Jump to content
April 2024 Challenge

LaraT23

Members - Bounced Email
 View Profile  See their activity

  • Posts

    329

  • Joined

  • Last visited

  • Country

    United States

 Content Type 

Everything posted by LaraT23

  1. LaraT23
    This has happened to us twice this year. Once with an Fya and once with a Jka. I am thinking it was secondary reponse, but extra vascular obviously. In the secondary both IgM and IgG are made initally but IgG rises much faster and at a higher titer,then drops off dramatically. Which is why just one unit does the trick in my book.
  2. LaraT23
    I would say good luck finding multiple k- cells to prove your point. And yes, it would have to also be D negative to get a true rule out. Good luck there too. We would rule out based on the hetero, plus your full crossmatch will catch any odd thing that also happens to be on that homozygous K cell, that might not necessarily be K..... Darn things don't read the books do they?
  3. LaraT23
    What is the antigen typing for the patient? We have seen several Auto E's lately. Did the previous Fyb react with hetero or homozygous cells exclusively?
  4. LaraT23
    I understand the concerns of everyone as far as mislabeling goes. But, I dont think we should just assume that things will be collected improperly and change our process to deal with that. If cords are "allowed" and "assumed" to be mislabelled, what about everything else collected by nursing. We also do not transfuse babies much, but our policy states that we would do a cord type and a screen on the mom's plasma. We would then give the freshest type compatible CMV neg that was available. I am the quality officer for the lab here, so I guess the whole mislabelling thing being accepted gets me going!
  5. LaraT23
    We generally finish the Type and Screen but then do not perform additional testing if the screen is positive. Our system does not charge for blood products until they are issued, so that billing problem is already solved.
  6. LaraT23
    We are using Policy tech.
  7. LaraT23
    I can't find anything that gives me the inkling about where AABB will go with storage versus transport. Currenlty we send blood to OR, or ED or the floors for dialysis or to an outpatient transfusion center across our parking lot in coolers. If i go with the 1-6 degree ruling, I am only going to get 2 hours from our current coolers. So, what is everyone else doing, and what type of containers are you using? Thanks!
  8. LaraT23
    We do ask, I worked with nursing to come up with some pre pre procedure, pre admission, type questions. We ask, have you been transfused, then in if Yes, is it in the past 90 days, then have you ever had complications, or reactions or antibodies detected, and lastly, do you have reasons to refuse blood products. These are asked on every admission for any procedure, ED, inpatient or infusion therapy visit.
  9. LaraT23
    He is actually white, and I did decide to send him off. Lifeshare is getting to play with it, He also may have a SC or Dombrock or perhaps some other low, as the second unit we got in identically phenotyped as the first was 1+ incompatible, so strange! I sent JoAnn Moulds my workups and a specimen so we will see what we get. I will update as soon as I get the report. Only us blood bank geeks like this stuff, so exciting!
  10. LaraT23
    He had a micro array done in July because he had been recently transfused. He typed E antigen pos then. We also did a tube serology test here Friday as we were just about 3 months to the day post transfusion, and he was 4+ that way.
  11. LaraT23
    We do Type and Screen on all OB patients admitted for delivery.
  12. LaraT23
    We have an electronic procedure system so that each procedure is documented, they open the procedure that is on their assigned list and click the mark as read tab and their name is electronically put on the has read this procedure list. We can then print a report either by procedure or by employee listing their read procedures. They do this annually.
  13. LaraT23
    We have a patient who had a delayed hemolytic transfusion reaction lat month due to an undetectable unknown to us historical Fya. He also made a C which we could only pickup by enzyme. He went to another hospital with diagnosis of uremia on top of his myleodysplastic syndrome and liver cancer. He survived that bout, and is back for transfusion again. He now has Fya, C, Jka, and we could not rule out K and E, however he is E antigen pos. Units negative for all but E are 1-2+ incompatible. We got a unit in that was deglyced and negative for for Fya, C, Jka, K and E and it is completely compatible. The DAT is negative, so E mosaic anyone? Auto E with negative DAT? Any insight or experience? He is to be transfused again tomorrow. Thanks in advance!
  14. LaraT23
