marvy1

We just purchased a number of room temp and fridge temp coolers from Thermosafe. They are easy to clean and come in various sizes. They use phase change materials for insulation. http://www.greenboxsystems.com/

User dmpollock had a different answer to this question in 2009: Hopefully most transfusion services are aware that they have to register with FDA, and thus will be inspected by FDA if they "manufacture" products. "Manufacturing" includes drawing donors and making components (other than splitting components). Even if the facility does not draw donors, but they leukoreduce products in the lab, or irradiate, they must be registered. I recently found that they require registration for preparing reconstituted whole blood. I am curious what people think of this and how they are handling it. From this page: http://www.aabb.org/Content/Programs...cripts2008.htm Question 37: I have a question regarding exchange transfusion. Can we issue AB plasma & RBCs in two separate bags that have been sterile docked together, but separated by use of a clamp so that the RNs can open the clamp and transfuse the product? Do we need FDA registration to do this? Response: If you sterile-dock plasma and RBC units together and issue it as a final product, you are performing a manufacturing step that is not covered by the exemption from registration in 21 CFR 607.65(f). You must register as a hospital blood bank. If you combine all or part of a red cell unit and a plasma unit and issue it as a final product, this is also manufacturing not covered by the exemption from registration, so you must register as a hospital blood bank. If you issue separate red cell and plasma units, the administration of these products is a practice of medicine for which we would not require registration. We encourage you to take a quality approach. Decide what process will minimize the risk and maximize the benefit to your patients, then determine the requirement for you to register with FDA.

John Moulds wrote a one-page QandA on this topic in the AABB news (Jan 2010). In sum: don't go looking for a cold ab...if it shows up in the ABORh testing for a cardiac case, there may be use in doing a 28 or 32C thermal range test (as well as the regular 37C). 4C testing is pretty much useless as most everyone reacts at that temp.

I'm sorry you cannot customize Cerner to what you need. I was allowed a fair bit of freedom when building and it turned out not so bad (we could bundle tests and could eliminate unused phases in testing). But even after customizing, Cerner is still inferior to both Sunquest and Cerner for Transfusion (I have used all 3 for years each).

Immucor might not like me saying this, but when we were having trouble with weak Anti-D reactions both in QC and patients, we eventually got a new camera. It solved our problems. We recently had ? results in the Antibody screen of QC when the result was supposed to be negative. This seemed to happen as the QC was getting close to expiration. I also noticed the screen reactions seemed a little fuzzy when observing the strip. Immucor suggested that we wash out the manifold but we also (with the help of tech support) refocused the camera image. I'm crossing my fingers that this will have solved the problem. Will find out this month when our QC gets old.

I used Softbank years ago and it was a real good LIS for bloodbank at that time. I can only assume they have improved since then. As for Cerner, I did the install of the Transfusion part of Cerner Millenium a few years back. It is an acceptable LIS and it is nice to have all the LIS/HIS systems together. However, the Transfusion portion (and most all of the lab portion) of the Cerner LIS is far inferior to the power of Softbank and SoftLab and SoftMic (in my opinion).

In my old hospital, we switched from Sunquest to Cerner about 6 yrs back. It went fairly smoothly from the Lab perspective. I must say though, most in the Lab felt it was a downgrade. However, hospital-wide, it was a positive thing.

We have had a few cases over the last couple years where we had a neg screen and then later found an antibody on a new sample. We went back to the old sample and re-ran it and found the antibody strongly reacting. Conclusion from Immucor was that the sample must not have pipetted into the well when the initial screen was done. That was when I found out there really is not plasma check done prior to testing. Antibodies in question were Anti-K and E.

I've been noticing weaker-than-expected reactions using both Fy(a) and Fy( for a few years now. I have seen this in various labs both in Canada and US where I have worked, so I don't know if you could attribute this to problems with a cell washer. If someone is getting good strong reactions with their controls, I would love to hear what reagent they use. We have tried Ortho, Immucor and Biorad and they are all not so great.

Using the suggestions given in this thread for improving + control strength using Immucor Fyb antisera, I compared cell washer vs hand washing and Immucor panel cells vs Ortho panel cells. Using Ortho panel cells and hand washing, I was able to achieve a 2+ grade for my positive control. Using cell washer and/or Immucor panel cell, the reaction strength was 1+ to weak macro. I think we will change our Fy antisera procedure to use Ortho cell controls and hand washing.

