new job next month as the director of the transfusion services at THREE large academic medical centers (two adult hospitals and one pediatric).  I am almost positive that one of these patients will show up in my first weeks.
I wanted to share that because I feel compelled to compliment you all on your willingness to share your own knowledge in these forums. I have been studying them for weeks trying to glean tidbits of valuable information that I might be able to use in the upcoming weeks, months, and even years.  BloodBank Talk has some of the best and brightest minds in the industry openly sharing a wealth of information, and I appreciate each and every one of you who contribute to the conversations!

You all are officilally scaring me.  I am starting a new job next month as the director of the transfusion services at THREE large academic medical centers (two adult hospitals and one pediatric).  I am almost positive that one of these patients will show up in my first weeks.
I wanted to share that because I feel compelled to compliment you all on your willingness to share your own knowledge in these forums. I have been studying them for weeks trying to glean tidbits of valuable information that I might be able to use in the upcoming weeks, months, and even years.  BloodBank Talk has some of the best and brightest minds in the industry openly sharing a wealth of information, and I appreciate each and every one of you who contribute to the conversations!

You all are officilally scaring me.  I am starting a new job next month as the director of the transfusion services at THREE large academic medical centers (two adult hospitals and one pediatric).  I am almost positive that one of these patients will show up in my first weeks.
I wanted to share that because I feel compelled to compliment you all on your willingness to share your own knowledge in these forums. I have been studying them for weeks trying to glean tidbits of valuable information that I might be able to use in the upcoming weeks, months, and even years.  BloodBank Talk has some of the best and brightest minds in the industry openly sharing a wealth of information, and I appreciate each and every one of you who contribute to the conversations!

You all are officilally scaring me.  I am starting a new job next month as the director of the transfusion services at THREE large academic medical centers (two adult hospitals and one pediatric).  I am almost positive that one of these patients will show up in my first weeks.
I wanted to share that because I feel compelled to compliment you all on your willingness to share your own knowledge in these forums. I have been studying them for weeks trying to glean tidbits of valuable information that I might be able to use in the upcoming weeks, months, and even years.  BloodBank Talk has some of the best and brightest minds in the industry openly sharing a wealth of information, and I appreciate each and every one of you who contribute to the conversations!

You all are officilally scaring me.  I am starting a new job next month as the director of the transfusion services at THREE large academic medical centers (two adult hospitals and one pediatric).  I am almost positive that one of these patients will show up in my first weeks.
I wanted to share that because I feel compelled to compliment you all on your willingness to share your own knowledge in these forums. I have been studying them for weeks trying to glean tidbits of valuable information that I might be able to use in the upcoming weeks, months, and even years.  BloodBank Talk has some of the best and brightest minds in the industry openly sharing a wealth of information, and I appreciate each and every one of you who contribute to the conversations!

You all are officilally scaring me.  I am starting a new job next month as the director of the transfusion services at THREE large academic medical centers (two adult hospitals and one pediatric).  I am almost positive that one of these patients will show up in my first weeks.
I wanted to share that because I feel compelled to compliment you all on your willingness to share your own knowledge in these forums. I have been studying them for weeks trying to glean tidbits of valuable information that I might be able to use in the upcoming weeks, months, and even years.  BloodBank Talk has some of the best and brightest minds in the industry openly sharing a wealth of information, and I appreciate each and every one of you who contribute to the conversations!

Thanks, Cliff, for the Velcro idea! It took a few hours to get all the old labels off without alarming the poor fridge but I relabeled our shelves this week.

I just took it this past October and passed.  It was crazy hard.
Study everything; the last two weeks, identify your weak areas and dig into them.  The test is very intuitive, quickly identifies your weak areas and tailors your test to torture you. 
My test was all molecular, complement, and HLA.  I had only one calculation and one question about panels.  A few of my classmates took the test: one had all donor stuff (her weakness), someone had a lot of calculations (his weak area).
If you can get a hold of the AABB Annual Meeting SBB review, I would recommend memorizing what's on there.
Wishing you the best!  If you want any specific details about the format of the exam, etc, private message me.

They're not going to die from that though - a DHTR may occur, but there have been cases where Kpb+ units have been transfused without any shortening of the red cell lifespan. They may have unpleasant clinical manifistations that the clinicians can deal with at some point but this is a better option than exanguination.
Stick them on iron, B12, folate and erythropoetin and they will produce their own red cells pretty sharpish - hopefully quicker than the transfused cells are destroyed with a DHTR.
As long as the clinicians are aware that it is going to happen, they can deal with it.