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PaulSunV

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About PaulSunV

  • Birthday 12/03/1953

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  • Location
    USA
  • Real Name
    Paul Greiner

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  1. I belong to a 22+ hospital system and we all only use 5 day plasma.
  2. 1. The nursing unit including OR comes to the blood bank when more than one or two units are needed otherwise we use a pneumatic tube system, which is how a majority of the units are delivered. 2. We have a phlebotomy team, however there are several nursing units that collect their own patient samples, such as ICU, NICU and L&D? 3. The phlebotomist witness the nurse draw the specimen. 4. NICU draws their own samples, the phlebotomist draws bilirubins and labortory tests, with the exception of PKUs and other State required testing which is performed by the nursing staff. 5. No testing is performed the date of surgery unless missed on pretesting, If the patient has a history of an antibody and it appears that antibody is still present at the time of the T&S then an addition 3-4 cells are run to verify nothing new has been created and of course 2 ag neg units are made available for surgery.
  3. We do not do an elution when the positive DAT is likely to be ABO related (O mother has an A or B baby) or due to RhiG. The treatment in those cases is the same the doctor only has to monitor the bilirubin to determine if more time under the light is needed.
  4. There are several ways to approach this depending on the size of your facility. A small facility (25-30 units) that doesn’t crossmatch many units could do the retype as part of the crossmatch process and then only label them as being retyped. This becomes somewhat of an issue depending on the computer software you have as this will sometimes leave those units on the pending work log. A medium sized facility that doesn’t have much room could put labels on the units as they come in indicating that they haven’t been retyped and that label could then be removed when the unit has been retyped. A larger facility that has the room can designate a shelf in a refrigerator for all units that haven’t been retyped, no label required as they are on a shelf that has that designation, and when they have been retyped the units would be removed from that shelf and placed in with the available inventory.
  5. We decided that going immediately to the 5 day expiration would limit the possibilities of errors and having outdated products on the shelf after the initial 24 hours. The number of hospitals in our group is about 23.
  6. We handle RhoGam only. Pharmacy does the rest.
  7. We have a label verify in Safetrace TX, if the computer isn't available then we have a paper log.
  8. I am looking for some ideas on how other facilities handle the Initiation of a Massive Transfusion Protocol. What we had is a patient that received RBCs at a small facility and it became apparent that the patient’s condition was so severe that they couldn’t handle it. The patient received 6 units of blood during that initial hospital visit and during transport to the larger facility which is where I am. While in the emergency room at my facility the patient received another 4-6 units of blood before being transferred to the operating room where more RBCs were ordered. The bottom line is that during this entire period no one considered the need for plasma products before patient received close to 18 RBCs. So how do other facilities track the volume of product that a patient has received where there have been numerous physicians ordering product without a clear understanding of what the patient has received? The Trauma committee thinks that the transfusion department is in the best position to be aware of when a physician should start thinking about ordering an MTP. The difficulty I see is that my staff has no way of knowing what units have actually been transfused as often we send blood out in coolers that doesn’t get transfused and never makes it from the emergency room to the operating room. That coupled with the grave yard tech doesn’t always know what the afternoon shift tech has issued. Anyway does any other hospital with a MTP require the transfusion department to act as a reminder department for the physician?
  9. It has been my experience that the problem isn’t really with the gel but with the Ortho 0.8% cell suspension. Apparently there is something in the mix that some patient’s just don’t like. If you were to take another manufacturers screen cells and mix them to a 0.8% cell suspension with the MTS deluent you will find the result are usually also negative.
  10. We set ours to outdate at 23:59 five days later and our software, SafeTrace TX, didn’t have a problem with it.
  11. The Reference I thought of initially was from the AABB Technical Manual 15th Edition page 548 under Postpartum Evaluation. “A sample of the mother’s blood should be drawn, preferably within 1 hour after delivery, and evaluated for FMH of a quantity greater than that for which 300 µg RhiG is immunosuppressive.” But you are both right I don't know of any hospital that I have worked that the cord blood sample arrives in the lab within one hour after delivery and the testing often isn't a priority.
  12. A type and screen is required for each hospital stay at each of the two hospitals where I currently work.
  13. I believe that it is necessary to read the entire post as opposed to the last sentence. When I read this post I assumed that the reference to a transfusion hospital meant that they are not a donor center. Therefore the weak D testing is not needed when verifying the donor blood type.
  14. I agree with "whbb" it is easier to set up all possible products in the beginning than to try to remember what hasn't been done sometime in the future when it is needed. When our supplier informed us of when they were going live with their ISBT labels they forwarded to each of the hospitals that they supplied a list with bar codes of each of the products that they supplied and any possible division. I entered all of these products as outlined by the corporate Webinar and then offered my services to the other hospitals in the area that utilized that same supplier. Only one took me up on the offer and while updating their dictionary I noticed that they were using inappropriate billing codes and brought that to their attention. One of the other hospital’s lab manager fancied himself as a computer guru so declined my services and he went with the easiest method possible. I reviewed his method and thought it would be interesting and nice if it worked. Well to try and make this story shorter his transfusion department can't bring in a 2nd part of a multiple platelet apheresis.
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