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shelleyk482

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About shelleyk482

  • Birthday 08/04/1958

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  1. I ordered an ultra-low thermometer for our plasma freezer that should have been in 30 ml of propylene glycol but when we got it, it was in sand instead. Thinking that the wrong thermometer was put in the box (we verified manufacturer's numbers) we called Cardinal and were told that these now only come in the sand. My question: would this be an appropriate thermometer for Blood Bank freezers? Are the heat transmission properties considered to be the same for sand as it is for frozen products?
  2. I ended up finding a battery-powered light box for $42.00. It still probably doesn't have the UL certification (it's not mentioned in the description) but I convinced Biomed that it posed little to no danger (lower voltage) and since the manual method is a backup to a backup and hopefully will never really be used (Tango is our primary method, Echo will be our back-up and if both of these fail at the same time then we will use the manual capture) I was able to convince them to approve it. I was very frustrated but as a Blood Banker, I know a lot of nurses that think I over-interpret regulations so I guess turn-about is fair play.
  3. We just received the ImmucorGamma manual capture system and our BioMed department will not approve the light box viewer for use. They are concerned that the "approved by UIL" label is on the electrical element inside the box and not on the outside so their interpretation is that the entire viewer is not UIL approved as required by the Life-Safety code. There is also just a 2-pronged plug that doesn't have a ground and the unit is not double insulated. Has anyone else had this problem? Does anyone know where to get a hospital-safe view box? I did a Google search and all I came up with were expensive Rh view boxes with heaters in them and most places had discontinued these anyway.
  4. I would just give antigen negative units. Baby can't make his/her own antibody so if you've identified the anti-E in Mom, ruled out other antibodies and have proven that baby does have the passive Anti-E, my understanding is that you just have to give antigen negative units until the passive antibody is no longer demonstrable in baby's system, no need for any crossmatch. For an anti-E, I would probably just give E-negative units without/XM until the baby is 4 months old or no longer needs blood (which ever happens first) without repeating any tests to see if the Anti-E is still demonstrable; it doesn't hurt to give E-negative units even if the antibody is out of the baby's system.
  5. The more I've thought about it, the more I like the idea of the 2 vendors. This would give me a second automated methodology rather than an automated & a manual. It is highly unlikely that any patient specimen would not be able to be analyzed by both methodology so if I get "iffy" reactions using the primary then I could put it on the secondary. If I have problems with both methodologies (either 2 automated or 1 automated and 1 manual), the specimen would be sent out to the blood center. As far as the generalists using the 2 different analyzers, they already use several different machines in the other areas of the lab, so this really doesn't seem to be a concern for them. We are already maintaining competencies on 3 "platforms": automation, gel & tube. This would just take the gel (and probably the tube) out of the mix. I do appreciate the input. This is allowing me to "think out loud".
  6. We currently have one blood bank analyzer and use manual gel for backup. I have been offered the opportunity to bring a 2nd piece of automation into the blood bank- a different manufacturer. At first, I totally dismissed the idea but now I'm actually trying to look at the pro's and con's and I would really like some other perspectives on this. My idea at the moment would be to use the analyzer we have now as the primary and to use the 2nd for retypes, as backup for the primary and as secondary methodology for complex samples (we don't do elutions or absorptions). If we have the two analyzers, I don't think I would need to keep a manual backup system. This idea is both intriguing (from a manager's aspect) and disturbing (as a blood banker). All of our techs are generalists and the ones I've discussed this idea with, don't seem to have a problem with the idea of doing maintenance on another machine; they seem to think that this would be faster than doing the QC on the manual gel system. I appreciate all input, ideas, etc.
  7. Last time I checked with CAP (and it's been a couple of years) they still wanted the actual physical check and not the electronic check. If you are CAP accrediated, I would definitely check with them before I changed my requirements.
  8. The Circular of Information states "Transfusion should be started before component expiration and completed within 4 hours". (pg 5, #12, Dec 2009). We would require Medical Director approval to start any transfusion after the expiration time based on the Circular statement. I hate to waste product but I would hate more to have to justify to an inspector or court why I didn't follow this for a "readily" available product.
  9. We use it for our outpatient cancer center & our L&D. The cancer center draws a "Hold" sample at the same time they draw the CBC on their outpatient; then if they determine they need to transfuse, we don't have to restick the patient. Very few of our L&D patients need blood bank testing but by drawing the "hold", we assure that we don't have to try to draw during a traumatic birth. We no longer let OR use this order; we apply a blood bank ID band when we draw a "hold" sample and we had problems with OR assuming that if there was a blood bank ID band on the patient that the patient had RBC's available.
  10. Check out page 10 of "Pediatric Transfusion: A Physician's Handbook", 2nd edition. It is a table that gives this information. The column does not say "platelets" specifically, it says "Plasma-Containing Components" which does include platelets.
  11. We accept verbal orders during emergency situations- trauma or OR. This generally happens with uncrossmatched for trauma or OR patients who start massively bleeding and we run out of what was originally set up. We try to get a computerized order but will not delay getting product to the patient if we can't get immediate compliance from nursing.
  12. I sent this question to CAP a couple of years ago and was told that this was just an electronic check and did not meet the requirements. I have not heard that their position has changed so we continue to do the maual method of alarm checks.
  13. We are a Cerner Millenium system and I just heard about the Bridge product that can be used on Cerner for tranfusion related documentation. Does anyone have experience with this program; if so, how do you feel about it? Is it a good system, what problems have you seen, etc?
  14. Our policy is that a sample collected at a different time requires all pretransfusion testing if it is going to be used for crossmatching. We do not automatically reject a short sample; we try to look at all of the factors that L106 mentioned above before asking for a recollect. If there is any reasonable indication that we may need need sample than we get, then I prefer that my staff get a recollection rather than run the risk of running out of sample during a dynamic situation.
  15. In which section of the CLIA regulations did you find this requirement? I've scanned through document and evidently missed it. Thanks.
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