    Why can't you order a T&S on the baby and comment, that you used the maternal specimen? Seems like that should work. Since the mother isn't technically a patient, you probably can't order anything on her at that point. Seems like billing should help you out with the ICD-9's. Those are usually provided by the ordering phyisician, in this case, the baby's physician. Anyways, I would avoid outpatient on moms if at all possible, unless you get waivers on everyone.
  15. LaraT23
    We cross reference the medical record number, which should never change even if the name does, and the date of birth. If those match, despite name change, we are good to go. Our system will also make name changes on babies retro active, so that if we look up smith, baby from last week it will show smith,jane today. We do the testing as requested on the new visit, as we have been asked not to add to inpatient visits past three days past dishcharge if at all possible.
  16. LaraT23
    I think that any good worth their salt reference lab will keep in stock the same reagents ( within reason of course) that their customer use, just for this reason. If I send my ref lab something, you better bet there is something wrong with it. Generally I can talk to the reg lab supervisor, who is an acquaintance of mine and talk to her about what was done. That being said, I recently got an elution result that was "negative", when I asked her, she said oh did yours look kind of like a low? Uh, yes and that would not mean negative. Maybe, not clinically signficant, as others have stated but not negative. This one happened when a fairly inexperienced tech was working and she felt better sending it out. I generally do quite a bit of trouble shooting and possible re education when I find a discrepancy between us and the ref lab. I usually find some training issue or once, a screen cell with a pos DAT! So, I think ref labs should not so lightly disagree, it causes action on our parts.
  17. LaraT23
    I am wondering how many of you are doing any sort of platelet bacterial contaminatin screening? The AABB bulletin that came out last week seemed to lean towards doing this only on long stored, >3 days old platelets. Any experience? Thanks.
  18. LaraT23
    Was wondering if anyone else has had yeast growth contamination in their screen cells? We use Ortho surgiscreen, and had yeast growing in cell one only. It was this odd brownish color and was giving false pos results on almost every patient, so we cultured it. Low and behold we had a pure yeast growing in less than 12 hours. Any experience with this?
  19. LaraT23
    We have had that issue with lots VSS476, VSS478 and currently with VSS479. I called Ortho and they said that my staff were probably pipetting incorrectly and contaminating the cells with the IgG diluent in the cards. They said the cells probably have a positive DAT. We do negative controls daily and would have caught that. I am not happy with the response from Ortho, and am glad it isn't just me!
  20. LaraT23
    Do you know of somewhere it says required? My director won't ask for capital on those coolers until we see something that says required instead of recommended.
  21. LaraT23
    Hello, I actually had this happen last week! One of our OB docs was none too happy so, we do all OB patients by tube and gel and then err on the side of the negative. I built in a canned text to explain briefly when there is a discrepancy. This helps as our deliveries are not always typed prebnatally here.
  22. LaraT23
    Our OB dept. gets their tubes in the delivery kit. We simply found a kit that included -plastic tubes for cord blood collection. We get plastic 10ml. red tops. But it is only a very recent change, within the last week or so.
  23. LaraT23
    In the most recent technical manual, the statement is made that it is recommended that all storage/transport containers except those from the collection to the processing facility be validated to maintain 1-6 degrees. What is everyone doing about this? We send blood in coolers to our outpatient infusion site, to the OR and to the floors for multiple unit transfusions but our coolers validate to hold 1-10 degrees as we determined them to be short term storage. I remember there being a great debate over this and it seems now a consensus is reached. Our facility simply cannot shell out 361.25 each ( what I was quoted) for validated storage containers that hold 1-6 degrees. We would be replacing 5 igloo storage coolers that hold 1-10 for 4 hours with no more than 4 units in each. Does everyone think this might become a requirement eventually?
  24. LaraT23
    Luckliy the manufacturer says: For quality assurance, 0.8% RESOLVE Panel A should be tested periodically with weak antibodies. So it seems to me that can be interpreted any way we would like.
  25. LaraT23
    a blood group = 10 days an antibody screen = 24 hours c) a DAT = 10 days - for pretransfusion d) an extended phenotype = 10 days e) an identification = 24 hours We keep them all refrigerated, not room temp. We do not separate the cells and plasma.
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.