clmergen

They are going to start requiring its use for the Fetal Screen test. And we haven't seen any problems either. I know that the last CAP Survey had non consensus but it's a screening test. I still have no problems with a false positive Fetal Screen test (again, hemo does the KB stain, so I really don't have room to complain). Now if I were getting False Negatives I would have already jumped on this wagon.

You can buy pHix from Immucor and make up small batches at a time. It just requires pipetting and QCing.

And that is why I am not revising our procedure until I have the updated package insert in hand. I am afraid Immucor will add something else without prior notice. Of course, Hematology does the KB stains not Transfusion so I really am not feeling an urgent need to switch to buffered saline.

They may have taken it out due to the proliferation of remote monitoring systems. The recording device is just a computer that records what the probe reads, its an all in one system. The intent of checking chart and thermometer is to ensure your recording device is recording correct temperatures so I would expect that an acceptable difference would be defined by your faciltiy, but would have to be reasonable.

The manufacturer's outdate should be such that the labile (ish) antigens are still detectable at time of expiration. IWe concern ourselves about those antigens only if we are using an expired panel. We ran an internal study to determine which antibodies could be ruled out using an expired panel and have that stated in our procedure. We do not run any QC on panels.

We create a weak Anti-D,Anti-c mixture by diluting it. And haven't had any problems with inspections at all. It isn't that expensive to make and it lasts until expiration of one of the ingrediants (which is the saline which usually expires within 30 days for less). Having the Anti-c lets us test the D negative screen cell.

I forgot you can get those anti-IgG and anti-C3d cassettes. The only hospital we have in our system using Gel uses IgG only cards. I personally haven't worked with Gel since the 2000, and at that time I remember we did on occasion detect a cold reacting atibody. Of course, I can't remember if we had anti-IgG only or the dual anti-IgG/C3d.

I thought gel was only supposed to detect IgG, much like solid phase. The gel testing was done at another hospital, we do tube titers at my facility. It did cause a lot of concern amongst the staff until I called and asked how the testing was done. Then it was like tring to compare apples and oranges. So I wonder if the patient would have been referred to the specialist if the typing had been done in tube to begin with.

Malcolm, don't forget the daddy's are not always in the picture. We are doing intrauterine transfusions on a baby and have NO idea of the dad's typings. But we always do a DAT on the cord blood of a mom with an antibody. Eluates are up to the doctor.

We ran into the problem with a patient having a titer of 1:64 (can't remember which antibody)t at a different hospital. She ws referred to High Risk OB doctor who sends all of his work to us. We got a titer of 1:2. Difference of Gel vs Tube.

Yes, I think this applies in this situation. Semi-annually, we will run a selection of specimens on the Instrument and by tube. The results should be the same.

Happy Birthday Rashmi.

I worked in a place that had such a rude inspector that I think the Medical Staff director was going to file a complaint. She was so loud in during the outbrief that a meeting down the hall could hear her. She also wanted copies of everything. She was a school teacher so you know she didn't know a thing about Blood Banking.

Malcolm, I work in an area that has 12 hospitals (more if you count the military hospitals). I work in the largest of all the hospitals with the most acute care. We recieve patient transfers from those hospitals plus from smaller hospitals outside this immediate area. I ONLY call for blood bank history on those patients that require a workup and this is ONLY if I can determine where the patient came from If the antibody screen is negative I call no one. Every hospital in this area treats patients that may likely come to my hospital. How is this different than the original question? Two different hospital systems should not be sharing patient information without cause. Potentially being a patient is not cause. What if some of the patients didn't like the new hospital and found out that the old hospital shared their information. HIPAA would definitely be pertinent at that point. Daily we all risk the non-detectable anti-Jka or some other antibody that has dropped below detectable limits. And that is why more sensitive methods such as Gel and Solid phase are being put into use. (wasn't going to respond but love a good debate)

When my computer system is replaced I will migrate all of my data over to the new system. As a system we have worked ways to migrate data from multiple hospitals to ours. It is possible and required. And whoever supplied my new computer system would be doing that transfer (most likely) In this case, there are 2 different hospitals owned by different healthcare systems . You can't upload one hospital's computer system into a second hospital's system. HIPAA would definately apply to that. As for sharing data, we do it all the time. Our area has multiple systems and we all call each other for the problem patients only. And the old hospital is already doing that for the new hospital. Maybe not in the timeliest of manners but it is being done.

But I would need about 15 of those portable refrigerators, storage would be a nightmare.

Has anyone considered the sheer logistics of being able to share this data? I have a computer system that is 18 years old and has 6 hospitals using it. How would I even begin to share that. This hospital is willing to share their information on an as needed basis, I think they are being very helpful.

We refuse to use the centralized monitoring system until they buy us 2nd probes for the bottom of the refrigerator.

In this case I would issue crossmatched A pos blood using an expired specimen and complete a Deviation Report.

The question is "Did you purchase the hospital or the building". When we purchased/merged with other hospitals we shared data by bringing them into our LIS. But if you purchased a building that used to be hospital and is going to be a hospital again, I don't think the records would belong to you. They belong to whoever had previous hospital. These sound like 2 completely separate entities. I worked in a city that had 2 hospitals. When hospital number one closed, they did not give us BB history on all of their patients that would now becoming to us. I don't see this as any different.

Even if I did a blood type on the Trauma patient and he was Rh neg, I would still give Rh pos blood if we thought he was going to use a lot of blood. And if they take uncrossmatched usually they use a lot of blood. The massive bleed patient from last week took 20 units of blood. No way would we have used jRh neg blood on him if he had needed it.

Ooh, nice lego. I bought my husband the Millenium Falcon for his Birthday/Christmas. He unpacked it and got overwhelmed by the sheer numbers. Have fun with it and with the family time.

happy birthday Cliff. Which Lego set did you get? My husband and I buy Legos on a regular basis (no kids involved).

We prefer to keep the men alive and keep enough Rh= blood on the shelf for the female trauma that may be coming in right behind the male. Or the Rh= woman bleeding out after a delivery. Working up an anti-D is easy. Intrauterine and exchange transfusions not so easy.

We only issue type O blood according to our Emergency Issue policy. The only thing we do try to honor are any antibodies found on the historical search, if time permits. But we rarely have a name when the uncrossmatched units are issued so it isn't a circumstance that we run into often.