Liz0316
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Everything posted by Liz0316
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we don't do any daily checks weekly - clean and check volume delivered quarterly - timer check semi annual RPM check annual - functional operation - check buttons, reactivity and confirm validity with check cells annual - change tubing and tube holder inserts Liz
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I drew lines where the perforations are. (I couldn't figure how to put in a dotted line!) This particular file is a word document that I created for computer downtimes, but its nearly exact of what comes out of SQ. SQ downtime trx ticket.doc anyway - entire ticket is a big label with perforations. top left is the "unit label" directly under that is a label we put on the back of the product - the nurses wanted that the top right corner stays in the BB until issue, final in the AM bottom two thirds goes on a mounting form (barcoded for scanning) in the chart. Hope that helps, Liz SQ downtime trx ticket.doc
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We do a cord eval work up (ABO/Rh and DAT) on infants born to Rh neg, group O mothers and mother's with clinically significant antibodies. We hold all cord for 14 days and determine ID my MR number if needed, which doesn't change. The DAT is only done within 24 or 48 hours.... I'm home and don't recall at the moment! Liz
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I will try. I may not get to this until the weekend, I think I know how to do it ?
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We have Sq. and use a ticket that is a full page sticker backside. The ticket is perforated so that the unit tag, and the piece we keep in the BB is torn off. The bottom 2/3 goes to the floor with the unit and is posted in the chart. The unit tag is part of the sticker, the glue is FDA approved. We print it from a laser jet. We get the paper/ sticker tickets from centurion.
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We use 3 days for inpatients, regardless of status and 21 days for pre surgical with a signed form stating no preg/ trx in 3 months.
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We only use CMV- safe, except for neonates.
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We perform fetal screens (rosette test) following obstetrical events on Rh negative women at 16 weeks or greater. In the past, the literature has discussed 20 weeks as the " magical number," so, to error on the side of caution, we perform at 16 weeks. The Kliehauer Betke is used for a variety of reasons, but if the clinician wants to give RhIg following an event that may cause a bleed - amnio, car accident, miss abort, etc... That is our number. Under 16 weeks we just supply the product after confirmation of Rh neg blood type of the mother.
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I agree, pre warm, done correctly, should be done by a tube method. GEL will only enhance some colds. I think the pre warming of plasma and reagents with a warm wash phase will give the best results.
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really?! well that changes things. Can't wait to discuss this with my inspector this year. I would love to eliminate just one thing! Liz
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Multiple Myeloma Therapeutic agent Darzalex interfering with testing
Liz0316 replied to ElinF's topic in Transfusion Services
I've ordered the DTT from Bio-Rad. catalog # 161-0611 - from the Life Sciences division . 1-800-879-2289 LSG.ORDERS.US@BIO-RAD.COM I hope that helps. Liz -
Multiple Myeloma Therapeutic agent Darzalex interfering with testing
Liz0316 replied to ElinF's topic in Transfusion Services
Sorry it took me so long to get back, I've been a bit ill. Anyway, I think I can only get it powdered and have to make it, I haven't ordered it yet. I'll check on the manuf. tomorrow and get back to you. I have instructions . Liz -
Multiple Myeloma Therapeutic agent Darzalex interfering with testing
Liz0316 replied to ElinF's topic in Transfusion Services
We are developing a protocol, where by we get a baseline sample on the patient, have molecular genotyping done and once the drug is started, we will be testing with DTT and issuing K- red cells. I'll keep watch on the thread and try to keep up with our progress on the protocol. Liz -
We use a saline method where by we use 4 drops of plasma to one drop cells, to super-saturate the cell. Incubate 30- 60 min and use IgG at coombs. This method has served us well in patients with warm autos. Malcom, of course, went into detail about strong bonds and titers, etc., but I tell my techs that "any self respecting allo- antibody will be detected by this method" - and yes, I'm old school. So it was, back then, once you have discovered there is a problem, or you have actually detected an antibody, going back to a saline method is a fine and accepted way to get around the garbage you may be detecting in GEL or other "enhancing" method. Liz
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Presently we have a manager for each department. We are not on site 24/7, nor do we get call pay, but we are expected to take calls at home for technical issues. We had a charge tech for the evening shift, but that has been eliminated and the bench techs are expected to resolve and or communicate the issue to the appropriate manager. We don't normally work the bench except for vacation or urgent coverage. We are a mid-size community hospital (250 beds?). Liz
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wow, lots of really cool thoughts on this topic. I have decided to use the cord blood for the ABO/Rh and DAT on baby. Mother's type and screen and possible XM. We will only XM if the mother has an atypical antibody. Other than that we are using O neg pedi packs. We are going to issue the units as emergency release - it's just easier in SQ As for ABO confirmation (second specimen) we can usually use a sample from hematology or chemistry, but when I spoke with the neonatologist he said that any baby needing a transfusion has a line in and if we need, we can always get a few drops for ABO confirmation. In the event that the mother is not available, a type and screen (and DAT) will be done on the baby from a fresh specimen. I also checked with other hospitals in my state and this is what they are doing. So I have avoided using the cord for type and screen, have a back up and everyone is happy.... halleluiah !
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thanks everyone!
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I was always taught that cord blood specimens shouldn't be used for the pretransfusion type and screen on a neonate. Is anyone using the cord specimen for the initial type and screen? If not why not? At our hosptial we don't, normally we use a bullet and the mother's plasma for A/S, but now I have a neonatologist who wants to change that. Thoughts? Liz
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Blood Requests after a Transfusion Reaction Workup
Liz0316 replied to goodchild's topic in Transfusion Services
We do the first 4 items, and the ABO/Rh on the post sample. We only do the A/S if we are going to continue with transfusions.... using the post sample for the new T&S. (provided no results are abnormal and it's not a hemolytic reactions). Liz -
We had a patient that was reacting to everything, though not IgA deficient. As a "last ditched effort" I tried washed cells, which she seemed to tolerate better. I have no formal "indication" in my SOPs Liz
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transfusing in trauma situations; or the use of K centra to help stop bleeding? Or - use of molecular testing? just my 2 cents, Liz
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we put a sticker on the back of the unit with abbreviated instructions. Rarely do they read it. But, when they call, we instruct them to use a form and on the form is the time they notified the doctor, as well as vitals and other pertinent data. (we also tell them to flip the unit over and read the sticker!) Liz
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thank you - I had a feeling that I still need some functionality in Gen lab.
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Does anyone know if SQ BB module can be used as a stand alone system? In other words if the Lab General module is replaced with another system, can our blood bank continue to use our SQ BB module? If so, how do you order? How are your specimen collections populated to another collection manager program? thanks for any input. Liz
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I use them - tube method.
