BloodBank

Does any one have comments on following issues? 1. Blood received at Hospital 1, confirmed, removed segments of 10 units and transferred to sister facility Hospital 2 (same LIS/HIS), stored at Hospital 2. 2. Specimen collected at Hospital 2, transported to 1 for testing. Hospital 1 performs Electronic Crossmatches. 3. If request for red blood cells received for patient at Hospital 2, Hospital 1 will ELXM and select RBC. 4. Hospital 2 will obtain RBC from storage, reprint compatibility label and issue in their computer. Can this be done? Any problem with regulation? Does it have tobe under same CLIA licence? Any reference? Any one is doing such protocol? Like to share? Will appreciate the response. workflow.vsdworkflow.vsd

Can anyone share their validation plan for sorvall cellwasher 2 Plus? We also use plastic tubes.

As far as my understanding when I validated Electronic Crossmatch is that one does not need to perform IS XM if your computer system is validated to ensure the detection of ABO incompatibility and prevents release of such units. In other words per logic table set in the computer, it does not allow us to select ABO incompatible red blood cells whether it is IS or Gel XM. So there is a mechanism to detect ABO incompatibility as long as computer system is used to select and issue. I may have to change computer downtime procedure for Gel/AHG XM to include IS XM in addition to Gel/AHG XM.

I also called CAP and they told me the same. Using CAP proficiency sample is a good idea. One does not have to come up with patient sample then. Also you do get three times a year JA samples or JAT samples for that matter.

Would anyone using ProVue Gel technology has SOP to share for the TRM "If laboratory uses more than one instrument/method to test for a given analyte, are the instruments/methods checked against each other at least twice a year for correlation of results"? We do run tube ABO/Rh, manual gel antibody screen for stat samples and tube panel for Gel all cells positive (warm auto). How could you correlate gel positive, tube negative or weak?

ASCP Teleconference on 5/26/10 Using DNA-Based Testing to Manage Patient Care in Transfusion Medicine is good resource to explain the heterogenicity of D typing. Different anti-D antisera reacts with different parts of D antigen, hence giving different results!!! There is also polymorphism found in E typing.

We give thawed plasma to all patients including neonates. If physician wants FFP they will have to specify the product by calling blood bank otherwise all FFP orders are completed with plasma.

We give 5 days expiration and label as thawed plasma from the time FFP is thawed so that we don't have to relabel after thawed FFP outdates.

At our institution, we devide in a way that all techs. on all shifts get to perform proficiency testing. For example, JA series we assign to two techs, first three samples to one tech and other two and antigen testing to another tech. In a year you get 3 times JA so that we cover 6 techs. Same with eluate, DAT, titer, fetal screen etc. This is our practice for many years and none of the assessors (AABB, CAP or FDA) have questioned this. At the begining of the year when we get the schedule from CAP web site, we prepare and post schedule for each test, and tech. This way when survey comes, supv. and tech. knows who will be performing the proficiency testing.

We perform weak D test only for cord blood of Rh negative (ProVue) mom. For all other patients including prenatal are resulted as negative or positive resulted by ProVue.

We use ProVue automation for routine testing but manual tube testing for STAT, trauma and as a backup when instrument is down. So we daily perform QC of reagents on instrument and manual tube test so that all equipment are also qced. cell washer, heat block etc.

Manufacturer's user manual does not mention to check power failure. Battery test key simulates an A/C power failure.

We had two thermogenesis equipment, one to thaw 4 and one to thaw 8 units. I will not advise any one to buy those. Bad experience, too much wear and tear, not a good design at all. We had it for three years. So much repair and now we do not have any one of those. We replaced them with Helmer Plasma Thawing System. Can clean easily and no downtime so far.

Helmer DH24 plasma thawing system comes with a capacity of 24 standard units, push button auto drain and auto fill, audible alarms for high temp., cycle completion etc. www.helmerinc.com

I am in the process of revising procedure to test alarm activation of refrigerators and freezers. My current procedure has not been revised for long time. Is it necessary to test alarm activation of low and high temperature set point by placing temp. sensing probe into cold ice and warm water bath or is it sufficient to test on the panel board for Harris freezer or refrigeratos with Hemapro 2000 surveillence center. Same thing is for power failure. Do we actually need to unplug the equipment to test power failure alarm even if equipment is plugged to emergency power outlet? I would appreciate comments.

CSL Behring 1020 First Ave. King of Prussia, PA 19406-0901 Tel 888-841-2444

CSL Behring

I talked to Credo 4 OR and they are coming up with 6 unit capacity cooler which will be available in October and also at AABB New Orleans if any one wants to view. For Level 1 trauma ceter like us, 4 unit cooler is not large enough.

We have active pre-natal clinic and L&D department in Chicago (500 beds hospital) and settelite clinics. Our usage is approx. 30 Rhogam per month. We have been using Rhophylac for last 3 years. It can be injected IV or IM and it is working just fine at cheaper price for us.

We had Rad source X-Ray irradiator. Lot of problems were encountered. Service (PM) contract is very expensive. Must have very regulated water pressure. We had to replace X-Ray tube which was very expensive. Many down times. In the end power supply was out and company will not repair at any cost. So we are down with nothing. Our Cs irradiator was for running with no problems for many many years. We bought X-Ray when we moved to new Facility. X-Ray irradiator was not even 6 years of usage and was told life span is 10 years. Now we have to buy new which is almost $300,000.

We have these problems time to time. We also visually inspect. If bubbles, centrifuge them and problem will be resolved. Sometime camera can not read barcode because of some fibers etc. Wiping to remove any particulates help. We also always place few extra cards each run to eliminate reidentification and delay process.

1. We have validated all our coolers upon receipt. Also validation was for different time period, 4 hrs, 6 hours, 8 hours and 12 hours at initial validation. 2. We chose 6 hrs. as optimum time although 8 hrs. was still within 6 degrees (storage temp.). 3. Twice a year we perform QC of all coolers for 6 hours. 4. We place thermometer in cooler every time we send cooler to OR. We call OR room at 4 hr. and ask the circulating RN to read the thermometer temp. and we document that in cooler log in Blood Bank. 5. At six hr. time if OR still needs coolar, we exchange the cooler/coolant. Again exchange time and cooler number is documented along with returned cooler temperature. 6. My cell safe coolar's lid latch is breaking down after using for almost 10 years and I need to replace them. I called Cell Safe and they say, those coolars are discontinued and newer ones are thermosafe which is on wheel but I am skeptical about durability of vinyl outer casing. Any one can tell me which cooler is better. I have cell safe coolant packs that can be used in other coolars? Where can I get Igloo coolars?

What is the product code E# (ISBT) for pooled plasma? We also pool plasma for TTP patients. What is the product code number on Hematrax label for pooled plasma because if I know that I can print the label on Soft Bank printer.

We have SoftBank Computer System and want to go for electronic crossmatch. Does anyone want to share their validation plan?

We also for the last two years subscribe Eluate and Anti-D titer survey from CAP. I would also like to drop Eluate survey if not required. Cost is again the issue. Also would like to mention to JMundon regarding testing near due date. One place I went to inspect, somebody cited the facility because CAP survey was not done like routine patient testing. Normally you don't keep patient testing pending for so many days. Just a thought.