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Everything posted by John C. Staley
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I never regretted my individual AABB membership. They can be an excellent resource, especially in your new position. Having said that, I imagine things may have changed since my retirement. I would suggest getting a membership, if you are not seeing the cost: benefit ratio in your favor you can always cancel or just not renew.
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Gel Crossmatch Rack
John C. Staley replied to San Diego Blood Banker's topic in Transfusion Services
I just had a thought that might help. Some one on staff surly has a kid or grandkid with a 3D printer. I imagine they could make you a couple exactly how you want them. I have a 9 year old grandson who made me some boxes for 3 different sizes of shotgun shells. They don't look all that different from what you are looking for. Something to check into. -
Over the years have I discovered that information like this is best provided to physicians by physicians. There were a few that recognized my knowledge and expertise on the subject but the vast majority did not and some were even reluctant to get it from my blood bank medical directors. I would recommend having your medical director provide the book recommended by Malcolm. I wish I had a copy in my library when I was still working. Good luck. Let us know what you end up doing and how it goes. I'm sure that this kind of problem will be with us for ever! Malcolm, you are correct, the info is relatively simple. It's getting them to step down, swallow their pride and listen that makes it difficult!
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Keep in mind that in some locations the time zone could change almost across the street or just across the state line and I live 4 miles from the state line and only 60 miles from the nearest blood supplier for the local hospital. Just something to consider when making broad sweeping statements. When I was supervising a transfusion / donor service we shipped blood any where in the country that needed it if we had a surplus. Time zones were never a consideration.
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If I were you I would cut my loses and go with a different company for my next analyzer. I never did like anything about Ortho and avoided dealing with them any time I had the chance. Just my opinion for what ever it's worth.
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"Keep Ahead" Orders
John C. Staley replied to San Diego Blood Banker's topic in Transfusion Services
This is just one more example of how inertia is the most power force in the universe and how difficult it is to battle the "that's how we've always done it" mentality.. -
Blood used organ donation services
John C. Staley replied to jtemple's topic in Transfusion Services
I'm curious, how is this group affiliated with the hospital? It seems to me that this is something that risk management should be made aware of and should, at the very least, be reviewed by the transfusion committee if your hospital has one. -
If the original type is for "potential" transfusion purpose then it is confirmed and the history of that type has been validated. It can be added to the paranoid reducing comfort level in assuming the current sample is from the same patient. If, on the other hand, the original sample was ABO/Rh type for some other reason and obviously not confirmed with a 2nd type then your level of paranoid reducing comfort will not be there when the patient returns for "potential" transfusions purpose. I have never been a proponent of the required 2nd confirmation ABO/Rh type. I would like to say it was for the same reasons Neil Blumberg listed above but back when I was living in the blood banking world we did not have the data he is noting. I just could not really see the cost/benefit ratio being in anyone's favor.
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I guess the question then becomes, if, in the future can an unconfirmed blood type be used as confirmation for a current T&S / XM?
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JCAHO - Issuing blood products
John C. Staley replied to San Diego Blood Banker's topic in Transfusion Services
I have heard that it is unseemly to walk through the halls of the hospital carrying a biohazard bag for all to see. We actually transported all of our blood via pneumatic tube system so this wasn't an issue for us. -
Lactated Ringers infused with blood
John C. Staley replied to Mabel Adams's topic in Transfusion Services
As bad as it was, it's good on occasion to see first hand what can happen if things aren't done correctly. That's when we become a true believer. -
Transfusion requirement for patient of A3 subgroup?
John C. Staley replied to Winnie's topic in Patient Questions
I believe the old saying is, "If the computer ain't happy, ain't nobody happy!!" -
Letting tube sit to catch rouleaux or cold?
John C. Staley replied to Noooooodles's topic in Transfusion Services
Malcolm, I've up graded that from Zebras to Unicorns. Thanks for remembering. -
Letting tube sit to catch rouleaux or cold?
John C. Staley replied to Noooooodles's topic in Transfusion Services
My question is, why are you looking at them under a microscope? My transfusion service stop doing that back in the late 80s! -
Same here. At that point it has become an academic exercise with no clinical value.
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Rh D type changing strength over time in same patient
John C. Staley replied to Mabel Adams's topic in Transfusion Services
That's what make the life of a blood banker so interesting!! Who wants to be an accountant where 2+2 always = 4!!! -
O Positive transfusion to unknowns in Massive
John C. Staley replied to Kym's topic in Transfusion Services
I'm paraphrasing quite a bit but I was one time told by a blood banker I highly respected; "Get the ABO right first and foremost, then take care of the rest the best you can!" Another favorite of mine comes from an ER Physician, probably the best I ever worked with. "Halitosis is better than no tosis!" I'm sure that applies similarly to a severely bleeding patient. -
O Positive transfusion to unknowns in Massive
John C. Staley replied to Kym's topic in Transfusion Services
There is going along to go along and then there is accepting ample amounts of data from extremely reliable sources. It's not about "sales" it's about trying to serve the population in general, based on the best knowledge we have currently and being willing to accept that. If what you are doing works for you in your little corner of the world, that's great but making light of advancements because it doesn't fit your paradigm and accusing some of the best professionals out there of being uncaring is.......... I'll stop now. I've been in this group for more years than I care to count and don't want Cliff to ban me. -
Rh D type changing strength over time in same patient
John C. Staley replied to Mabel Adams's topic in Transfusion Services
I'm sure I know the answer but I have to ask, did you test a second sample drawn at a different time? I'm sure the 1st thing you did was confirm right patient, right blood but had to ask. -
O Positive transfusion to unknowns in Massive
John C. Staley replied to Kym's topic in Transfusion Services
I've said it before, inertia is the strongest force in the universe. From my 35+ years as a blood banker and supervisor of both donor services and transfusion services, I have come to the conclusion that, as a general rule, blood bankers are extremely slow to change when not resisting it completely. This appears to be especially true if they are not actively involved in the change or keeping up on the literature. I saw a great may changes during my tenure and not all of them were comfortable at first. Giving O Pos blood to massive bleeds was just one of them. The data supports it, no matter what our long held concerns and fears try to tell us. Many of those long held fears and concerns were primarily theoretical, especially in how prevalent and disastrous the outcomes would be. I have a number of stories to prove my point but I think I'll stop now and step off my soapbox. -
Remote temperature monitoring for Blood Bank refrigerators
John C. Staley replied to HMB's topic in Equipment
WOW! That's taking the old belt and suspenders about as far as possible! You are right, no one will ever fault you for not doing enough. -
Proper storage space for pRBCs while in refrigerator
John C. Staley replied to AHulk's topic in Transfusion Services
I don't remember any organization or agency that addressed this issue. I assume you have recording thermometer(s) in the refrigerators as well as other thermometers. If you are concerned you could get multiple stand alone recording thermometers and run periodic checks of different points through out the loaded refrigerators. Personally I never considered it an issue. -
If I remember correctly most of my FDA inspectors carried around the CFR Title 21 and did most of their inspection while constantly referring to it, primarily those sections referring to blood bank but sometimes they were looking at other sections as well. It's been too long for me to remember the specific sections. I went through CFR21 and highlighted the areas I thought were most important and prepared for them. I actually had one FDA inspector who was a SBB and knew what they were talking about. She did our inspection so we could get a license to ship blood products interstate. That was the best inspection I ever had in 30 years of supervising blood banks.