clmergen

I joined this page 13 years ago but haven't really looked at it in at least 5 years. Through moves and promotions, I haven't been as involved in blood banking as I used to be.  I was surprised to see my password worked (luckily I had it written down).  I was happy to see many of the members from so long ago.  I see we still need to grow the non-blood bank forums. I suggest this site to every medical laboratory scientist and student I know as it has helped me greatly in the past.  I am glad to be back. 
Carrie 

I joined this page 13 years ago but haven't really looked at it in at least 5 years. Through moves and promotions, I haven't been as involved in blood banking as I used to be.  I was surprised to see my password worked (luckily I had it written down).  I was happy to see many of the members from so long ago.  I see we still need to grow the non-blood bank forums. I suggest this site to every medical laboratory scientist and student I know as it has helped me greatly in the past.  I am glad to be back. 
Carrie 

I joined this page 13 years ago but haven't really looked at it in at least 5 years. Through moves and promotions, I haven't been as involved in blood banking as I used to be.  I was surprised to see my password worked (luckily I had it written down).  I was happy to see many of the members from so long ago.  I see we still need to grow the non-blood bank forums. I suggest this site to every medical laboratory scientist and student I know as it has helped me greatly in the past.  I am glad to be back. 
Carrie 

I joined this page 13 years ago but haven't really looked at it in at least 5 years. Through moves and promotions, I haven't been as involved in blood banking as I used to be.  I was surprised to see my password worked (luckily I had it written down).  I was happy to see many of the members from so long ago.  I see we still need to grow the non-blood bank forums. I suggest this site to every medical laboratory scientist and student I know as it has helped me greatly in the past.  I am glad to be back. 
Carrie 

We have our collection bottle stored in another container with a lid to help with the fumes.

Hmmm, there is a mechanism, the same one by which a 4-channel lab timer might end up in your kitchen.....

I think Parafilm should be available for home use.

Or answering the phone by holding the bar code scanner to your ear !

This just made me feel better because i thought it was just our laboratory with these problems.

My hospital helped develop an Massive Obstetrical Hemmorhage Protocol that has garnered recognition for our multidisciplinary team.  This is an email that I sent out to my staff to help understand what is going on. 
 
 
There are risk levels and stage levels. 
 
A risk level is “how likely is the woman to have a hemorrhage”. Therefore, we draw and test initially based on a risk level.
Low Risk = Band and Hold
Medium Risk = Type and Screen
High Risk = Type and Cross 2 units
 
Stage levels coincide with “how is the patient doing”
                Stage 0 = Routine delivery
                Stage 1 = Increased bleeding but still watch and see
                Stage 2 = Increasing bleeding. Maternal Hemorrhage called. DIC panels every 30 minutes initiated.  Products are NOT ordered at this stage.
Stage 3 = Blood loss is >1500mL. DIC panels every 30 minutes.  Need MOH Pack (3 RBC, 2 Plasma, 1 PLP, 1 cryo), additional packs as needed.
                Stage 4 = Modified post-partum care based  on what stage 2 or 3 hemorrhage.
 
Patients may go through the levels quickly but remember that the physicians are trying all options to stop the hemorrhaging. Therefore patients may never go to stage 3 but stop at stage 2. And not need any blood products.
 
We have found over the last 3 years that they will typically transfuse everything but the cryo so we have changed the policy to not give the cryo until specifically requested (which is usually with fibrinogen <200)

My hospital helped develop an Massive Obstetrical Hemmorhage Protocol that has garnered recognition for our multidisciplinary team.  This is an email that I sent out to my staff to help understand what is going on. 
 
 
There are risk levels and stage levels. 
 
A risk level is “how likely is the woman to have a hemorrhage”. Therefore, we draw and test initially based on a risk level.
Low Risk = Band and Hold
Medium Risk = Type and Screen
High Risk = Type and Cross 2 units
 
Stage levels coincide with “how is the patient doing”
                Stage 0 = Routine delivery
                Stage 1 = Increased bleeding but still watch and see
                Stage 2 = Increasing bleeding. Maternal Hemorrhage called. DIC panels every 30 minutes initiated.  Products are NOT ordered at this stage.
Stage 3 = Blood loss is >1500mL. DIC panels every 30 minutes.  Need MOH Pack (3 RBC, 2 Plasma, 1 PLP, 1 cryo), additional packs as needed.
                Stage 4 = Modified post-partum care based  on what stage 2 or 3 hemorrhage.
 
Patients may go through the levels quickly but remember that the physicians are trying all options to stop the hemorrhaging. Therefore patients may never go to stage 3 but stop at stage 2. And not need any blood products.
 
We have found over the last 3 years that they will typically transfuse everything but the cryo so we have changed the policy to not give the cryo until specifically requested (which is usually with fibrinogen <200)

Did you read the CAP article? "Based on these data, it seems reasonable to attempt to vortex samples as a first-line attempt to resolve platelet clumping." This is from CAP. I'm pretty sure that the people working at M.D. Anderson are M.T.'s. Theirs is just an opinion. The article, produced by CAP (I believe they are still reputable) says that in 50% of the cases it works. Here, i'll link it again:
http://www.cap.org/apps/cap.portal?_...geLabel=cntvwr
Again, we have to agree to disagree. I don't believe any harm is being done to the patient. I would argue that, at least 50% of the time, we are saving a patient from an un-necessary recollect.

Well, I view every post but I know nothing about setting centrifuges for platelet yields. As you can see, I have no useful information but I have replied.

We don't have enough use for it to keep enzyme. I allow rule out of anti-E & C in the presence of anti-D with a single heterozygous cell for each because the odds that I will give a unit that is pos for either is less than that I will give a Co b pos unit in an electronic xm to someone with an undetected anti-Co b. We don't worry much about that, do we? All but a couple of percent of D neg units will be C neg and E neg. Even if we missed one, we would be very unlikely to give more than one unit that is pos for either C or E to the same patient in the same testing episode. If the antibody is too weak to be detected with a hetero cell (especially with a sensitive technique like PEG or gel) it probably won't cause any noticeable transfusion reaction. Remember, we rule out anti-K with a single heterozygous cell on every negative antibody screen we do.