richardsonj

Hello. We currently have an array of Helmer products throughout our lab, refrigerators, freezers, cell washer, plasma thawing unit, platelet incubator. I am very happy with each of these pieces of equipment. I will be looking for a new plasma freezer in the near future and our new bio-med guy is dead against getting another Helmer product. He wants only Follett. I of course would buy another Helmer due to the reputation we have seen (and besides, then they would all match! ) Any feedback comparing the two would be greatly appreciated! Thanks!!!

We use the same as BBK710. I have two of them in each refrigerator, one upper and one lower. We check them against the internal iCenter of our Helmer frig. The are usually within 0.5 of each other.

We use Bloodloc also. We require the nurses to send us back down the bag, lock and blood ID tag for each unit. That way we have proof that they didn't cut the bag open. I have only received one bag down that was RIPPED open. When I questioned the nurse, they said they forgot and ripped it open then remembered and then used the code to open the lock. The lock was opened when sent down and they did not try to hide it so I guess I have to believe it. ;/

We recently set up our Echo analyzer in 2010. When they were here teaching us, the technicians told us we needed to have a check method on our AHG crossmatches because solid phase "may not" detect an ABO incompatibility. They quoted the AABB technical manaul. This information can be found on page 453 (16th edition) under Antiglobulin Crossmatch in the first paragraph. "Although tube and column agglutination AHG crossmatches will also detect ABO incompatibility, the AHG crossmatch in solid phase may not. An additional procedure is required to verigy ABO compatibility, such as the IS or computer crossmatch." Since we do not have the electronic crossmatch, we do an IS with every AHG crossmatch performed on our Echo analyzer.

We do them here at our hospital. We have specially trained phlebotomists who perform the actual phlebotomy but it is under the direction of the Transfusion Service.

Hi. We just went live with our Echo on May 10, 2010. We use the Anti-D series 4 and 5. We use the same reagents on the Echo and on the bench. We do use both anti-D antisera on the bench as well as on the Echo for a couple of reasons. First, I wanted to keep everything consistent so the techs didn't have to think about which reagents to use. This is important for the generalists on the evening and night shifts. Also, when I built the tests into our LIS, I built the calculations to include both antisera. That way we only have one "type" calculation in our LIS. Lastly, for me it kept the ordering of reagents more consitent. For the validation, since we were using different typing sera prior to the Echo, I validated the Echo first against our current reagents and then validated the Echo to the new type reagents.

Thank you AMcCord. Do you have a policy or procedure that you are willing to share that deals with this scenario or something close? Thank you all for your help!

I am from a small community hospital with no neonatologists. I have worked here for 13 years and have never given out blood for a baby, however we do have a policy to give o negative (freshest available) out if needed. My question is how do we issue this blood? Do we just give the whole unit to the ambulance staff? If we had a baby in distress here at this hospital, we would be shipping it immediately. There is 99.9% chance this scenario would never happen, but it is the 0.1% chance that scares me to death. Could anyone give me some direction on this subject? Thanks a bunch!

[quote= Rhogam will not be detected after few weeks of last dose. We have picked up Rhogam as far as three months after the last dose using gel or solid phase technology. We do full crossmatches on those patient's due to the positive antibody screen. For one, you are not sure that it IS actually from Rhogam and two, it is easier to have a consistent protocol.

I would like to get this forum's opinion regarding autocontrols and/or DAT. Currently, when we get a positive antibody screen, we then run a panel with an autocontrol. If the autocontrol is then positive, we then do a full DAT (poly, IgG and Comp). If the IgG portion of the DAT is positive, we then perform an eluate if the patient has been transfused in the past 30 days. We just obtained the Immucor Echo analyzer. We were told the Echo does not do an autocontrol and we would have to do a DAT. We have determined that we could still do the autocontrol and run in as a XM with the patient's cells and plasma or do the DAT as recommended by Immucor. So, my question to you all is... What do you do and why? Thank you all for your responses! This forum is invaluable!

We have had this same problem...running out of the donor cell due to multiple people doing antigen types on the bottle. I like the idea the mcgouc presents...thank you.

We have 2 very ancient dry block incubators for tube incubation, which thankfully still work, however, I need to put in our budget for new ones in case they decide to CTB. Has anyone purchased one lately and can recommend a particular one or manufacturer? Thank you for your responses!

Amen!!!

