Laurie Underwood

We perform cord blood testing mostly on the TANGO. We only check for clots and centrifuge for 5 min. prior to testing. It does not require us to wash the cells. If we test using tubes then we wash x4.

We do not use a coverslip. View with microscope using low power. Liquid does not come into contact with objective.

Trying to find out what others do in the area of Rh typing for Emergency department patients. Currently it is our E.D. protocol to have an Rh ordered on all female patients suspected of being pregnant with abdominal pain or pregnant with bleeding. Do you perform an Rh on all of these type patients or, if the patient has a type on record, go by their history?

Congratulations, Terri!!

Here is the change control form we use. I am not sure if we used some ideas from AABB best practices or a form we saw on the internet. We have used this for a few years... when we implemented the TANGO, changed our policy for Weak D testing, and our computer upgrade. CHANGE CONTROL REQUEST FORM.DOC

We run Rh+K typings on sickle cell patients and those patients we ID an Rh or K antibody will receive a full Rh+K antigen typing on the TANGO.

Yes, we run Rh+K typings on the TANGO. We have a monthly standing order for 2 boxes of Biotestcell 3 which we spin down and take off the supernate from the cells. We run them as needed on the C rack and have them set up with the other controls as AGID1, AGID2 and AGID3. The only thing you need to do is adjust the settings of the K typing on the controls as that changes from month to month.

1. Supervisors work M-F on day shift, no weekends/holidays. (We use to but a consultant came in and said we needed some perk ) 2. Supervisors work the bench and do supervisory duties as workload or staffing permits. 3. No charge tech or supervisor on 2nd/3rd shift. Supervisors take calls 24/7. Being the Blood Bank supervisor, they call me all the time, at ALL hours. 4. There is a supervisor for each section of the lab. 5. About 300 beds

Agree with R1R2. This has happened to us on more than one occassion. We just document on the emergency release form which the doctor signs that a specimen was unable to be obtained before patient was transferred to another hospital. In this case, patient refused specimen to be collected.

We do not issue out any products if they have food in there hands. It specifically states in the nursing policy for admin of blood products that they cannot pick up products with food. I have turned many away for doing this (i.e., eating an apple at our issue window). I tell them that I am just enforcing their policy.

Is your EBA21 a new centrifuge purchase? We have 3 in our Blood Bank and I wanted to purchase another one. When I called for a quote they said they discontinued making them and gave me a model # that took its place.

You are unable to purchase just the incubator anymore. When I called to get a quote they said they stopped making them. You have to purchase the new combo.

We were JC inspected this past fall and the inspector asked me to pull the package insert for our Ortho Panel A 0.8%. He pointed out that it stated that the panel should be tested periodically with weak antibodies. We do QC our panels whenever we receive a new lot # and I was able to pull the folder to show the inspector we were in compliance. We use Ortho Confidence Antisera 1:40 dilution for the positive control and Bio-Rad Solidscreen II Negative control. We perform QC using these controls for both our gel panels and our 3% panels QC'd on the TANGO for all new lots received.

QSA.05.01.01: The laboratory has written policies and procedures for the blood transfusion service. 1. The laboratory has written policies and procedures for the blood transfusion service. 2. The policies and procedures for the blood transfusion service are current and revised whenever standards of practice change. 3. The policies and procedures for the blood transfusion service are available to staff involved in transfusion service. 4. The blood transfusion service director or an individual qualified as a technical supervisor in immunohematology conducts a review of the policies and procedures of the blood transfusion service every two years. The review is documented. 5. The transfusion service director has oversight of policies, processes, and procedures related to the blood transfusion service, including blood administration. 6. The laboratory's writtent policies and procedures for administration of outpatient transfusions include instructions for monitoring adverse patient reactions after release from direct medical observation. 7. The transfusion service obtains written documentation of approval from the medical director when clinical situations warrant an exception to policies, processes, or procedures. 8. The laboratory follows its policies and procedures for the blood transfusion service. 9. The policies and procedures for the blood transfusion service define the staff responsible for the provision of blood, blood components, tissue, derivatives, and services.

Yes, we have a High Risk form where one of the boxes that can be checked off states: This patient has a warm auto-antibody rendering this unit incompatible and we discourage the transfusion of such a unit. The doctor must sign before transfusion.

We are on Meditech with a TANGO. We cannot export AHG XMs, antigen typing and panels performed on the TANGO to Meditech. We print these results from the TANGO, manually enter the results and save the paperwork. We were told these tests could not be exported

Positive Control = Check Cells Negative Control = Cord Blood with known negative DAT which was performed on the TANGO

I just received the following email today: Due to the huge northeast weather event and production there is a chance that your red cells will not arrive until Tuesday morning. Do you have enough to get you to Tuesday? We are also allocating so there is a possibility that you will receive a partial shipment. We are on track to complete your order by Friday the 16th. Thanks for your understanding during this unusual time. We are being proactive to make sure that we can meet all of our customers’ needs. If you do not have enough, contact Ortho and they will make sure your order goes out today for delivery tomorrow.

We also use a similar spreadsheet as jgabbard. When we receive a new lot # in, we record it on the spreadsheet and place a "New Lot" sticker on the box, so when we start to use it, the tech will record the in use date on the spreadsheet. We do use some Ortho reagents. We have the Ortho site to look up package inserts under "Favorites" on all of our Blood Bank computers, to make for easy access when receiving in rgts. We record insert date and see if the insert has been updated.

We result the XM as Least Incompatible. We have a form which covers Warm Auto, unidentified antibodies, which they still want to transfuse the patient, and instances where we lack the antisera to antigen type the unit but the unit is compatible. We do call the MD. They will sign the form, if they are in the hospital, before transfusion. If the MD is not available, the MD will give a telephone order to our RN house supervisor, who will sign the form so the patient can get transfused. The MD still needs to sign the form within 24 hrs.

Yes, you will get the warning. Set up your dictionary and then in test, create a patient with Anti-D and try to crossmatch an O Positive unit. You will get the warning that the unit has not been antigen typed for the D antigen. This process should be done to validate your process.

Go to the Dictionaries - Blood Bank - Blood Type. Enter in a negative blood type (A Neg) and then go to Page 2. You can list the compatible blood types and the components. So you can enter A Pos as an option for all the different red cell products.

Each section of our lab has a month designated for SOP's to be reviewed. Our manuals are reviewed and signed by our lab director, Medical Director and section supervisor. Each SOP is reviewed and signed by all 3 individuals annually. There is a area at the end of each SOP designated for their signature and date of review. I do know that they look at them, because they have found spelling and grammer mistakes which they have corrected.

Ours is set at 35.5C and the alarm at 36.5C. The alarm needs to go off before 37C to be in compliance with regs.

Our unit tags are white with black print. It is just the mounting paper that the tags are placed on that is pink. It is a mounting form with pull-off tape that they use to mount the chart copies of the unit tags on for the patient's chart. This way it is easy to locate and medical records can still scan.