kmoremedtech

To be honest...I don't know. I did not set the policy merely walked into its pre-existance. I believe it comes down to ... giving the floor as much time as possible to administer the product. As for ED and Surg patients..I agree with John. The physicians do order the RhiG evaluation...and if it is missed...it is their problem. If we set up a product and it is not picked up...it is out of our hands. We have done our part, which is filling the request.

We do not thaw an FFP, even if ordered STAT until the RN calls --and they must call us, we do not call them--to tell us it will be transfused within 30 minutes. We also have a Blood Committe made of DR's, pathologist and BB supervisor, who look at the monthly report of waste and usage in an effort to keep product loss down. It helps having the physicians understand that certain products can not be set up until patient is actually being transfused.

We TS all OB patients. All babies of Rh neg patients have type and DAT performed. If baby is Rh positive, then a STAT Fetal Screen test is ordered. If it is neg...patient receives 1 vial of RhiG. If pos..then a KB stain is performed STAT and patient recieves appropriate vials of RhiG. When RhiG is ready for pick up, we call the floor and document in computer. The floor usually comes right away to get it.

Thanks for all the great ideas! This is the greatest asset in the world. Does anyone know of a forum that exists for microbiology?

do you run a diluent QC on a daily basis? Or only with each new lot number?...I read the insert to say run on a daily basis with each lot---meaning each lot in use.

We do a type and screen on ALL OB patients coming in for delivery. This way it allows us to deterine antibodies, Rhig evaluation, etc..while the patient is delivering. Saves a lot of time. If we have a historic type, we do not require a second seperately drawn sample for confirm typing. If the patient does not have a historic type on file, then another type must be preformed on a sample collected at a different time than the TSOB sample. Usually, we can pull a sample from hemotology seeing as it is also required to draw a CBC before the patient goes home.

Yes. The Provue appears to be very sensitive to weak expressions of the D antigen. Patients that had historical types as Rh neg are now being interpreted as D positive on the Provue. These patients did not meet our criteria for performing manual weak D previously to using the Provue, so we can not compare the results in that sense. However, we are no longer testing women of child bearing age due to the sensitivity of the analyzer.

Our correlation studies with the reformulated cells were ruff at best. In order to keep our reagents stable, we rotate our racks every eight hours. We have two manual racks that are QC'd daily in the am. We also have three separate racks for our analyzer, which we switch out every 8 hours and run QC on once every 24 hours.

We used to do Weak D testing on all Rhig canidates and newborns, until last week. We have an automated system that uses gel technology and catches most of our weak D population. So we no longer do Weak D testing on women at all--only newborns.

Has anyone out there validated prewarm crossmatches in gel? Ortho has a procedure for prewarm antibody screens--has anyone modified it for crossmatches on patients with cold antibodies?