Hi. We just signed a contract for the Immucor Echo and manual capture workstation. I was told to have unbuffered saline available to make into PBS with Immucor's pHix reagent. I am trying to get a handle on the different salines... Currently we use Nerl Blood Bank Saline pH 7.0-7.2 which I was under the assumption was a phosphate buffered saline... However, to comply with Immucor's request for installation, I purchased S/P Certified Blood Bank Saline from Cardinal Health to add the pHix to. So now...do I use the S/P Certified saline for everything else in the blood bank and add pHix to a cube for the Capture and Echo and only buy one kind of saline...OR....do I keep the Nerl Saline for everything else and buy the S/P Saline for Capture/Echo? What is everybody elso doing? Thanks for your help!

Merry Christmas to all and Happy New Year! Santa will be bringing us a shiny new Echo for Christmas!

We are still working on our interface with the Echo. We are Meditech C/S. We were able to get the type and rh to cross, but even changing the abs to T tests no luck. Meditech always says it is someone else's fault. I hope someone can help me. We have just placed our order for the Echo and the interface from Meditech. Daltonp, what version of client server are you? We are 5.55

Well, you all asked for me to let you know what the final answer was and here it is: TODAY, I just sent our Immucor rep off with a purchase order and signed contract!!!!! The Echo is on it's way. Since it is so close to the holidays, we are looking at bringing up the capture workstation first thing in January and then the Echo a couple of weeks later. If anyone out there has any insight or tips, hints, whatever on validation and setting up automation, feel free to shower me with information! Thank you to all of you who gave me tips, tricks and moral support. This forum is awesome! richardsonj@acmh.org

We have been using the Blood loc system for as long as I have worked here (13 years) and even before I came. It has worked great for us. I saw the comments about nurses cutting open the bags...we have a system in place that prevents this. When we XM a unit of blood we attach a 2-ply form to the unit which identifies the unit and where the nurses write the monitoring duing infusion. They chart the one copy and the other copy comes back to the blood bank so we can transfuse the unit in the Lab BB system. We have them send the BB copy inside the blood loc bag with the blood loc device inside. That way we know the bag wasn't cut open. I have only had one instance where (and this is the insane part) the nurse actually sent down a torn open bag. Yes, they actually sent it to the lab! Anyways, I immediately called up and inquired and was told that he did it without thinking, but then opened the bag using the code from the patient's wristband. The loc was in fact not attached to the bag and the only way it could have been off was if it was dailed off with the code. He was reprimanded and we went on with our business. The right patient received the right blood. One the other hand, it has saved us also. A couple of months ago, we issued a unit of blood to a floor on the patient that they presented a card for. They took it up and then called to say the loc wouldn't open. We told them to bring it back to the lab. The BB tech checked and it was in fact dialed to the correct letters and opened for her down here. They sent the unit back up. Same thing...did not open. Come to find out, they were at the WRONG PATIENT!!! The blood loc not opening saved the patient from potentially getting someone els's blood! We have had several inspectors amazed by the system.

Well, you all probably thought I forgot to update you on whether or not we got permission to buy the Echo. I haven't forgotten...we just have no news yet. The new offer from Immucor is going to CEO next week so keep your fingers (and toes and legs and everything else) crossed. If they don't sign this time, I don't think they ever will!

First, I just want to tell you that I feel your pain! Our OB department recently adopted a new policy to do a TS on EVERY OB admission so we too are seeing all kinds of Anti-D. We too set up 2 units of blood on these patients for delivery. We result the antibody as Anti-D and put in history that it is probably due to Rhogam given on (date). When the screen is negative in the future, we then just treat the patient as if they always had a negative screen. We also use gel, but do not do the D-modified protocol.

A frantic ER nurse shows up in the blood bank and demands 4 units of FFP RIGHT NOW! Well, it you can infuse it rock-solid frozen... A surgeon calls from the OR and states that he is not putting his patient on the table unless we can guarantee him an "endless supply of platelets" (small community hospital about 1 hour from nearest blood center...you do the math!)

Thank you! Is there a written standard from JCAHO stating something to this effect? We are not accredited by them so I do not have their standards and they are not available on their website.

I sure will! Even if you're just being nosy!!! We are also looking for best practice out there...how many patients should a tech be working on at one time using manual gel to ensure patient safety? Some of my techs have come to myself and our director (and these are the cream of the crop techs) and told us they feel they are working at unsafe levels at some times. I know myself, I have had 6-9 patients in my rack at one time. (not to mention the phone and the tube system and handing out units and irradiating blood and... we only have 1 tech each day...) What do you all think?

Hi neighbor! I will try to add my spreadsheet here... if it doesn't appear, give me your email and I will send it to you. A Day in the Life of a Blood Banker.xls

Ditto on the Helmer products. They are great...especially the i-Series with the i-Center.