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aafrin

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Everything posted by aafrin

  1. aafrin
    It is a really very good site. The podcasts are superb. Dr. Joe Chaffin conducts lectures for The Osler Institute's Clinical Pathology Course.
  2. aafrin
    Same here. No wastage.
  3. aafrin
    Our A & E draws a sample for typing & cross-matching on RTA patients prior to shifting them to OT or ICUs. The OT or ICU will draw a second sample & send it when they send request for issue, otherwise we will issue O group packed cells. Yes Terri, we also do have to deal with rude and unprofessional, pampered surgeons.
  4. aafrin
    Couldn't agree more. We also call only when DAT is positive - it is one of our critical call-outs, otherwise they can check in the LIS. We even refuse info' about blood types on phones - two residents wrote wrong groups in patient files - long ago when read-back was not in policy. Hence now no reports are given on phone.
  5. aafrin
    Terri, can you share this doc here? Thanks
  6. aafrin
    Yes. Once it's alarm system went haywire & it continued to wail for around a week at odd hours. sms were also sent to registered mobile numbers wrongly. The problem was in the software connected to alarm. The temp. recorder was working fine, nor any problem with printing logs.
  7. aafrin
    For Aliquots, we consider the following: For platelets - SG 1.03, empty B Bag 33 gms. (actual weight without any labels) For Packed cells in ADSOL unit (not apheresis) - SG 1.06, empty B Bag 30 gms. (actual weight without any labels) We calculate as: weight of product minus weight of bag into SG. We also keep 10 gms. extra for tubing. We have never considered "weight equals volume" ever. Usually the aliquots are given in pediatric wards or OT and they always use pump and these calculations have met the ml. requirement - no complaints as such. Would love to hear from others what they do.
  8. aafrin
    We also have a continuous monitoring system, but our techs. record the temp. manually every shift (8 hourly) too. We discontinued the chart recorders years back for reasons Tricore has mentioned above.
  9. aafrin
    Terri, 2 points - <We do the same...no more blood goes out the door and we have it in our policy that no physician is allowed to stop a transfusion when the patient is showing symptoms of a reaction. > Then who will stop the transfusion? <Not only do most physicians not know what TRALI and TACO are, they can't even spell them. LOL> Couldn't agree more.
  10. aafrin
    I agree with David & Malcolm. We had a clinical trial going on with end stage ca patients with multiple mets. They were to be transfused with granulocyte concentrates (GCs) according to the trial protocol, but cross matching of GCs was not included in it. When the actual unit was sent for transfusion, the ICU doctors saw the GCs contained a lot of red cells. So they referred the blood bank and we went & saw the guidelines for GC on net and recommended cross-matching. The same was incorporated in the protocol.
  11. aafrin
    I agree with R1R1; at new admission the problem has to be re-investigated & resolved.
  12. aafrin
    Yes, there is no residual plasma in the packed red cell concentrates. I know for sure because once we had a transfusion reaction with a unit and we could not get reverse typing done from the bag sample for re-confirmation.
  13. aafrin
    We have default value of 300ml for PRC bags (350 ml collection) or 405 ml for PRC bags (450 ml collection). For FFP we have default value of 150 ml. We have FFP with default value of 50 ml for pediatric patients. For PRC to pediatric patients we issue quantity they ask for +25 ml, since they use pumps and there is always some calci problem. We do not issue any components in syringes.
  14. aafrin
    We are using IgG+c3d card for cross-matching. We are not in US, but we do repeat ABO & Rh upon receipt of blood by tube and at the time of issue by slide. Apparently the tech who did the group by tube made a mistake. But the IS cross-match was also negative until carried further after incubation to IAT, when it showed +1 agglutination under the microscope. If seen visually it looked negative. That was frightening.
