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May 2024 Challenge

John C. Staley

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Everything posted by John C. Staley

  1. John C. Staley
    Just an overly simplistic thought. It was mentioned the patient had received winRho the day before. Could this be a prozone effect with her antigen sites being blocked by the passive D. I would think the DAT would be positive but maybe not.
  2. John C. Staley
    We stopped doing any "on receipt" testing years ago. It was determined to be of no value. We use the Echo and never even considered what you are asking about. I'm curious, what is your motivation for such testing?
  3. John C. Staley
    Very similar process. Initially we went through all the cards and entered anyone who had antibodies ID'd or transfusion rxns or other problem we felt we would want to know about. Then for the next year, as a patient would come in we would pull their cards, update the computer files with previous data then box them up. At the end of the first year we threw away all of the non-problem/non-transfused cards and archieved all of the problem cards / transfused card for 10 years.
  4. John C. Staley
    We've had our Helmer blood bank plasma freezer (i Series) for about 4 years and have had no real problems with it. My only complaint is the small 4 inch recorder charts are hard for old people (me) to read.
  5. John C. Staley
    Ditto on what KRichards just said. Also, only about 80 - 85% of our antibody screens are currently automated for one reason on another so the staff still gets plenty of practice with tubes and peg. We are staffed 24/7 by blood bankers but there is still a variability from tech to tech on how they read their tubes. That is one of the biggest advantages to automation, every test is read the same. Until a year ago we had generalists who covered the entire lab to include transfusion services on the night shift. They were expected to do at least an attempted antibody ID when they found a positive antibody screen and they did very well for the most part. They are MTs and CLS, they know how to do it, they just need the practice to stay confident. Also, any tech working for me has full authority to refer any testing to the local IRL for help. Just for point of reference the local IRL is about 50 miles away.
  6. John C. Staley
    We are using the Echo and our manual backup is Tube/PEG. Most of our panels are being run on the Echo.
  7. John C. Staley
    I have yet to find a L&D that can consistantly label cord blood samples correctly. We NEVER use a cord blood sample for NICU testing purposes. If you are getting that kind of discrepancy on cord blood testing my first thought is the inability of L&D to get the right label on the right tube.
  8. John C. Staley
    I suggest you think long and hard before using a security code for your blood tansactions. We've been "tubing" blood for 6 years and chose not to use the security code system and have not regretted that decision. On the other hand, a sister hospital opened a year ago and decided they needed to use the security code system and it has been a nightmare for them with no apparent value. If you chose to use the security code system I suggest using a number that is readily available to the nursing staff. The other hospital is required to call the nurse to tell them the code and that can take more time than the crossmatch!
  9. John C. Staley
    Bev, I've never heard of such a thing. A few years ago I was discussing the demise of American health care with my medical director and she agreed with me that the down fall began when CEOs of hospitals were no longer physicians or other medical people but MBAs instead. Currently I am struggling with the idea that we are exactly the same as a Toyota factory.
  10. John C. Staley
    I'm curious, what justification did the inspector use for recommending always doing a gram stain and culture of the unit in your first tier of testing? Was this inspector CAP, AABB, FDA, State?
  11. John C. Staley
    We can thaw up to 8 at one time but prefer not to thaw more than 2. Bottom line, if the ED orders 6 we thaw 6. Tried to second guess them once and really got burned. Never again. They order it we thaw it.
  12. John C. Staley
    Mabel, make sure what ever syringe you go with is compatible with NICU's syringe pumps. I'm not sure how "universal" they are so it does not hurt to check.
  13. John C. Staley
    How much does it pay and can I work from home? :explosion
  14. John C. Staley
    Hey Bob, You back in the blood bank business or are the trains running a little slow lately? I've seen an increase in your posts and just wondering if you had returned to the fold. John
  15. John C. Staley
    Thanks KLCarter, I could not have said it better myself.
  16. John C. Staley
    We get charged by our blood supplier for the Hgb-S testing so we pass it along just like we do for the antigen typing they do for us. Why would that be any different? Once again you are dealing with one person's opinion, if you do a lot of this testing you might want to seek another, possibly more qualified, opinion before giving up on it.
  17. John C. Staley
    That's kind of what I thought. Mostly patients that would have come to me as an outpatient transfusion will be staying with you. Not a bad idea. Congratulations on appearing to break new ground in an area where that is very difficult to do sometimes. I'll look forward to the article. Keep us posted on how things go. :pcproblem
  18. John C. Staley
    We have an incompatible plasma protocol that is most often used with platelets but would come into play for FFP if needed. :surrenderI find it interesting that "we" don't seem to blink an eye when giving incompatible plasma in the form of platelets but giving an equal volume of incompatible FFP causes a great amount of anxiety.
  19. John C. Staley
    Thanks Dawn, I was asking the question for our IS folks. We're in the process of implementing SafeTrace TX and they were having issues with CMV testing. I'll pass your info on to them and we'll see where it goes. Thanks again for your help. John
  20. John C. Staley
    I'm curious, what kind of patients will you be transfusing?
  21. John C. Staley
    Is anyone out there currently using SafeTrace TX and ISBT128? If so how are you dealing with CMV tested units of blood. Also how did you work with Codabar and CMV units as well. We are going live with Tx in about 9 months and are trying to figure out a few little sticking points. Thanks
  22. John C. Staley
    I can't give you my 2 cents worth on this question, we don't do any surgeries on newborns or infants that would require transfusion support. Those patients get sent to the local childrens hospital about 1 hour away.
  23. John C. Staley
    We provide all of our Neonates with irradiated CPDA-1 RBCs, we do not irradiate and must purchase it from the blood supplier who is 2 - 4 hours away depending on day of the week and time of day. We set up a baby on a unit that is generally 5 - 7 days old and keep that baby on it for the life of the unit or the duration of stay. One baby/one unit. We've been doing this for approximately 10 years with no known problems. (Knock on wood if you can find any in this plastic world!)
  24. John C. Staley
    Could you provide a few more details? I don't have a clue as to what you are asking.
  25. John C. Staley
    Morning Bev, In my world the clock starts when the transfusion service receives the sample. (That's assuming we also have an order at the same time or before.) That's the soonest we have any control in the process. The problem is, the docs start the clock when they first think about ordering something. The nurses start the clock when they tell the clerk to order something after reading what the doc has written. Lab QA starts the clock when the phlebotmist receives the order and specimen processing starts the clock when they take the sample out of the pneumatic tube. TO MANY CLOCKS!!!!!!
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