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clmergen

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Everything posted by clmergen

  1. We pulled numbers magically out of the air. For the first instrument we did 100 samples of types and screens to "prove" methodology acceptance. For each subsequent instrument at the other hospitals we did decreasing amounts of testing. As for acceptable percentages, again we pulled numbers magically out of the air that seemed acceptable.
  2. It depends on the product. Sickle cell trait units often do not leukoreduce properly so that can be an issue.
  3. I am not sure these numbers are calculated as tests per hour since an antibody test takes 28 minutes but a blood type takes 12 (on the Echo). And batching tests saves time over running them one at a time.
  4. I am so jealous, I wanted to go but unfortunately couldn't.
  5. We are using the saf-T-Vue 10s to cover the situation of a unit being pulled out of a cooler and left on the countertop for an hour. We validated our coolers to show they maintain a 1-6C range to cover the FDA requirement. We QC this twice a year to show that coolers are maintaining temperatures. We are using Saf-T-Vue 6's for this. And we are validating for use the infrared thermometers to get rid of the 30 minute rule (for those units that may not have a Saf-T-Vue 10 on them).
  6. We do alarm checks as per the manufacturer's instructions.
  7. We built a template that we text in our DAT results, which includes pre/post. The ABORh is part of the super group for the post retype. We also use a form that we keep for all additonal testing as necessary. Pathologist conclusions are a text answer.
  8. We don't do an immediate spin XM with our AHG crossmatches. We rely on the computer's compatibility tables only. AABB didn't comment on this last month. CAP is coming in the next 2 months......
  9. No job is lined up yet. I haven't bothered since I don't have my CA license. I would like to stay in blood banking but I don't think any of the hospitals in the area have BB only jobs. So I am assuming i will be a generalist if someone hires me. It depends on how far I might want to commute. But I am moving back to somewhere i lived 10 years ago and I am kind of excited about working with my old coworkers again. i think they want me back (if a job is available of course). I took the CA state exam ten years ago and passed on the first try. When I left CA I let my license lapse. Now to get licensed in CA, I have to take the ASCP MLS examination. It's been 21 years since i took it and they have renamed all the micro bugs so that exam has me worried. And I have to take it in CA, I can't even take it ahead of time. Luckily the SBB made me get current on hemo and coag so I think I may be okay in those departments. I think it will all work out in the end, because it always does. And I will be back in the middle of some very good wine country.
  10. It depends on your definition of good. My husband is being transferred to the California from Virginia. I have to travel for at least 5 day with my two cats (not so good). I have to take the ASCP generalist exam in order to get my CA license (really not good). I am giving up a very good supervisory job with a lot of responsibility to become a generalist probably working nights (not so good). I might end up working with Antrita (again)( that is good). BUT, my husband and I have been separated from each other for the last year because of his job, so we will be together again and that far outweighs the not so good. I am getting excited about what will happen once I get there but dreading everything I have to do in the next three weeks.
  11. One thing to consider for the Helmer if it is used a lot, the "wheels" will wear flat and start scratching the back of the thawbath. We transfuse a lot of plasma and we check these quarterly and end up replacing annually. I don't think our smaller sites have had to change these yet. We clean ours monthly or more often if we have a plasma exchange patient. We have the DH8 and DH4s throughout our system and really like them a lot. We purchased the digital thermometer with each one and that is easy to calibrate if needed. We did lower our set point for the waterbath to decrease the alarms that would happen when thawing the maximum number of units.
  12. Ahh vacation..... Does being unemployed while moving from the East Coast to the West Coast count as a vacation?
  13. We do have an agreed upon protocol although I have to admit that it changes often as we become more familiar with the instrument. If the Echo screen and panel results are all positive and tube (LISS) is negative, we call it a Solid Phase Reacting AB and we have a comment written by the TS Medical Director for the physicians. We perform AHG crossmatches which must be compatible and we do a Deviation Report that is signed by the Medical Director also. If we have "extra" reactions on the echo but all significant AB are ruled out, we do do the same as above but we don't do the tube screen. If we can't rule out on the Echo and must do tube testing, we run at least one cell that is positive for the suspected antibody(ies). It must be positive or we don't use tube to rule out.
  14. We only perform microscopic examination on DATs for Cord Bloods. For adults, it has to be macroscopic positive for us to call it positive.
  15. We have Echos in 7 of our 9 hospitals, with hospital number 8 getting one by the end of the year. With decreased staffing and generalists working everywhere, I feel more confident having an instrument do our work. That being said, we are working out how to deal with those non-specific antibodies consistently.
  16. I don't think Helmer makes a double door freezer. I know I didn't see it on the website either and I just ordered a freezer from them.
  17. I do know that they work hard. If I sounded flippant, I apologise. I have a great relationship with the staff at my blood supplier and this is something I would say to them jokingly. They are amazing at getting us the units that we need when we need them.
  18. Finding blood for him is easy - I call my blood supplier and make them find the blood. Patient was started on transfusions at a facility that did not have a sickle cell disease protocol and came to us with the antibodies and the reactions. He has similiar reactions in another state. I wouldn't be surprised about HLA antibodies. Washed cellls have not been discussed for him, but I know that IVIG has been.
  19. Isn't it unusual to see weakened reactions in an apparently healthy 47 yr old donor? We usually only have this problem in the elderly or otherwise immunocompromised.
  20. He doesn't hemolyse the cells, but he gets a fever, chills, etc. He has antibodies to Jkb, Fya, E, C, S, M, Jsa, and Kpa.
  21. A type and screen on the Echo takes 28 minutes of processing time.
  22. We have a sickle cell disease patient that routinely has transfusion reactions from blood, even with premedicating with tylenol and benedryl. He now will only agree to a transfusion if his hemoglobin is less than 4 g/dL (I think those are the right units).
  23. Franklyn posted a picture of his in "platelet storage outside the blood bank" thread from 2009.
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