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Everything posted by webersl
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Dear Khalid, We use TempTrak by Intelliware. We are very pleased with the performance. I am only the end-user. I cannot speak to the computer set up and installation or price. But the features are similar to what was described for the REES system. There are several helpful reports and graphs that can be reviewed. You can make comments in the system (even multiple comments) about each refrigerator/freezer when they alarm, or you can make comments unrelated to an alarm. When temperature is outside of acceptable range, you can program TempTrak to e-mail, page, or have a sound and a flashing pop-up on as many computer screens as you like. If no one responds within the time that you programmed, then it will continue to the next person/pager/screen that you programmed.
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I assumed he meant DVI - being called Rh+, getting Rh+ blood, and then forming anti-D.
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When the physician orders a "Rhogam Workup" we get a type and screen. We are thinking of adding a result line to those tests that is "Suggested Rhogam Dose". We would fill this out after going through all the necessary testing. Rhogam is stocked and dispensed through the blood bank. KB is done in hematology.
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With Immucor, techs were used to a 4+ the vast majority of the time. With Biotest, you can expect a 3+ frequently. Sometimes, (much more frequently than with Immucor) you get a +/- or a 1+. Techs who are expecting a 4+ will shake too hard and too long and they can shake away a +/- or a 1+ until it looks negative. This has happened several times with us. For adults, it is a tollerable error (no IAT is done on adult patients). For newborns and cord bloods, we have always required IAT on negatives (weak D testing), even with Immucor. What we find with Biotest is that if it is weak at IS, it doesn't really get stronger at IAT, but it doesn't go away either. Our rule for Biotest is: if it is positive in any way at any phase, the person is to be considered Rh positive.
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I use commercial antisera and do doubling dilutions in 6% albumin to find the reaction strength that I am looking for (1+,2+, etc). Then I make up a batch at that concentration. It doesn't always come out right though, and it is time consuming. I do this when I am trying to verify that my staff can accurately grade tube agglutination reactions - it's not really for students. I use real patient serum (frozen) for students. I don't bother trying to match it with red cells. I just teach that concept separately.
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Anyone Using Bio-Rad's Blood Bank Reagents?
webersl replied to jhaig's topic in Transfusion Services
We've switched from Immucor to Biotest for ABORh and rare anti-sera. Validation went fine, but it should be noted that anti-D is often a weaker reaction (but still clearly positive) - so unsuspecting bench techs should be warned in advance. Really like the cost savings. -
Draaa, What country are you in?
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I promise this is the last time...
webersl replied to Brenda K Hutson's topic in Transfusion Services
I think, just two independent identifiers? 5.11.2 -
Same for us. We only keep them out of fridge 8 hours per 24 hours. Reduced problems, but not cured.
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I agree.
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We confirm the ABO. We do not confirm the antigen type from reference lab whether historical or actually tested. We sent it to the reference lab because we do not have the resources to do it in house. We contract with them to provide this service. Since we do the AHG crossmatch, we would catch a clerical error, if made.
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How many times do you perform an antibody identification?
webersl replied to javvcr's topic in Transfusion Services
If we hadn't had a specimen in the last 3 days, we would start with a screen, and then do a selected cell panel to rule out everything but the previously ID'd Aby(s). -
What does that MEAN? Is that some kind of English proverb? On expired panels we QC the specific cell for the specific antigen we will be eliminating based on a negatvie reaction with that cell. (So if we are using cell # 4 to rule out anti-S, we check for S antigen on cell #4.) Unfortunately, we do not have access to truely weak antibodies and use commercial antisera - you're going to die - undiluted. There is a rumor that a study was done regarding the need (or not) for QCing expired panels and it was published in Transfusion a few years back, but I haven't found it. If anyone knows of it, please do tell.
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Level I trauma center in USA. Our hospital switched to Full Name and DOB as "dual identifiers" (for TJC) so that they could ask the patient to participate by stating both (which is good). But then they tried to say that Blood Bank specimens (drawn by nursing) would be labeled with name and DOB (only) and wanted to nix the Medical Record Number. We are currently "in discussion" with nursing because of CAP TRM.40230 (unique identifier) and 41300 (hospital number). In the end, we control what we will and will not accept into the Blood Bank. As of this moment, Name and MRN (among other things) are still required on BB specimens. Our MRN's are assigned in sequential order and are not based on name, MRN, or SSN.
