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Posts posted by Likewine99
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We have been on the 2 cell screen for as long as I can remember and we perform panels.
Price is a consideration, one less gel well, 2 cell screen set is cheaper than the 3 cell set.
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We are CAP and not AABB. AABB was dropped about 15 years ago due to cost, we are comfortable with just being CAP accredited.
Staffing also factors in to this as our supervisors across the lab all have more than one discipline to manage and I function as BB sup and lab manager.
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We see this occasionally and find with pregnant patients that it is often a cold. Instead of doing the whole panel we often do a tube (LISS) screen or a prewarm screen.
We get a fair amount of rouleaux, not necessarily on pregnant pts but the is easily resolved. Remember gel is a tool on our tool belts, you could also repeat the screen with PEG or whatever other enhancement media you have.
If we can't resolve the reaction we call it "all common clinically significant abs r/o" and these pts would receive an AHG xm if they needed a transfusion.
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We currently don't have this problem but have had it in the past but not at the 40% level Centrifuging the cards seemed to help. If you're not happy with them have Ortho issue credit or send new stock.
The 2 times I have asked to return cards they have always sent a new lot and told me to keep the old lot and use on the bench.
This leads me to believe that other users complained about that lot number. Don't hesitate to complain, we all pay lots of $$$ for their product.
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Lekota40, if you are unhappy in your current position you can fire your manager. This can be accomplished by moving on to another job at another blood bank.
Re: a person not working a bench reviewing work, John has summed it up in a nut shell. If you are concerned about your current supervisor's ability to reviwew your work I would suggest you talk directly to him/her.
Prior to the coversation you should have a minimum of 3 concrete examples where you feel your supervisor is in error or has reveiwed your work incorrectly.
Supervisors are criticized all the time, welcome to my world!!! Remember, we are human too and can make mistakes just like plain old bench techs. Everyone in your BB needs to work together as a team and do your very best to deliver the best possible result for your patients.
Working as a team includes everyone at all levels of experience, from those techs with hands on expereince, and those techs with book smarts, and those lucky individuals who have both.
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Congratulations!!!
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I had a surgeon ask for FFP stat and I explained it would take 30 min to get it ready. He said that was too long and he was sending someone up right now to pick it up, it better be ready.
When the pick up person arrived she said he wanted it regardless of how thawed it was so I sent it out about 1/4 of the way thawed, not even close to being slushy, big huge ice chunk still in the bag.
It came back up in about 10 minutes with the instructions from the surgeon to "thaw it all the way". I think he may have said please!
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We have a ProVue and love it. I am a supervisor and work the bench in a Level II trauma center that does about 25-30 T&S a day. Haven't had the problems that knittie5 has had and like anything else, once you get the hang of it you will like it. Once you go automated you wonder how you ever got anything done the old way.
E-mail me at Mary_Mendel@ssmhc.com or feel free to call anytime: 314-344-6859 an I can give you the in's and out's of how it works for us.
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I ran a CBC on a pediatric sample collected in a Microtainer tube. This patient was in the ED and the plt count was <10,000. I called the ED and asked to speak to whoever had drawn the blood on this pt to see if there was any possibility that this specimen could be clotted.
The doc came on the phone and I explained that I thought it was unusual that the plt count was this low when everything else looked perfectly fine.
I asked if he thought that the spec could maybe be clotted and he said, "I know there aren't any clots in that specimen I removed them myself".
Come to find out, the ED had applicator sticks in the dept and they were checking their specimens for clots prior to submitting them to the lab.
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We had a pt that was an O pos and was scheduled to go to OR. We had 2 directed donors for this pt, both donated by her adult children that were A pos.
I called the surgeon to let him know that we did have the dd's but that they would not be compatible for the pt. The pt was apprehensive about receiving blood from someone she didn't know so the surgeon suggested that "maybe we should send her husband down to donate for her".
As diplomatically as possible, I asked the surgeon if the pt's husband was the father of the children and he said, "of course he is".
I proceeded to explain to the surgeon, diplomatically I might add, that since the kids were group A that the husband was also group A and his blood would not be compatible either. I saved the husband a trip to the blood center!!
