jayinsat

I just replaced mine last month. I used to use deionized water on the old one until I read this (taken directly from the Helmer manual):

I believe that is a number you establish as part of your quality management program. Ours is less than 5%. Our transfusion committee set that number for our system.

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This is one of the biggest frustrations of my job, exactly as you have described it. Our Medical Director does not want to direct contact patients/family members. Some treating physicians do not want to take responsibility for this. I would meet with your director of quality and facility chief medical officer and get them involved by first helping them understand the FDA requirements. They can help educate treating physicians on their responsibility when they order transfusions. A lot of these physicians do not understand that this is a real risk. Perhaps that will tighten up some of their maverick blood ordering practices. I recently had one where the donor tested repeated positive for HIV. The patient is now deceased but did spend time with his family between the time of transfusion and his expiration. 2 years later, we are battling how to contact his spouse and mother, both of whom cared for him in the interim. We do not even know what primary care physician to contact in this case. If we did, I guarantee they will not want to cause that kind of alarm in the surviving family, possibly risking a law suit.

At our facility (MEDITECH User), when we bring units into inventory, the LIS automatically orders a retype test (front type only) and generates a specimen barcode label. That is matched up to the unit and is placed on the specimen tube that is loaded on the analyzer (we use IMMUCOR ECHO Lumena). The LIS programs the analyzer just like any other patient specimen and results are transmitted back to the LIS when complete. This is a very efficient system. Have you considered that route?

@rmilford, have you considered the DCLS program at UTMB? Since you are considering the SBB, which I think is worth the knowledge alone, you may find that the DCLS program will do the same and more, giving you a terminal degree. I anticipate the role of DCLS will become important in healthcare in the near future. It also opens up more possibilities outside traditional lab roles, including teaching higher education. Just another thought.

There are several layers to this question. First, you will need a fresh O negative, CMV-, irradiated prbc available rather quickly. We are not small but we only transfuse neonates about 3-4 times/year yet we receive a fresh unit every Monday to use for emergency transfusions. If it is non emergent (say for iatrogenic anemia), then we order from our supplier a fresh unit with satellite bags sterile docked so we can continue to use that unit for future transfusions on that baby. The goal here is to limit donor exposure. You may not need to worry about that if you do not have a high level NICU. Are you aliquoting the unit into syringes? You will need a procedure and supplies for that. You need to meet with your Neonatologist and work out your logistics. Those are just a few things to think about. I assume you already have policies and procedures in place for this.