L106

Ahh...what a cutey!
 
The Fire Brigade's loss is Transfusion Medicine's gain!!

Our physicians are pressuring our Blood Bank to start stocking Factor X, Prothrombin Complex Concentrates, etc. for reversal of Apixaban, Xarelto, Pradaxa, etc as they are routinely prescribing these dregs to their patients. Our pharmacy does NOT want to stock factor concentrates. The problem is the expense, return policies, etc. We would like to know how other facilities are handling factor concentrates. Does your facility stock these factor concentrates? If so, in the Pharmacy or Blood Bank? Thank you!

On a slight tangent, I have never seen a blood bag that could be broken by simply dropping it.  At one facility we bagged them in paper sacks.  The administration thought that friends and family of patients might be disturbed at the sight of units of blood being carried through the hospital! 
 
I have, however seen one explode,  I was packing a unit of whole blood in one of the old spring loaded presses.  As I was slowly rasing the lever I was distracted and the lever slipped out of my hand at the beginning of the process.  The plate that, normally, gently squeezes the blood bag slammed into the unit with such force it ruptured the top seam and blood covered the walls as well as myself.  We had most of it cleaned up when a new house keeper arrived.  She took one look at the blood dripping from the ceiling and running down the walls, turned into the closest bath room, threw up repeatedly and then left.  No one ever saw her again. 

Thanks to all for your thoughts.  I'm at Boston Medical Center, we received 23 severely injured.  Cliff is at Brigham and Women's and I think they got a similar number.  As others have said, you never think it's going to be in your own backyard.  All the Boston hospitals were terrific - you are right that no one died after the fact once we got them.  But the real saving grace was the medical tent and a fleet of waiting ambulances at the finish line of the marathon.  All the emergency rooms in Boston brace for dehydrated and hypothermic runners at the end of the race. Without the immediate response of these EMTs, RNs, MDs, many more would have died.
We used 72 units of red cells that first night.  Somewhat more than our trauma room normally uses! 
 
One great point - we practice at least a couple of times a year for a mass casualty event.  Our system was not perfect, but better than anyone anticipated due to the disaster training and planning.
 
Plan for the worst, hope for the best. 
 
The outpouring of support from everyone has been asstounding and humbling.  We utilize the AABB National Blood Exchange for 99% of our blood products.  Blood centers across the country were calling us and offering us O's.
 
Our sports teams - Red Sox, Bruins, Celtics - have had incredible receptions at other city arenas.  Incredible!!
THANK YOU!!    
 
We are not alone.  You are with us.  We are BOSTON STRONG!!

Thanks to all for your thoughts and prayers.....
 
We are strong---BOSTON STRONG!
 
Yes, Cliff and I are BWH'ers (Brigham and Women's Hospital) we had 10 trauma rooms going on Monday evening---an unusual occurrence, to say the least!!!!!
 
----By day I am Blood Bank at a neighboring Boston hospital, by night I am a Chemistry specialist at BWH. We were on lockdown all day Friday----having SWAT teams in your hospital and State Police manning the doors is still surreal to me, but that is what we endured all week last week and culminating Friday night. We are recovering----but it will be a while before we get back to "normal".......we are so fortunate to have had the resources to absorb the influx of injuries. From First responders to the trauma teams to the ancillary services, we pulled together and saved a lot of people.
 
Here's to hoping that no other city goes through anything like what we just did......thanks again for all your support!
 
 

There was an article posted by The New Yorker about the Boston hospitals' response to the bombing. I will try to attach it here.Why Boston Hospitals were ready.docx


I hope that the upgrade of the software means that Cliff is ok.

One of the things that frustrated me the most towards the end of my career in blood banking was being thrust into the position of the "blood police".  We really were not in a position to accomplish a number of the tasks that were forced down out throats.  Trying to explain why this was not a good idea only got us labeled as not being team players.  This is about the only aspect of blood banking I don't miss! 

This is what I have in my validation procedure.  The IQ (did we "install" it the way the manufacturer wants us to?) and OQ (does it do what the manufacturer says it does?) I get from the user's manuals.  The PQ is to make sure it opererates the way YOU need it to at your facility.
Equipment only: prior to validation, the BioMed department will inspect the equipment and perform an electrical safety check.  The equipment will then be assigned a unique tracking ID#.  The following elements will be performed: Installation qualification: demonstrates that the equipment is properly installed in the environmental conditions specified by the manufacturer. Operational qualification: demonstrates that the equipment operates as intended. Performance qualification: demonstrates that the equipment performs as expected for its intended use and that the output meets expectations in a normal working environment.

Unfortunately, the order does not automatically print out on the label printer in Blood Bank (and, no, the pc doesn't ring a bell. That would be nice!) So whenever Surgery (or anyone) wants a unit of blood issued, they also have to call Blood Bank.
We (primarity our lab aide) deliver the blood to the nursing units and Surgery - no one comes to Blood Bank to pick up blood (alas!)

Thank you, SMW! That was exactly what I was looking for!! (So I didn't just imagine it!) Thanks for your help!!
Donna :handshake

We do not routinely call other facilities, but once in a while we do if we are having a difficult antibody identification problem and the patient tells us they have been treated at another facility. I do not recall ever being denied this information.
Also, there has been occasions when we have identified an antibody on a trauma patient, but the patient is transferred to another facility, so we have called the Transfusion Service at the other facility to give them a "heads up" and notify them of our findings.
Has anyone out there been hit with a "violation of confidentiality" problem with this topic?

And, as I always tell my staff when they ask me questions, "Whatever I don't know, I just make up!!!"
(I'm just kidding, OK?)