Mary**

We do not routinely do weak D testing on prenatal samples. I am interested in how you explain to the doctor when the patient has a positive fetal screen rosette test due to the fact that she is actually weak D positive. Do you give multiple vials of Rh immune globulin if the KB stain indicates that they are needed?

We have recently purchased a commerical document contol program mostly for procedures. It is tedious, but suppoesed to be worth it. Send me your email and I will give you the names of the company.

:cries:We don't usually identify it. If we can establish that the patient has received prenatal RHIG, we just run the 3-4 Rh Negative cells on the panel that are designated with an @ and result these cells as negative and report the antibody screen as negative. We also enter a patient comment about it in the computer. No one is really interested in passive anti-D and it takes too many man hours to identify it.

Why do use 60 days past expiration?

:bonk:Most surgeons will not understand what you are trying to tell them!

What is the number of this CAP question?

:bored:I completely agree with you!

Nice sign!!

Why would tha antibody screen have to be done within 3 days of collection?

HemoBioscience.

TRM.40700 from CAP states that patients must receive ABO Compatible plasma products. Occasionally, the only platelets that are available are ABO incompatible. I am interested in learning how others handle this.:fingerscr

I think we used to use 20 weeks as the cut off.

What is the meaning of your title (I like it)?

Am I correct in saying that the 72 hour expiration date for patient specimens who have neen transfused in the past 3 months only applies to red cell transfusions and not to plasma and/or platelet transfusions?

Thanks. It seems to have stopped.

I TOTALLY agree with you JE.

Frequently I sign in to BB Talk and I get the welcome and when I try to post it repeatedly says I am not signed on. The only way around it is to sign off and back on. This is fairly new.

Due to the recent CLIA requirement that gel crossmatches my not detect ABO incompatibility, we are having to do both immediate spin and IgG crossmatches for patients with antibodies. Has anyone had billing problems by charging for both? I feel if we have to do both, we should charge for both.

We do the same as David.

We do not perform phlebotomies on out patients. We are asked to do a few inpatients annually. These inpatients probably do not have a diagnosis that would warrant needing a phlebotomy, nor will they need a therapeutic plan as is described in these regulations. Any suggestions on how to handle tese regs?

:bow:There is another (easier, I think) way to do emergency dispense in Cerner. Using the dispense function, type in the patient's medical record number and enter the unit(s) numbers. You will get a message that a crossmatch is required. Override it with a reason and accept. We designed an Emergency Tag to print out of this function.

Try Shamrock.

[ATTACH]453[/ATTACH]We require a copy of the doctor's order to give and we return it with the product so everyone is looking at the same thing. We also require a Request for Dispensing Blood and Blood Products with the patient's name and MRN signed by the nurse. A copy is attached. LAB-355 Request for dispensing blood and products.pdf

:ohmygod: I agree with John and L106 as well. I love it when they question something. They have even caught some of our mistakes but I am sorry to say that they had to do this. Thank God they were looking closely.

:bored:On 6/7/08, my 225 bed hospital was flooded. The lab was in the basement. The water spread from floor to ceiling and into the first floor(14 feet of water)! Information Services, Food Services, Elevator Services, Pharmacy, Electrical Services were also in the basement. The patients and personnel were all evacuated within 3 hours with the help of the National Guard. No one was injured. Needless to say the hospital was closed for 5 months. We lost EVERYTHING in the basement. It was later declared a 500 hundred year flood. The hospital is next to a very small creek. The lab had an off-site blood drawing station where we resumed out patient services 2 days later. We sent the specimens to a reference lab. Within 2 weeks they moved in a mobile Emergency Room for which we purchased new lab equipment and provided basic services for these patients. We stocked 4 units of O Negative blood in a blood refrigerator in a house across the street where the Helicopter personnel lived. Management personnel were housed in an airport hangar. Within a few weeks, we had new computers and began trying to think of everything we needed to replace. It was a huge task. I wished I had had a document listing all of our equipment, etc. I was greatful that our procedures and our personal hard drives were able to be restored on the computers. It was a devasting experience, but due to a lot of hard work, 4000 construction workers, and FEMA we moved back in to a temporary lab in 5 months. The hospital was reopened. It was a great relief to the community since we are the only hospital within miles. 6 more months later, we moved into a new lab (on the first floor!!). Lessons learned: I don't think you can fully prepare for such a disaster and our hospital and lab Disaster Manuals didn't work! We didn't have land line phones for days and computers for weeks. We even ran out of toilet paper in 2 days in the off-site location! We now have new disaster plans, but I have lost confidence. In hind sight, communication with personel was difficult. We set up a lab group email so we could at least communicate with them at home if they had computers. I now keep their phone numbers at home. Everyone remained employed in some capacity. Positive aspects included that people from all departments learned to work together and there was good comradarie. I hope that none of you ever have to experience anything like this.