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May 2024 Challenge

LaraT23

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Everything posted by LaraT23

  1. LaraT23
    I have a "hold" order built, but only lab personnel can order it. It is used when ED draws Blood Bank for a "just in case" and we get no orders for the entire shift. Then we can order the "hold" which generates a specimen number, and we just result the clot expiration and BBK id number. This way there is a tracking in the computer that we have a specimen. Otherwise, even if the doc orders "Type and Hold" he gets a type and screen. Then, they can add the crossmatches.
  2. LaraT23
    Hi Sheri, We have not implemented this yet, and we are on 6.0.5 of meditech client server, so if you do get any takers, would you share those with me? I am planning to try to implement those as soon as I can. Thanks!
  3. LaraT23
    Yes, it is! I did not go through a school myself. I did however have to do some extra observations as we do not collect donors or do any donor testing. I could give you some more information, if you want to email me directly! Message me on BBT.
  4. LaraT23
    Another jealous one, that is what I get for working in a small non profit hospital! Hope everyone had a good time and learned alot
  5. LaraT23
    Nursing service and the physician are the persons responsible for obtaining consent here. I just required that this is documented on the form that nursing brings when they pick up units of blood. For those transported to surgery, the physician in charge of the patient is deemed as responsible for the consent being given before he or she hangs the unit.
  6. LaraT23
    For those of you who do the 2 separate specimens, how do you handle outpatient surgeries? We have a preop clinic that will draw the preop labs and a blood bank tube. For many of our surgeries, the surgeons orders that blood be crossmatched the day before surgery and is ready to go. We may then get a call from surgery wanting to have the blood brought to the OR. No where in this scenario is an additional specimen drawn. We also are using an blood bank specific armband, that has an area to affix a pre-printed label (comes out when the testing is ordered) that is signed by the person drawing it that the person was identified as that person. There are several labels that printout when the order is filed, so you have another one for the tube.
  7. LaraT23
    I am A neg with A2 cells and am CMV neg. I donate for many of the same reasons as other people here, seeing how much blood we go through and then seeing how much better patients do when they are given a needed transfusion, it really can lengthen their lives. As to why I don't donate sometimes? I live in a small town and we do not have a donor center here. The blood center closest to me comes in to town on their mobile units, and I will donate if they are here on weekends or here at the hospital. Most of the time for me it is location or time constraint or sinus infections!
  8. LaraT23
    I am trying for the first time to attach a document, I hope that this works! antibody rule outs.doc
  9. LaraT23
    Give me your email and I will send you our rule out procedure sheet. It is very well written by a former pathologist specializing in transfusion medicine and hematology.
  10. LaraT23
    That sounds odd, because doing a screen on the cord " plasma" is the same as doing a screen on the mother. The physician should know that. Maybe He or She was asking for a DAT and elution and then antibody screen on the elution? Not sure. I don't think you will find any literature on this.
  11. LaraT23
    My question is who routinely runs anti-H? That seems odd to me. We also do not routine run Anti-AB anymore, unless we have a discrepancy and are looking for more information. Those two tests being run on the routine typing seem to be wasting time and money. 9 times out of 10 running those without any other issue is not going to tell you anything more. Of those, I would run the AB first with a discrepancy. Just my thoughts on procedure. Thanks Malcolm for that great explanation.
  12. LaraT23
    Hmmm, that sounds like the PANTS version is less sensitive than the regular version. Am I understanding that one right? In which case, why even consider that at all? If the regular procedure for antibody screening on donors is better than what you are condering, why dumb it down? I just helped to build, customize, train and install our magic 6.0 CS version for blood bank and I can assure that no PANTS were considered... I mean it doesn't have legs anyway, it is a computer( sorry just couldn't resist!). I do hold with the theory that it does have a mind, and that it really does hate me some days though.
  13. LaraT23
    We require that the patient be registered as at least John or Jane Doe and the date; so for example it would be John Doe100510. Then we use the emergency release routine in meditech, which has two different ways to issue, one that orders a specimen to be drawn and another the adds to a specimen that is drawn. We keep the pigtails off of the units and crossmatch after we issue. The docs have a spot to sign on the issue card that was created via a canned text in the computer. This sheet is then returned to the blood bank after the units are transfused. If the patient is tranferred to another facility, the nurses make a copy of our form and send the copy with the transferring service and we keep the original. Hope that answers everything!
  14. LaraT23
