jayinsat

I worked at a site that sent cards. Never did any good. For all the work there was no benefit. As for the chip...pass.

I agree with Malcolm. I would dig as deep as possible to find that antibody history. If none can be found, I would do AHG crossmatches. If it was a frequent antibody, the titers should rise to detectable levels soon.

Can you give a little background on this? I am curious as to what this is.

I agree. CAP had a HIPPA compliant process for this during COVID and it was a PITA (see if you can figure out that acronym ). Outside of that, I would inform them that all those records would be available upon their arrival.

Lol. Do you have a validation guide and procedure for that?

There is one danger in this process, and I have seen it happen. Miscommunication between shifts opens the possibility of an expired unit being successfully issued because the expiration date in the LIS is different then what is manually written on the unit. If you are not changing the expiration in the LIS, you will need some sort of system in place (in policy and practice) that shows you mitigate this possibility.

I am not sure I understand your question. If the mother had an admission type and screen and was rh negative, then all that would be required post-delivery is the fetal bleed screen. Why would you want to repeat and antibody screen post delivery?

You are in a tough situation. Either your facility will need to invest in a digitrax printer to print ISBT labels or you should not modify the component in the LIS, only manually change the expiration date on the face label and document the new expiration after issue and transfusion (or by comment). I do not like the former option. I would insist on obtaining an ISBT label printer if I were in your position. That is the cost of having a blood bank.

We do not accept units from our regional supplier from donors with alloantibodies.

We have to open it to get freezer packs for coolers and thaw FFP so the gas gets dissipated a few times/day. Thanks for the warning though. I'll put that in my freezer downtime policy.

All, I am about to blow your mind.... Our plasma freezer is down and so is our backup. The freezer will not get colder than -18 C. I was preparing to move all the products into boxes with dry ice until I had a conversation with my 87 year old dad, a retired blood banker from University of Chicago. He said to me, do not take the plasma out of the freezer and put it in boxes, PUT THE DRY ICE IN THE FREEZER, IT IS THE BEST STORAGE BOX YOU HAVE!!!! MIND=BLOWN!!!! I did that. Our freezer is currently reading -25.1C and getting colder. Furthermore, the probes in the freezer continually monitor the temp in the freezer so you don't have to record temps every 4 hours, the chart is doing that for you!!! Isn't that cool? That perfectly illustrates the difference between wisdom and knowledge there. I wish we could hire my dad. I just had to share this here. PS. Freezer is now at -26.4C.

You did everything that was required in this situation. The patient was a trauma and needed emergency transfusion. The risk of death outweighed the risk of a hemolytic transfusion reaction in that scenario, according to the treating physician. I once had a trauma surgeon tell me "I can treat a transfusion reaction but I can't treat death!" That put things in perspective for me. That is why thy sign the consent. Next step would be to report this to your risk management department so that follow-up can be made, including monitoring the patient for the s/s of DTR.

It is an orderable test. When it is ordered with the source "Emergent/Triage," it triggers the physician electronic signature requirement. With HCA, we have LIS coordinators that build these things. I do not know how to set up the parameters. Sorry.

I think the only real option in this case is to place 2 units of O neg in a monitored fridge or validated cooler for emergency use only. We have MAX Q blood bank coolers which we validated and hold temp between 2-6 C for 24 hours. They could rotate the blood and cooler daily until they get a blood bank fridge to put in the ER. You will need to come up with a process for them to manually document the transfusion and provide notification to the lab when someone is on duty. We have freestanding ER's (FSER) in our area that are not staffed with labs at all. All testing is POC performed by nurses. There is a blood fridge located there with 2 units O neg that we rotate regularly. That was our solution. Not perfect but it works.

Agree with AMcCord. We use Cardinal CH5214-18. Question: why are you looking for glass pipettes? We were forced to stop using glass pipettes years ago by our infection control team (glass breakage/employee injury risk). We were able to keep the glass tubes because of the potential effect on antibody detection. I do not believe using plastic pipettes pose any risk though.