[Point of Care Rh testing]

Our ER wants to give the Rhogam just based on the Rh result.

and the reason is the same as above, many patients want to get instant

reassurance and get on the way.

So what is the hospital's transfusion service's fiduciary duty when the Dr wants to give Rhig and let the patient go.

Is the type and screen necessary.

Does the patients gestation come into effect. Like less than 20 weeks, 13 weeks, etc.

What is the ER physicians duty as to instruction to the patient in regards to prenatal care and the event of Rh-sensitization and positive clinical significant antibody identification.

I work in a large Texas hospital system with ER and L&D. we also would like to just "give and go" the Rhig to L&D antenatal outpatients with DR office T&S results.

Thank you for any comments.

[20yr blud bankur (New Orleans- native, San Diego, Waco)]

Congratulations

[Second blood type prior to UNOS listing]

If safety is the big issue, then keeping accurate accounts of mislabeling would be helpful.

Maintaining a strict enforcement of the drawing procedure.

Have a 2nd verifier at the time of the draw recorded on the collection record.

A 2nd specimen drawn by a different person and typed by a second tech.

Stress accountability and education and enforce policy.

Any deviation from procedure needs to be with the Pathologist permission and documented.

Do not allow multiple tasks in the BB during the processing and testing of BB specimens.

[Specimen Labeling; let's try again..]

Blood bank bascis are not really established anywhere, it is something that seems to be handed down from blood banker to blood banker. Its great to see these baxic process somewhere to reinforce basic blood banking that I have found key to gain trust and simplicity in avoiding error.

[Specimen mislabeling]

I would think re-education and training should satisfy the FDA since this error was a one-time problem and not a recurring issue. You may also evaluate how the tech that did the work had to deal with so many interruptions to begin with. Not being familiar with your department's setup, I'm not sure of where the distractions came from. Is there a way to screen phone calls so that techs doing actual benchwork do not have to answer the phone? Does the bench tech also perform multiple duties, like issuing blood etc. while performing bench work? I know that in these times that less people are stuck doing more work, but maybe focusing on limiting outside distractions could be beneficial.

A collection record paper for recording double checks at the bedside and double checks of the relableing in the lab should exceed the FDA expectations. Have a place for initials for each specific check, name, number, DOB, etc . And it would be good to train the checkers to initial after each check, like check the name, initial, check the number, initial, check the DOB, initial. You really will "get-it" once you try it.

We fear that distractions will only increase as more automation and computer upgrades evolve.

Onetwomanytesttubes:eek:

[Horizon Safetrace]

Thanks

I think you misunderstood the thread. We are looking to make it more difficult to issue rh positive rbcs to rh negative patients in the computer. Although this would be quite an obvious thing not to do, the Horizon Safetrace allows it with only a warning that looks similar to the warning of giving rh negative blood to an rh positive patient, which may, in a rush or hurried situation, be a problem.

[Horizon Safetrace]

Hi Safetrace users

Does anyone know if it is possible to have Safetrace make it more difficult to issue Rh positive RBCs to Rh negative patients. Currently, with our version, the only thing we get is a warning box, not a mandatory over-ride. We would like to see an override at the Supervisor or Pathogist level. The slip also says this substitution is Compatable, which is not quite accurate, since permission is necessary to give Rh positive to Rh negative patients. All the other safeguards have given us a false sense of security.

Anything Can Happen.

[A Weak D Dilemma]

We currently do weak D testing on all rh negative females age 55 or less. and cord blood rh negatives born to rh negative moms

Since we do all the OB testing by gel, it looks like it would be quite advantageous to drop the weak D on the OB mothers,

If we pursue this, do we need to validate or prove that for CAP, FDA, or any other agency that watches over a Transfusion Service.

a time saver vs quality blood banking

meow

[Gel titers for HTLA]

I am very interested in what is HTLA. Is it human T-lymphocyte antigens? And if it is why it will present on red cells? Thanks for any help.

high titer low avidity

proved by serial titer showing 3-4 reactions at the same strength in neighboring titers

[Confirmation of ABO/Rh Type]

is there a list or source of information to confirm the standard of practice for 2 specimens when there is no blood type history,

is there any information concerning retyping versus immediate spin xmatch when there is no blood type history

[Horizon Blood Bank software]

after we changed to a new system, I can tell you to do as much research as you possible can. and what is very important is how you implement your new system. much time may be needed for learning and validating

many people have trouble using a mouse or browsers with drop down menus

[Info Written On Blood Bank Bands]

someone had a reply about not using a tx slip from the BB

that is amazing, we would like to know more about that, who thought of it, how was it implemented, validated, etc This appears to be a big time and paper saver. what systems are involved

[frequency of antibody identifications]

try other methods , other reagents, and storage of reagents may make a difference, think out of the box

like gel igg cards work better stored at room temp

etc

otherwise, we do what Cathy does, Igg xmatch, gives us peace of mind

[Problems with Customer Service-Ortho]

Ortho is bad about that

bad

[ORs at satellite locations - requiring crossmatched blood!]

:(thats horrible, I would not want any extensive surgery there, Especially any kind of L&D

Hi all,

My hospital has a satellite location approximately 25 miles away, where some (minor) OP/day surgery is currently being performed. This location does not have a Blood Bank or lab on site, nor are there plans for one at this time. There is currently a small blood refrig out there with 2 O- in it in case of emergency.

A decision has been made to expand the number and kinds of surgeries performed at this location, and this will include surgeries for which blood will need to be available/crossmatched. Theoretically what this means is that the samples will be sent to main hospital for T & X, units packed in patient specific coolers which will (all) be picked up by a courier in the morning and delivered to OR for disbursement to each room. The coolers would then have to be shipped back at the end of the case/day/whatever. (if there was an icon available showing someone freaking out, I would put it here!) And what about the potential need for FFP/platelets etc??!!

Is there anyone out there who has an arrangement like this in place? If so, how do you do it?

Or, if you had an arrangement like this that failed please tell me the details.

Thanks to all!

[billing for Antibody identification]

thank you, this really fits and expands our situation, we want to avoid

time consuming elutions and other techniques that are best done by

dedicated blood bankers.

we rotate a number of techs thru our blood bank, it would seem difficult

for all of them to acquire the experience to perform the difficult AB-ID's.

and space was another concern.

Is it necessary to do both IG and poly DAT's for panels,

and is it best to do the panels on the automated analyzer for BB by gel

or use manual gel [should save reagent, I understand the prime uses a lot of

reagent]

LK

[How long can FFP be out at Room Temp and still relabel as Thawed Plasma?]

I have seen FFP thawing upon shift change and no one knew when the units began thawing. Since the units were totally warm and there was no indication of when the units began thawing, I decided to waste the units.

We have no written guidelines, so we assume the 30 minute rule after the completion of the thaw. I have also been informed that FFP sent to OR in an ice chest is not eligible for re-issue because it needs to be refrigerated for 8 hours before the hemotemp can be applied. Does anyone have information that would shine more light on FFP room temp limits and re-issue.

[billing for Antibody identification]

Does anyone have a cost analysis of antibody ID, reagent cost, time cost and amount of refrigerator space, necessary equipment, cell washer, limited ID and full service, etc

We are looking into doing our own AB ids, currently we send them out to another hospital which increases our TAT

[MTS-Gel Back-Up methods]

Does anyone have a cost analysis of antibody ID, reagent cost, time cost and amount of refrigerator space, necessary equipment, cell washer, limited ID and full service, etc

We are looking into doing our own AB ids, currently we send them out to another hospital which increases our TAT