  15. aafrin
    Hello, I have a query - do you all do blood group of blood bag on slide just before issue? We do. The reason I am asking this is that two days ago a B Positive patient was cross-matched with AB Positive Bag (which was mislabeled as B Positive) and found to be compatible with manual gel technique. At the time of issue when slide group showed AB Positive the blood was not issued & re-checked. The donor wasA2B positive; the reaction with anti-A was +2 in tube method and the serum group also tallied. We re-did the cross-match 3 times in gel, even with washed cells as well and every time it was compatible. I am confused how this was possible. By tube method it looked compatible to the naked eye, but did show +1 clumps under the microscope after incubation and IAT procedure. Same in immediate spin also. We even do blood group from plasma segment (reverse type) at the time of FFP issue. I am really worried of the consequences if that blood had been transfused.
  16. aafrin
    The most basic vitals to be recorded are BP and TPR. So yes, respiration rate has to be recorded. Nursing always record these parameters generally. Will have to look up reference.
  17. aafrin
    I also have both the books in e-book version. They are excellent.
  18. aafrin
    Working in blood bank is like walking on a tight rope, a little imbalance and off you go taking everything with a toss. Getting motivated techs to work with is like a myth. With generalists -small & silly annoyances have to be put up with daily and rectified. That said, it is still the only place I love working in. Great suggestions from everyone and thanks Kathy for summing them up nicely. As an aside -- going through all these posts I was reminded of a story about Anybody, Nobody, Somebody, and Everybody You’ve heard that story ? "An important job had to be done and Everybody was sure that Somebody would do it. Anybody could have done it, but Nobody did it. Somebody got angry about that because it was Everybody’s job. Everybody thought that Anybody could do it, but Nobody realized that Everybody wouldn’t do it. It ended up that Everybody blamed Somebody when Nobody did what Anybody could have done."
  19. aafrin
    I loved it. I showed it to all my colleagues and even mailed it to our HOD. The blood bank part is hilarious, especially dirty blood/washed blood and ticking all the check boxes. So true. The Chen Liu Show was great too.
  20. aafrin
    Malcolm, thanks for answering the query I had in mind. Since the baby was grouped from cord blood I was wondering whether there could be contamination with mother's blood which was giving this result or something else masking the anti-H reaction.We had asked the father as well as consultant to get the baby's blood checked at two years age (preschool), but wonder whether he will? I know the consultant wouldn't be bothered much since both the mother & child have been well & discharged from the hospital.
  21. aafrin
    Malcolm, what a co-incidence we had a pregnant Oh patient for delivery just 3 days ago. They asked for 2 units of PRC to be kept ready. The best thing or worst thing (as you look at it) was that this was her second delivery and they didn't know her blood group. The first delivery was done elsewhere.She already had a 4 year daughter. We spoke to the consultant as well as her husband (he was A+) and stressed about importance of knowing the blood group of their first daughter as well as the propositus's siblings (3 sisters & 1 brother) & parents. He said he will inform them as they were elsewhere, but would bring their daughter for blood grouping next day, which he did not. They just didn't bother. The baby she delivered was A-ve and she was also H Ag negative. Really that time of the year
  22. aafrin
    We issue CMV seronegative blood for IUTs and for exchange transfusions only. For top up transfusions we usually do not give CMVN blood unless consultant asks for it. For BMT/SCT all blood is leukoreduced as well as CMVN.
  23. aafrin
    We actually make a separate file of package inserts every year. If there are changes mid-year we place the particular new insert in the file and mark the old insert as "out-of-use" and date it. These files are stored for 5 years.
  24. aafrin
    Our Policy allows for verbal orders for emergency situations, so long as they are followed up by written orders after the emergent situation is over. But we have to chase for paperwork to get completed - cry... coax.. cajole.... threaten.... plead... whatever... and not necessarily in that order.
  25. aafrin
    We also fumigate the component manufacturing area monthly and take swabs from tables, centrifuges & top of LAF Bench. The process is repeated next day if there is growth on BA plates.
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