    We are changing vendors and will most likely be using typenex barcoded bands. These include an area to insert a preprinted label and has a water proof overlay that will stick down. I am going to required that the lab person and a nursing person initial the preprinted label before it is stuck to the band to ensure that the patient was properly identified. This will help us as well when we go to electronic transfusion in meditech soon. We are going away from handwriting due to difficulties reading certain handwriting.
  15. LaraT23
    This actually happened to us. We ended up unfortunately being Hospital B in that scenario and the patient did subsequently pass due to complications of that DHTR and kidney failure.
  16. LaraT23
    Hello, congrats on your pregnancy first of all. While I understand having concern during pregnancy I am a bit confused as to why your doc would mention this at all. The truth is that Lutheran antibodies( Lua and Lub) have not been found to cause issues during pregancy. The most dangerous issue that your doctor is thinking of is called HDN or Hemolytic Disease of the Newborn, this is caused very often by other antibody systems but not Lutheran. This is because for there to a problem your antibodies need an antigen to "attack" in the fetus. Lutheran antigens are not well developed at this age and so are not usually a problem at all for the babies. I am sure most of us on the board will agree that we will use the words usually and most of the time because every now and then there is the exception. I would continue your prenatal care and do your best not to worry too much about those pesky antibodies and try to have a calm rest of your pregnancy.
  17. LaraT23
    I have two calculations set up for ABO, RH. One is called BT, and uses just ABD, AC BC ( with the last being cells). the other is the TYPEF calc and it has rules for WD and RHC, for controls. Which meditech version are you using? We just went to 6.0 Client server from Magic 5.62, and I had both set up. If you set up the TYPEF calc, use the label as DU for example but the trigger test is WD, then DUC and trigger being RHC for test. The target test for this is BT, which includes only ABO RH, and will report just A pos for example. Feel free to email me privately and I can send you some screen shots! lthedford@petersonrmc.com
  18. LaraT23
    This is just my own supposition, but since Jkb is expressed in on kidney tissue cells, is the the transplanted kidney Jkb pos? Also, the genetic tie for the entire kidd system is that is it located on the urea transporter gene, and so goes with the kidney tissue expression. I would check on the kidd antigen status of both recipent and donor, it might shed a little light on things. The decreased urine output also makes sense for the recipient to be kidd neg, as those individuals are clinically unable to maximally concentrate urine. Of course the patient would also have to be Jka neg to have that affect.
  19. LaraT23
    Just wondering if anyone else went with this conversion. I would like to know how your historical conversion went and whether you have background job issues. Thanks!
  20. LaraT23
    We just went live with CS 6.0 ( SO FUN) and we still do the same things. We result the TS on the prein registration, and hold the unit set up to the night before surgery. Billing then converts the visit to the inpatient one if there are not medicare/insurance issues. If there are, we use the move to another account routine before we set up the crossmatches. This is of course only on our 10 clot patient who answers the pregnancy and 90 transfusion questions as No. If they are yes, we draw a new specimen the morning of their surgery, and that goes on the inpatient visit number.
  21. LaraT23
    I have researched this quite a bit as I am considering going to the ABD gel card from the Ortho tube reagents. Even within the same company, different clones are used for different methodology. If we switch we do run a slight risk of changing RH types. We have decided to leave any previously negative OB patients as negative just to be safe so that they get Rhogam. This may also happen from one facility to another depending on methodology.
  22. LaraT23
    As a matter of fact I am on the technical/scientific commitee. I am going to suggest that as one of our speaker slots and then work to find someone qualified to come out.
  23. LaraT23
    I think after reading this and other threads it might be a good idea for annual meetings to have either a presentation or round table discussion featuring an FDA representative or quality expert to help give us some guidance about these things. what does everyone else think?
  24. LaraT23
    I have a 97 year old woman in house this week with the D, C phenomenon. I do not differentiate for G, I just give D neg units neg for C. It really is the practical way to do it. Of course we have known about her for a few months in our case. As for your patient, Yes, could be both either of the previous suggestions. Although I have not personnally seen the Rh's drop in titer much. Case in point my in house patient whose titer has been 4+ for 7 months, despite transfusion of antigen negative units and no other stimulus. I am leaning toward the Anti-G in your case. In the mean time, you need to give D negative units that are neg for C. Differentiation only becomes an issue when you are dealing with OB.
  25. LaraT23
    There are seven antigens in the Diego system - Dia, Dib, Wra, Wrb, Wda, Rba, WARR. I am finding the first one discovered in 1991 but not sure if that is correct. Help me out anyone?
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