OxyApos
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Everything posted by OxyApos
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Buffer cards/ IS XM are validated for detecting ABO incompatability. The IGG card has not been validated to detect all possibilities of ABO incomp per the IFU. The Vision can be configured to perform ISXM and IAT XM simultaneously.
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I believe the antibiotics and antifungals start to degrade after 5 days onboard rather rapidly. The excessive ? reactions are not worth the hassle.
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why not just use grifols' cells?
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Hoping you have upgraded by now. this update didn't involve the LIS so there should have been no side effects from upgrading.
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Have 2 blood types that give a pos & neg reaction in each gel column, like the A neg and B pos of Albaq accomplishes. For a 3 cell screen, an Anti D in a tube and an anti c in a tube. Use plasma or a plasma like matrix, not just saline. The number of drops of antisera depends on the strength or reactivity you want in your screens.
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You can now edit QC on the Vision. You may also use User Defined QC. Whole blood samples for Blood Bank and hemolysis can be problematic with any vendor or homemade creation. The AlbaQ has less problem when stored in the upright position during storage, even the vials not yet in use. It is very reliable and there's the ease of use with standard results and barcoding.
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Vision allows for in date selected cells to run. You cannot run a room temp panel or anything that alters the set incubation temp or times.
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New software update in the Vision allows for editing QC!!!
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Oh Malcolm. Sunquest has one big area for all of that info. Your "codes" you create when designing the system are the only tools you get to distinguish the info. For example , we designed all "antibody" codes to start with Anti.... so they'd be segregated. Antigen typing is Pos... or Neg...... Real molecular testing info has to be hand typed into a "comment". Real fun for new generalist techs to make heads or tails of a juicy sickle patient at 3am.
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We have solid phase and occasionally get these "warm auto" like reactions. Doing a tube screen w/o enhancement ( aka 30" saline) is our problem solving method. If the patient has been transfused we'll do AHG XM just to make sure. Like Malcolm says, before all these new fangled but convenient techniques people were not dropping dead from every transfusion.
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Our Blood Bankers used to perform apheresis. It became a drain on our staffing ( which the hospital didn't care about) but it was also risky to these very sick patients. As David points out, the patient can code, have severe side effects to the procedure, etc and traditionally MTs are not fully trained to deal with that. This was ages ago, but once the machine malfunctioned & wouldn't return the patients blood/plasma. Talk about an oh $!-!I+ look between techs!!!
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Does anyone know if our ASCP certifications is adequate to work in Spain? This would be a full BSMT, MT with specialty.
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I would like feedback for the following: Unit is issued and NOT spiked. 30 min have elapsed & something happens that causes the transfusion to be stopped/ delayed but it is possible the situation will be fixed so that the unit can be transfused within 4 hrs from issue. ( ie. IV infiltrates) We would like for the BB and Nursing to have some discretion on these cases so that units aren't summarily discarded. I have researched & read feeds on here that give us some grounds for altering our policy. I would like to know if anyone else does this and any problems or unanticipated consequences. Please state the size of your facility and if you are not in the US, please say so also.
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Echo user since 2008. I see these sporadicaly mainly in Obstetric patients and septic patients. My ARC reference lab advised me when we first got the machine to perform a tube screen. If that was negative, there was no point in them working ( or attempting ) to work it up. So...we do a tube screen and IF its negative, which it almost always is, we call it negative BUT put in an internal comment to perform AHG XM if needed just to be safe. I always, also, run a Ready ID just in case there's multiple allos, which has happened on occasion. I have used Gel, tube, and Solid Phase & in my opinion is detects E & JkA with way more sensitivity, like previous responses have said.
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We have been using Epic for almost 2 years and Sunquest in the Lab since 2001. There is the "prepare..." in Epic that translates into a lab order for us to execute. Then there is the "transfuse..." order in Epic that is strictly a nursing order. They cannot hang a component in Epic without a TRANSFUSE order which comes from the physician. We occasionally have them neglect to order the Prepare and call wondering where their component is hours later. Epic isn't great but an EMR has helped alot.
