jayinsat

Does the patient have thrombocytopenia? Could they possibly be treating him for ITP using WinRho?

We are a 7-in-1 system and our committee meets quarterly. We provide blood usage statistics on a common spreadsheet monthly.

Mabel, helicopter (and ambulance) use is the ideal place for LTOWB. The main reason we are even considering its use is to cut down on wastage. Without trauma center and other hospitals becoming a rotation site, LTOWB wastage can easily exceed 30%. Like you, the cost is the reason we have not moved forward.

Here is a link to excellent resources regarding studies and risks for Low Titre O Whole blood. https://www.strac.org/blood. I think this may help answer a lot of questions. Here in San Antonio, I have seen great results from pre-hospital (ambulance and helicopter) use of cold-stored LTOWB. Patients who have received units have arrived stable where, in the past, would have surely been an MTP activation. Our local trauma centers are using it, up to 8 units before switching to components. The results have been positive.

Yesterday I attended the first of what I am sure to be many National Whole Blood Summits here in San Antonio. https://strac.org/summit/ If your facility or trauma surgeons are not already pushing it, be prepared. It is coming back. The conferences was excellent. The information and statistics presented was compelling. Low Titre O whole blood is coming (back) and will be the preferred product in traumas and hemorrhagic shock. Get ready!

Considering the push to using Low Titre O Whole Blood for MTP and trauma's, i'd say the benefit outweighs the risk. I have personally seen two incidents where a panicked Blood Banker accidentally issued O FFP in emergency release situations. In both cases, the patients turned out to be incompatible blood types (one A one B). Guess what, there was no adverse effect whatsoever in either case. No sign of hemolysis or transfusion reaction weeks later.

We are evaluating this as well. It will be an emergency release product only meaning no pre-transfusion testing. If our patients have a current Type and Screen or have already been transfused, they will not receive whole blood. We will stock O pos Low Titer whole blood that will be given to Adult men and woman >50, only for hemorrhagic shock. We do not receive traumas at our facility. Currently, our EMS ambulances and helicopters stock the O pos Low Titer whole blood and administer it en-route. They do not do any pre-transfusion testing. Our trauma centers are the same. Whole blood is issued as emergency issue only without pre-transfusion testing. Post-transfusion monitoring for hemolysis is done per AABB recommendation.

Reviving a dead post.... I am growing increasingly concerned about staffing shortages in the Blood Bank. I'm in Texas and most of our good techs are aging out of the field. It is almost impossible to find and experienced blood bankers that are not already working full time somewhere. Filling positions with techs that have blood bank or micro experience is HARD! New techs are not staying in the field and lack the experience to work alone. At 51, I am at least 10 years younger than blood bank staff on all shifts and am worried about filling those roles over the next 5-10 years. What are your experiences?

I had been a MLT (ASCP) since 1991 and recently completed my Bachelor's degree. I have worked exclusively blood bank for the last 12 years. I wrestled with whether to take the BB (ASCP) or the MT (AMT). I went with the MT (AMT) because the hospital systems here in San Antonio prefer the more generalist MT level certification for supervisory and off-shift positions. My HR department said they would only be able to hire me at the MT level for BB only if I went that way. Having an extensive generalist background, I decided MT (AMT) was the best option for me. I used LabCE's Medialab practice tests and Patsy Jerreau's CLS Review to prepare for the exam. I studied about 2 months and passed first time around on November 30th 2017.

We have always done our own calibrations. We use the PCS 2 system that is shared between our sister hospitals. It's cheap and easy to use.

We just went live 3 weeks ago in 5.67. We chose to keep all significant except Cold-Auto, passive C,D,E's and Warm-Auto's with no underlying significant ab's. As has been said, the current antibody screen must be negative in all cases. We love it btw.

Yes I have for both our automation and back up methods. Any methodology, or change in methodology, used in blood bank must be validated before it is implemented. That means, you must run tests using the new method in parallel with the old method and prove that it yields acceptable accurate results, sensitivity and specificity. After that initial validation, you only need to perform QC on a daily basis.

We have an antibody "Passive Anti-D" that we report if we have identified a recent Rhogam injection.

I say change your SOP to match your practice, as long as it has been validated, passes daily QC and doesn't contradict manufacturers requirements. I don't know of any transfusion services that wash the cell suspensions routinely anymore.