We have been experiencing weak reactions with Fyb antisera for quite some time. Tried Ortho, Immucor and Biotest (Biorad) and all are weak.

I have used several systems. Currently using Meditech which is one of the worst for Transfusion. In the past, I used Softbank by SCC and found it to be a very good system. A little bit keystroke heavy but overall very easy to work with.

If you are looking for a big freezer, also try Gem (gemref.com). A little more affordable than Helmer.

In my previous experience in a reference lab, when we had a major ABO incompatability in a BMT, we would report whether the offending isoagglutinin was macro pos in the reverse. When the offending isoagglutinin became macro neg, we would perform a DAT (and elution if pos) to confirm the loss of the offending isoagglutinin. If the isoagglutinin was macro neg and DAT was neg, we would then switch to donor type. This protocol avoids the cumbersome titers and yet ensures the engraftment success.

We were having problems with a stinky echo too. We changed our procedure to include an addition of Virkon 1 % (which I believe is the Canadian version of Rely-on) on a daily basis to the waste container. It seems to have contained the problem. We make up fresh solution weekly and use daily.

We do a tube DAT on all positive screens along with an Echo Panel

We are getting ready to go live with the Immucor Echo. The instrument will not run Type and Screens unless their proprietary WBCor QC controls are run daily (once every 24 hours)

I am doing Echo Validation. So far the Echo picked up 1 Anti- C, 1 Anti-E and 1Anti- Jk( missed by Gel. On the other hand, Echo missed 7 Anti-K found by Gel. Did not DTT treat to see if the Kell were IgM as some people on this forum are suspecting. Also of note: found multiple examples of Anti-D or Anti-D +E found in Gel that only appear as Anti-E (+ or - the occassionaly D pos E neg cell reacting weakly) on Echo. Has any one else noticed the difference in reactivity of specimens with Anti-D between Gel and Echo/Immucor Solid phase?

In my varied career, I have used Soft, Misys (Sunquest), Meditech, Cerner and others (?). I built the Blood Bank module for Cerner and it replaced our existing Misys. The replacement was a downgrade for us but overall I think Cerner was liked by other (non-Lab) people. I have used Soft before and liked it. I am currently using Meditech...and for the Blood Bank (I cannot speak for other departments) it is by far the worst system I have encountered...poor customer service, poor ability to upload history, poor method of antigen typing, and doing anything in the sytem requires changing multiple settings and having a PhD in computer sciences. It just doesn't have to be that difficult.

We use dataloggers that have a visible alarm (flashing light) that displays when the logger is out of the user-determined limit. I have the remote site read and record the temp daily and also have them document if the alarm light is (or is not) flashing.

We are a larger hospital but 6 hours away from our blood center. Occasionally, we get IgA deficient patients or (more commonly) pregnant females with high incidence antibodies. Would like the ability to receive rare frozen units from our supplier and only thaw and deglyc if required.

Mabel, I use a datalogger for a remote room temp storage site. Its cheap and easy to use (download data once a month). I agree for fridges and other alarmed equipment that dataloggers are not the best solution. However, for room temp monitoring, I find it works as an acceptable, inexpensive alternative to having an integrated temp control system. Mine is from Extech and it records temp and humidity every 4 minutes for over a month (greater than 60,000 data points). I can then print graphs and tables when I download. It also has a visible alarm when it goes out of defined temp range that I have the nursing staff monitor once a day.

We are thinking about getting a blood washer for those rare times we may wish to wash or deglyc frozen blood. Wondering if anyone can share their opinion as to what I should be looking at? I have used an old COBE before somewhere else and it seemed to work ok, but curious about the Haemonetics washer and others?

We have found 2 cases of weak-reacting K found in Gel that were missed by Echo. On the other hand, I did find 1 Anti-Jk( missed on Gel but picked up on Echo. We are still in the preliminary phases of validation, so time will tell...

I have seen many examples of weak to 1+ examples on screening cells and 0.8% panels in Gel. Since their reformulation this has become a fact of life. The reformulation seems to bring up a lot of "garbage". If there is no clear specificity, we rule out using "home-made" 3% diluted to 0.8% cells which almost always are clean negative.