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DeeMc

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About DeeMc

  • Birthday 05/10/1954

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  1. Are you alerted when the network is down? What if temps do not post to the server for over 4 hours? Do you also use paper charts for documentation of temps at least every 4 hours? The laboratory in my facility uses Temptrak but I have been hesitant to use it for the Blood Bank blood storage devices.
  2. Happy Birthday!

  3. How are name changes handled in your facility? Does your policy indicate that the compatibility label always match the identifiers on your specimen? Does a name change always require a redraw? Does your system process name changes automatically? If you use an additional Blood Bank band, do you require a redraw so the Blood Bank band identifiers match the patient identification band after the name change? Is your policy the same with Trauma?
  4. We provide Rh and K antigen matched, Hgb S-neg for PRBC transfusion to all our sickle cell patients. Exchange transfusions also require units < 14 days old.
  5. I am about ready to go live on the central temperature monitoring system. We will be doing annual NIST temperature verifications on all sensors and quarterly alarm checks. We plan to review the CTM temperatures daily and document that review. I am still unsure if the annual NIST certification is acceptable or do I have to correlate the digital thermometer to the CTM sensor readings more often. Any advice is appreciated.
  6. Several inspections ago I was cited by CAP for not performing alarm checks on my water bath. I asked if facilities with water baths that do not have an alarm get cited for this. I still received the citation but I challenged it stating that a water bath was not a blood storage device and my citation was expunged. Just in case, I implemented the alarm check anyway
  7. I have attached what we use... the formatting of the tables did not work well in the post MTP for pediatric patients.doc
  8. For those of you who are totally paperless, what does the nursing staff document in the EMR? Do you have an electonic system that automatically enters the unit information by barcode scanning? Is this information also documented in the EMR when transfusions are given intraoperatively?
  9. Practice does vary from NICU to NICU. There are multiple studies that have shown that small volume transfusions (10-20mL/kg) given over 2-3 hours cause no change in K+ levels. Larger volume transfusions, however, are a different story. Strauss R. Controversies in the management of the anemia of prematurity using single-donor red blood cell transfuions and/or recombinant human erythropoietin. Transfusion Medicine Review. 2006;20:34-44
  10. My facility transfuses 100% pre-stored leukoreduced CMV-safe products to all patients (including neonates and transplants). Any requests for CMV sero-negative must be approved through our Medical Director.
  11. It can be difficult to identify those infants who fall into the categories AABB lists as those that require irradiated products. One of the immune deficiencies encountered in infants is DeGeorge syndrome (an immunodeficiency that often occurs with cardiac anomalies). That diagnosis is not identified immediately upon admission to a NICU or CVICU. My institution has a 98 bed NICU and a 28 bed pediatric CVICU. For patient safety, we irradiate all products for infants in NICU or CVICU regardless of their birthweight. Yes, we do have our own irradiator. We also limit donor exposure by designating a specific unit for a baby and use until its expiration for small volume transfusions. If a large volume transfusion is needed (for OR) a fresh, irradiated unit is selected. And we do give fresh, < 5 day old blood to all cardiac surgery patients < 2 years of age.
  12. How does your nursing staff document start and stop times for units that are used for ECMO Primes? Is it enough to indicate "For circuit prime" and not document start and stop times?
  13. We switched from a cesium to an x-ray irradiator in 2009 and we have had 2 downtimes since installation. We irradiate approximately 4500 - 5000 irradiation cycles per year and we still have the original x-ray tubes. One power supply had to be replaced. The recommended maintenance is easy: time check, door and canister interlock check, etc. and two dosimetries per year. Our vendor supplies one PM per year (this is based on usage; if heavier use - 2 PMS recommended) Pros: Up to three units can be irradiated at the same time. No regulations Very easy to use Cons: Requires water supply at proper flow rate, temperature and pressure Replacement x-ray tubes and power supplies costly Must wait for parts to be delivered (One of our downtimes was 5 days) I have been pleased with my x-ray irradiator and so very happy to be rid of the regulations associated with our cesium irradiator (which I imagine will only get worse). Our processes for irradiation are pretty strict and are designed to help protect the x-ray tubes (we perform a warm up cycle if the the irradiator has not been used in the past 30 minutes). Probably a little overkill but we have never had to replace a tube. We are also in a very warm climate and we do not use a chiller for our water.
  14. Searching by last name has its limitations as well. I am at a Children's Hospital and we have more last name changes than we have duplicate MRNs. Searching by either MRN alone or Last Name alone will miss patients with historical records. You can choose one criteria for your first search and if no history is returned, search by the second criteria.
  15. Hopefully someone can help confirm the correct ISBT codes to use for Thawed Plasma, frozen within 24 hours. I think.... an E2555 (PLASMA|CPD/XX/<=-18C|Frozen<=24h) once thawed becomes an E2701 (Thawed PLASMA|CPD/XX/refrig|Frozen<=24h) with a 24 hour outdate. If I want to extend the outdate to 5 days it appears as if the ISBT code would be E2684 (Thawed PLASMA|CPD/XX/refg). But this is the same product code that I use when I extend an E0773 (Thawed FRESH FROZEN PLASMA|CPD/XX/refg) Am I on the right track?
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