John C. Staley
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Posts posted by John C. Staley
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19 hours ago, REN_NH said:
Women's Services has the patient sign a "Consent for the Administration of Blood Products" upon admission and this covers the RhoGAM as well.
This is the way it should be, if at all. The blood bank / transfusion service has better things to be doing than worrying about consents being explained and signed. Just my 2 cents worth.
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19 hours ago, Michelle R said:
Baby is doing very well. Clinically stable per providers. Hct stable at 37.5. No need for transfusions at this time. Slight thrombocytopenia at birth but has resolved without intervention. Sepsis ruled out. He needed phototherapy for hyperbilirubinemia for a couple days, but interestingly needed less days of light therapy than what is "normal" for preemies. We have included our neonatologist team to see if they have any input/insight, but so far nothing of note.
That's good news. So far sounds like an interesting academic exercise without a lot of urgency. My experience with NICU babies is if they need transfusion it is generally do to blood loss from testing. Keep us posted and hopefully someone here can come up with more ideas as to what you are seeing in the blood bank.
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I'm curious, aside from being born at 28 weeks, how is the baby doing clinically?
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1 hour ago, Malcolm Needs said:
With a syringe and cannula I trust My Good Sir!!!!!!!!!!!!!!!!
Most assuredly!! She's a nurse and would not allow such activity unless performed with the upmost professionalism!
- Yanxia and Malcolm Needs
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Not many have my option. My wife has an Anti-D, an Anti-K and for a short time a detectible Anti-s. I would just draw some of her blood every so often.
- Cliff and Malcolm Needs
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I have no supporting references but for me, common sense dictates that in a space that small you could not get the probes far enough apart to get any significant temperature variations. Having said that, regulations, requirements or other such problems seldom involve anything resembling common sense. Much like common courtesy, common sense is seldom common.
- exlimey and Mabel Adams
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Thanks Cliff, that is some interesting data. When I was working in Utah there was a push for licensing Clinical Laboratory Scientists every couple of years in the state legislature. What I found most interesting, surprising and some what alarming was that the most strident lobbying opposition came from physician groups. My assumption was that they did not want to have to pay for qualified people to do the testing in their office and clinic labs.
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Cliff, I've been glancing at the birthday list and it got me thinking (dangerous, I know), how hard would it be to run an algorithm that could calculate either the average age or the median age of group members. It might give us some perspective on the need to recruit more people into the profession. Just a random thought.
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19 hours ago, ryffelj said:
Can anyone help me understand why the immediate spin XM step is required if you are performing the IgG XM on gel? I am struggling to find guidance on this.
I'm not sure if this is still the case but the IS step was intended to confirm ABO compatibility.
- REN_NH, Malcolm Needs and SbbPerson
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First question, is the patient actively bleeding? If not and they just want to "top them off" then A neg is the choice. If they are and your A negs are very limited then stay with the A pos blood. As far as RhIG goes, as mentioned above, forget about it. All it will do at this point is cause more problems. That's what I would do.
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I'm curious, what is the motivation for moving from Solid Phase to Gel?
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21 hours ago, REN_NH said:
Let's assume all units are reacting the same way due to a cold antibody. What needs to be done to deem the units ABO type compatible?
So, is this then not a real and current situation but instead an exercise in, what if?
Why would pre-warming be out of the question if you are already convinced that the antibody screen is negative and all you want to do is confirm ABO compatibility?
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Why are you even asking for a urine for an allergic rxn to platelets?
- albaugh and Marilyn Plett
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1 hour ago, Townsend said:
LTOWB and TXA
As much as I hate to ask it but having been out of world of blood banking for a few years, would you mind telling us boomers what the acronyms LTOWB and TXA stand for. Maybe in all his spare time Cliff can include a list of current acronyms for us.
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My motto was "when in doubt, shake it out". Seemed to work for me.
- Kelly Guenthner, Malcolm Needs, Jsbneg and 3 others
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Malcolm, you appear to have know all the greats. I had the honor of meeting a few of them over the years and it's sad to witness the passing of an era of such amazing discoveries.
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If you will be getting any of those units back then a FDA inspector may want to see their storage records. Some will, some won't, depends on the inspector. Better to be prepared for the one that wants to see them. In this case a little paranoia may be a good thing.
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I'm curious, years ago we were looking into printing stickers to apply directly to the bag but there was some concern about applying an adhesive to the bag that may not have been FDA approved for such use. Is this still an issue or was our QA department going off the deep end?
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23 hours ago, MAGNUM said:
They are AO's, then I am sure that they are still working. Why is your upper management trying to mess with a good thing?
My guess is they want to know when they will be asked for money to replace them. Apparently everything must have an "expiration or best by" date.
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Personally, I think you should respond to CAP exactly as you did in your post. You make a logical and compelling argument. I could say more but I think I'll stop for now and see what other responses you get.
FDA Inspections
in Accrediting Agencies
Posted
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.