In New York State, the Clinical Laboratory Standards of Practice (Jan 2008 pg. 46) states, "Laboratories may use reagents beyond the expiration date only if the manufacturer has provided written authorization to do so. The laboratory may not conduct its own validation studies to extend the shelf life of reagents." Every time a New York State Lab Inspector comes into a lab, he/she looks at outdates of most reagent, but specifically they look at the blood bank reagents.

Intraosseous infusion is an infusion into the bone marrow, usually in the tibia of small children when IV access is not possible. The material drawn before infusion is bone marrow. About the only test it would be good for is a forward Group/Rh for an emergancy transfusion.

Bone marrow is too thick for ISTAT tests and the chemistries are not the same as in serum/plasma.

I worked in two institutions where Medical Records had control of the MRN's and the MR coordinator was even more anal they I about patient identification before MRNs were changed, or before records were combined. I would suggest that you review medical records policy about the situation. Once records were changed--we added comment to all existing reports and then reprinted labels and reports with new name/MR#.

Which is correct terminology--"hematology" or "haematology"? Let's not be too critical of people, isn't this blog designed to be informal informational instead of critical?

Have you considered creating a "test" in the computer titled 'Label checked' with a yes or no answer. Put this test with all other tests for the patient. This creates a reminder to double check label at the time of resulting tests in the computer. Good luck

Can you do a custom screen in MediTech, otherwise I would agree with Mabel about Excell.

mhc has quoted AABB which references a 2007 AMA reference, but the REAL ANSWER lies with each area's local Medicare intermediate. We have less than 50 days to be ready for the 2009 reimbursement changes (Mar 1) so quoting 2007 FAQ's may not be accurate anymore.

1. Any letter sent should be sent by the Transfusion Committee, "The Transfusion Committee reviewed the C/T ratio's for the year 2008 by individual ordering clinician... This review was performed according to state and/or national regulatory standards." This lets the clinician know that none of this is personal.

2. Give the aggregate C/T ratio and the individual's C/T ratio. Also, you might note the C/T ratio for the clinician's medical specilty and that others in the specility were xxx & yyy, etc without naming any individuals.

3. Depending on what you wish to accomplish, depends how you might word the remainder. Do you want an explaintion (response) as to why or is the committee just trying to give information to the ordering clinician hoping that the clinician will alter ordering patterns.

4. If this information is to become part of the clinician's permanent record for creditialing information remind him/her where records are kept and for how long.

Have fun with the new position.

Depending what you want the information for--under Management, there are several reports and similar to the Blood Bank Log is the Worksheet listing under management. If you browse around, you will find 2-3 ways to get almost any information you want.

We have a few patients just like yours and continue antigen test units and full IgG xmatch each time we transfuse them.

We have SCC, if we have no name our system is set up that we "transfer" the unit(s) to the ER or OR and print a blank transfusion record. Frankly, it is cumbersome this way. Over the years (>35), I have used SCC, Meditech Magic, and Meditech CS for blood banking and have come to the conclusion that emergancy release done manually is the easiest and fastest way.

We use only Panel A.

Forgot to tell you--Screen cells were correct. Another lot of panel cells ID'd antibodies at same strength as the screen cells.

Are you using Ortho 0.8% Cells? Did this just happen? We had similar situation within past week. Private message lot # of Screen cells & panel cells, please.

:confuse:I'm not sure but I think a few places may still draw a limited amount in heparin for special reasons that I can't seem to remember at the moment.

Many years ago, heparin blood was used to prime bypass machines. Is it still used?

What does the Test Validation document state? Also, if all validation procedures were properly completed and documented, then you have documentation that the system is working properly--IF these same versions were tested the same as what is in live.

It is the computer system's responsibility only if that is what is stated in the contract.

It's the same idea--do all your PC's run the exact same version of operating system with all exactly same updates on ALL PC's?

New York state would require a Limited Transfusion Service permit with regulations pertaining to much of what you are concerned about. The regulations can be found on website: http://www.wadsworth.org/labcert/regaffairs/bloodbanks/index.htm. Hope it helps address some issues for you.

Typically, our dialysis patients get 2 units when the Hgb falls below 6.5. However, there are no special criteria for these patients, just what the physician writes in the orders when patient first begins dialysis.

I worked with a MediTech C/S system as a manager for almost 5 years and found them to be most unhelpful with anything new. Your best bet is to contact the instrument company to see if they know of any MediTech users, then contact the user directly. With permission and pressure, MediTech can copy the other labs interface file to your system.