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Everything posted by BBK710

  1. BBK710

    Kleihauer Betke

    Who performs this test? Hematology or Blood Bank? Is it done on all shifts as a STAT test? If so how do you maintain tech competency if your 2nd & 3rd shift techs are generalists? What is your turnaround time? The majority of the KBs that we do are ordered by physicians on antepartum patients who have fallen or have been in a car accident. Our current policy is that this test is done on day shift only since that is the only shift that does evaluations on Rh neg moms post partum. We have a physician who wants us to change our policy to to the test stat on all shifts. Obviously our generalists are having a fit. Any information that you can offer would be appreciated.
  2. BBK710

    Cord Blood Testing

    We only test cord bloods from Rh negative mothers. But we hold the cord blood on O pos moms in case the pediatrician wants it tested. Does anyone test these "held" specimens after the baby has been discharged? If so do you have patient identification issues? Many of our babies have a completely different last name after discharge. Do you bill under the inpatient account since that was when the specimen was collected?
  3. BBK710

    HDN procedures

    We do a blood type and DAT. If the DAT is positive we do an antibody screen on the mother. If the mom is type O with a negative antibody screen and the baby is A or B we report this as presumptive evidence of ABO incompatibility. We stopped doing the LUI freeze thaw years ago.
  4. BBK710

    General Blood LLC

    Has anyone heard of or is anyone using General Blood LLC?
  5. BBK710

    Blood Bank FTE's

    I am curious about all of those who staff with 2 or less on day shift. Do your techs work every other weekend? Are you automated? How many types/ type and screens do you do daily?
  6. We check our computer system using the patient's medical record number. We also keep a card file on all patient's with antibodies or special transfusion requirements. We check that as well and would investigate any possible matches or discrepancies. I know a card file may seem out of date but it is great for downtime and registration errors.
  7. BBK710

    Nursing orders to transfuse

    Currently we require that nursing documents on the blood request card that they have verified the physician order to transfuse. We only crossmatch units if there is an order to transfuse. We do not "hold" blood for anyone except the OR and those units are not issued to anyone but the OR. If they are to be transfused post-op we require the physician to place a new order to transfuse. We are in the process of creating a nursing order to transfuse that will print in the blood bank so that we know there is an order to transfuse.
  8. We just got a patient today. Positive in cell #1 VS633 and in cell #4 on Panel A VRA 181.
  9. We require a second specimen to verify ABO/Rh on all transfusions when there is no history. In that case we would still need a specimen when they prep them for surgery. We currently do a Type and Rh on all L&D admits. If they need a screen added for surgery we use that specimen and request a second specimen for Blood Type confirmation. Unfortunately they almost never send them because the patient is already in the OR.
  10. BBK710

    Not issued in the LIS

    We have upgraded to 7.0 and they have NOT improved this process. It still times out. And it is very easy for a tech to get distracted during this process particularly if they are the only person in the department at the time. I would be very interested in hearing what process others are using to prevent this. For those who don't print the unit tag until time of issue do you identify units in the refrigerator prior to issue? Obviously the process to issue will take longer and I am not sure that the nurses who come to pick up blood will be happy about that since they are always in a hurry to get back to their patients.
  11. BBK710

    syringe ISBT code?

    Once the blood is transferred to the syringe from the aliquot by nursing how is the syringe labeled? All of the information is on the aliquot which would be discarded once the blood is put into the syringe.
  12. BBK710

    frequency of unit inspection

    We actually visually check daily at the same time we are checking that the groups are not mixed up and in expiry date order. We do not have a large inventory so this is not a problem for us.
  13. BBK710

    Frequency of Alarm Activation

    We do it quarterly as recommended in the AABB Technical Manual. We also document any alarms when they occur.
  14. BBK710

    frequency of unit inspection

    We document visual inspection of all units upon arrival, daily and at issue.
  15. BBK710

    Use of CPT Code 86885

    We do the same. I have noticed that our reference lab no longer charges the 86870 AB ID/each panel and media. They just charge the 86885 for each selected cell. Sometimes we are charged for 25+ cells. I have not heard that we have had any problem with these charges going through.
  16. BBK710

    0.8% screening cells

    We aliquot from the bottle daily and keep the aliquots in an opaque plastic container when out on the bench to keep away from the light. We haven't had as many contamination problems since we started doing this. A question for those who dilute the 3-4% cells. Did you do any kind of validation?
  17. BBK710

    Stability of Rhogam

    I contacted Ortho tech support with this question several years ago and was told that it may be left at 33C for 10 to 15 hours.
  18. BBK710

    Weak D

    When we receive an autologous unit labeled Rh positive for a patient who types or has a previous Rh negative we will do weak D testing. If the patient tests weak D positive we report the patient as Rh positive with a comment that it is a weak D and patient should be transfused with Rh neg blood after the autologous unit has been transfused.
  19. BBK710

    Gel testing anyone?

    We do the same as Brenda. I am in no hurry to do blood types in gel since I have read that there are so many weak D issues with historical types etc. And I agree that it is much faster and in my opinion easier to do the blood type in tubes.
  20. We had the same problem with the temp going below 1C. Thermosafe validated the coolers using packs that were "conditioned at -20C +/- 5C for 24 hours. Since our plasma freezer is always -28C or colder I figured that was the problem so we now keep our cold packs in another departments freezer that is -18C to -20C. This has worked and has validated fine although having to go to another dept. for the packs is a nuisance. Fortuanately we don't often have to use the coolers.
  21. BBK710


    We also do this platelet function test using verify now. If a physician orders platelets for an OR procedure because the patient is on Plavix or asprin we will not order platelets (we do not store platelets) until they have had the testing done and the testing show a specific level of platelet inhibition. Our medical director will contact the surgeon if the testing has not been ordered.
  22. BBK710

    Thermometers in Glycerol solution

    We get ours from Cardinal Health. It is a "kit" including the thermometer and 250 ml. bottle of ethylene Glycol/Water specifically designed for Blood Bank refrigerators. Catalog number is T8401-6.
  23. BBK710

    ASCP certification

    We require certification for all MT's and MLT's. If we hire a new graduate they must take and pass the exam within 6 months as a condition of their employment.
  24. BBK710

    IS crossmatch with gel

    Our crossmatch maintenance is built for phases IS, 37 degree, and AHG and CC. We enter reaction results for only the phases that we test and ND (not done) for the ones that we don't. This allows us to use the test XM for any type of testing performed. I believe that there are CPT codes for IS, 37 degree and AHG phases but I am not at work and can't check my CPT code book.

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