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Though not required in the US, I would be very interested in looking into this. Unfortunately, we do not have the number of data loggers required. Hmmm. I could use Safe-T-Vue 6's (temperature indicators) in multiple locations throughout the fridge - and see if any of them got activated.... Sounds like a good project for a student.
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CAP is an org in the US that is allowed to inspect on behalf of the FDA in certain institutions. (Ours is one.) CAP has a bunch of points on temperature monitoring, this is just one: Is there evidence that all large refrigeration units maintain the proper temperature throughout the unit? We normally accomplish this by having the temperature continuously recorded, and alarms connected to, both the top shelf and the bottom shelf. (A very large unit would require more.)
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Thanks! That is a logical explanation that I hadn't thought of . Our "trauma units" (2 O negs) end up making multiple trips in the cooler (validated 1-6 for 23 hrs) back and forth from BB to ER. We continue to use the same Safe-T-Vue once it's been applied and don't remove it. Sometimes the same 2 units go back and forth from BB to ER for >2 weeks, yet the indicator remians white. The example in my previous post had only been out and back once. Hmmm. I don't know what to think. I had my staff review the insert and watch the video to make sure they were handling and applying them correctly to see if that helps.
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Removing bone marrow is extremely painful. Not just the access part, the suction part as well. If you need a type and can't get venous access, please, just do a heel stick or finger *****, or even an arterial stick. Just my opinion.
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I'm in a Hospital based Transfusion Service in the US (not a blood collection or manufacturing center). I am not familiar with the term "Temperature Mapping". FDA requires blood and blood products to be continuously monitored (alarms). Temps must be recorded at least every 4 hours for the entire life of the product. Don't know if that helps.
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We have had a rash of red indicators lately (which was causing us to destroy a lot of blood). I began paying closer attention to the circumstances and found that in at least one case (and suspected in another), the indicator was white (pass) upon return from ER and removal from the cooler. The unit was placed back into the fridge overnight. The next day, the indicator had turned red (fail). The refrigerator has integral alarms, in addition, there is an external montioring system (TempTrak). Neither alarm went off; temp graphs are all within range. Has anyone else experienced this?
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I agree with clmergen on this
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Set: 36.5 Alarm: 37.3 Logic: Why 36.5? To be as warm as possible, but far away enough from the alarm set point so that it is not alarming all the time. Why 37.3? All regs previously mentioned give only two significant digits (37, not 37.0). The temperature controller display on the Helmer DH4 and DH8 gives an additional digit (37.n), but you can only be held to the number of sig digits in the regs. To compare your set point to the reg, you must round your set point to the nearest two digit number. Therefore, rounding 37.3 to 2 digits = 37 and you're good. To JLF: The thing in AABB about setting alarms to go off before the temp range is exceeded is specific to STORAGE devices, and a thawer is not a storage device.
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Can someone explain the logic of why most of these blood bankers, even though they have proved that the anti-M is not reactive at 37C and therefore is not clinically significant, why they proceed with full AGH crossmatch, instead of just doing an immediate spin crossmatch? AABB Standards 5.15.1.1 are clear that you are only required to do and ABO crossmatch as long as CLINICALLY SIGNIFICANT antibodies are not found (and no history of such). I understand that by choosing to do ABO crossmatch only, you will get interference with the anti-M, so you will have to crossmatch many more that you actually need to see a clealy negative ABO crossmatch, but this saves a lot of time and reagents. What is the logic - why continue with the AHG crossmatch?
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Help! I am a Transfusion Service Supervisor dealing only with blood and blood products (and RhIg). Tissues was handled by OR. We just had a bad JCAHO inspection regarding tissues. I know this is going to end up in my lap, but I know nothing about tissues. WHAT SHOULD I READ? Where do I start to learn the products and the related regs?
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We only do cord bloods when mom is Rh neg, O, or has antibodies. I would like to get away from doing O mom's (unless Rh neg or has antibody) and let jaundice speak for itself! I'll see if the perinatal guidelines support my thoughts.