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Several years ago the lab and hospital moved to a new computer system. A nurse called me looking for a CBC result.
We were guiding them through the new screens so they could get the feel of how the lab screens looked and so they could look up results for themselves w/o having to call us all the time.
I guided her to the CBC result line and she said, "the status of the test is D-O-N-E, what does that mean?:eek:"
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You know gray has always been one of my favorite colors. Goes well with navy blue!
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Hi Trey, I'm also from STL , I work at DePaul in the BB. It's great to see a newbie who loves Blood Bank and you will find this site very informative and very helpful.
Welcome to the group, you will love this site.
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My organization, in the state of Missouri, allows MLT's to work any shift any dept including BB unsupervised. It's not the credential, it's the competency.
In my many years I have worked with many different credentialed individuals(MLT through SBB) and I've seen both good and not so good blood bankers at all levels.
If where you interviewed is using this as an "excuse" or if it is in fact true, then you might not want to work for them anyway, they'd keep hanging it over your head.
Sometimes this policy is set by individual hospitals but I think it limits their applicant pool, there are MANY qualified MLT's out there that are more than capable of working in BB either supervised or not.
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Lara,
It is not a difficult transition, you can get labels from your blood supplier to validate your computer system. We don't split units either, it only happens a couple of times a year and it wasn't worth messing with.
The nurses hate the long numbers but the BBers get used to them pretty quickly. If your computer system doesn't generate labels, as in during an FFP thaw or cryo pool, you can get product labels from one of the commerical vendors.
I'd be happy to share more info with you: Mary_Mendel@ssmhc.com
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Can you tie it to patient safety? Less chance of an error with an automated analyzer. Facilitates crosstraining of techs which benefits the lab overall.
Don't forget if you automate you can eliminate some QC at the bench if you are using like methodology and reagents, this saved us about 45 minutes/day plus reagents.
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All electronic for us.
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You should QC the tube reagents "each day of use". We do the same as you, do a quick tube while the T&S&XM is on the Provue.
We label 2 sets of 3 tubes (6 tubes total) for anti-A, B, D and add 1 drop antisera to each tube. We have an Oneg and ABpos pt we use for the pos and neg controls. We use the MR# as the lot number and they expire 2 weeks from the day we put them into service.
Make a 3% suspension of each pt, add the Oneg pt to one row of tubes, the ABpos pt to the other row of tubes, spin read, voila done! Takes all of 5 minutes to do, evenings does it every shift.
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We are the same as sgoertzen
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I agree with AMcCord. We use gel, both automated and manual at the bench. The current JAT survey isn't configured for antibody ID so we do those with the manual gel survey.
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I had a 3 day onsite visit by the FDA about 7 months ago and she could not have been any nicer. Your Medical Director should speak with someone in authority at the regional office where this inspector works.
I'd also mention her rude and disrespectful behavior, she was there to perform an inspection and that's unprofessional.
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Lcsmrz is right, doing your own validation is a great way to learn the system even though it is very time consuming. Having a plan and validation documentation is a must.
You can have a 3rd party validate your software, now days I think they can remote right into the hardware that you will be/are using and perform the validations on that hardware. Open up your wallet though, I know it doesn't come cheap.
We have multiple sites on the same server and just went up last fall, we did our own vals. If you have questions send me an e-mail Mary_Mendel@ssmhc.com
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And those of us using Ortho reagents will probably be held hostage too.
You know, we're have such better quality than the other guys and you should be lucky to have us as your vendor, blah blah blah $$$$$
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We use the CAP website and the techs like it (me too). The price was right but off the top of my head I don't remember exact pricing. It's a good deal.
can you tell if Rouleaux is present just from looking at the gel card?
in Transfusion Services
Posted
trisram,
Blood Bank can be quite intimidating but in this day and age even a Microbiologist can do BB!!
Seriously though, David is absolutely correct. You can also tell rouleaux because sometimes the cells kind of "cling" to the sides of the gel tube. It sort of looks like a ropey thing sliding down the side of the tube. Sorry for the highly technical, BB terms!
BTW, you wouldn't want me in Micro, there are organisms out there that weren't even around the last time I worked Micro. Good luck in the BB.