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We use Sunquest in the Lab. Nothing happens in Epic for these patients. In Sunquest, we have a test called EON ( Emergency O neg). We have a fake trauma patient in SQ. We order this test on the fake patient and are able to document what's going on while we wait on a valid name, specimen, tysc, xm. We have a paper form the doctor signs. Once the work is completed, we transfer the unxm units to the "real" patient and document real times and unxm status there. But the EON gives us labels and a paper trail to keep things organized in the mean time.
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If you have the manual system, I would repeat on there just to see if its instrument or reagent related. The picture is small and grainy but it looks like the control button is not as tight as it should be. This sounds stupid, but if its intermittant, are you making sure theres a stirball, and only 1, in the indicator cells?? How's the QC on your probe dispense test to make sure its not running out of fluid by the time it gets to well 8 of the strip. And the most useless advice, have you called Immucor??
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Echo by Immucor - USA/ ARKANSAS - @ 600 TYSC/ MONTH @ 55 PANELS/ MONTH ---- LOVE IT. Had it since 2008 and the only other fully approved instrument was the Provue. Techs who have used both like the Echo way better than the Provue.
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Has anyone out there used this group? They market themselves ( and quite costly I might add ) as an intermediary for reviewing blood utilization, physician follow up, and eventually cost savings on products not being transfused unnecessarily. The don't reveal client lists so we have nothing except their word for success. Our Blood Bank pathologist changed our trigger points to 7/21 ( with exceptions of course) last January & our red cell usage has decreased by 30%. This took a lot of time on his part to gather literature for an evidence based approach, several meetings and education. But not near the cost these guys are wanting for a 3 year contract.
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Operating Room Risk Reduction Plan for Mistransfusion
OxyApos replied to ejani's topic in Transfusion Services
We have just adopted the bag lock FinalCheck system from Typenex. Our OR protocol will be for 1 unit to be sent in the locked bag. Someone from the OR calls us to confirm they were able to open it by checking the armband. Subsequent units won't be sent locked. -
Preadmit Specimens with positive antibody screens
OxyApos replied to kmmoton's topic in Transfusion Services
Ours is like someone above, if they haven't been further exposed to antigens ( trans or preg ) then the specimen is valid to use. We only allow 10 days. People with antibodies are the whole point of PAT in BB...to not delay surgery because of the unexpected. The billing from one account # to another is a nightmare so there has to be some advantage for us!! -
We still have a cardioplegia screen in our manuals as part of our protocol. Our Medical Director won't get rid of it. But the reality is...we use Capture/ Echo which rarely detects colds. We make our patients electronic XM eligible with our retype policy. So the main avenue for detecting colds are not happening. What they don't know won't hurt them ( the heart team).
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Blood bank testing for OB admit patients
OxyApos replied to ffriesen's topic in Transfusion Services
I see this topic was resurrected. We deliver @150 a month at a "low risk" facility. We used to only to front types on the OB patients but they were BB armbanded just in case. Well a patient almost bled out and needed UNXM cells. The OB docs wanted to know how that scenario would Never happen again. We said an antibody screen on everyone so now we do. We transfuse maybe 8 units to L&D a month, rarely during delivery. We do see about 1-2 non passive Anti D antibodies a month. Even if its PAD, we AHG XM for consistency. Now that we have Epic & I can easily access the scans of the prenatal records to confirm Rhig being issued prior to delivery, I'm amazed at how many "reference" labs get the blood type wrong and don't titer antibodies. We have over half of our deliveries on some type of Medicaid or charity reimbursement. -
Tube DATs are cheap and it gives the generalists practice using the scope more frequently than problem solving time. I would like to put them on the Echo but clots, turn around time, and cost are the issue. I can do the tube method in about 5 min rather than the steps to putting them on the Echo. I also can't batch them...the doctors want them run as we receive them. If I could batch them, I would put them on the Echo.
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If you have Sunquest: We do the type and screen and antibody workup on the pre admit billing number. On the day of surgery, crossmatches are done. Before they are entered , you can go into GENLAB under the accn number for the TYSC and change the billing number to the new inpatient number. All subsequent charges will go on that number now.
