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jayinsat

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Everything posted by jayinsat

  1. ISBT has an excellent podcast I have been listening too. You can listen and subscribe here:https://www.isbtweb.org/resource/announcing-our-new-podcast-transfusion-practitioners-across-the-world.html
  2. This looks like a typical reaction due to an antibody against a low frequency antigen (like anti-Dia). This is how they are usually found. If you have the ability, I would run a selected cell panel on the pre and post using panel cells that are positive for Dia, co, V, LuA, KpA, etc. If not, send it to your reference lab to identify the antibody against the low frequency antigen. In the meantime, as you have already done, all xm's should be AHG.
  3. Same. Are you doing both DAT Automation and DAT manual survey's?
  4. Wow. Ortho does not produce their own qc material for antigen typing? We use the ECHO Lumena and the WBcorQC make that such a simple process. I'm surprised Ortho does not make their own. Now, if we can just get CAP to produce their RBCAT proficiency testing vials so we can run them on the ECHO's. That would be great!
  5. Our window opens in October. I will not budge! If our inspector gives a deficiency for this item I will take my fight to CAP. If I do not win, then I will make the change. I am hoping by then they get their collective heads out of their posterior waste removal orifices and accept the rational and logical process.
  6. I have had the exact same concern for years now. This is a strange position to be in, especially if you are a manager who regularly works the bench.
  7. 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.
  8. 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.
  9. Can you give a little background on this? I am curious as to what this is.
  10. 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.
  11. Lol. Do you have a validation guide and procedure for that?
  12. 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.
  13. 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?
  14. 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.
  15. We do not accept units from our regional supplier from donors with alloantibodies.
  16. 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.
  17. 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.
  18. 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.
  19. 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.
  20. 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.
  21. 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.
  22. Same as @AMcCord. We use MEDITECH and cold antibodies are listed as clinically insignificant in our rules table for determining if EXM will be allowed. For those who are panicking, note: EXM will be rejected if the CURRENT antibody screen is positive EXM will be allowed only if the CURRENT antibody screen is negative and THE ONLY antibody listed in the patient's history is a cold antibody. EXM will be rejected if any other clinically significant antibody is present, regardless of the current antibody sreen. That's how we handle it.
  23. CAP does not recognize a "30 minute" rule. Each facility has to have a validated policy and procedure that defines when a unit may be returned to inventory post-issue. That usually involves have some sort of thermometer to measure temperature upon return, especially if issued outside a validated cooler. The time of start of transfusion is really a separate issue that was tied to the old "30 minute rule" that we all went by. The main point for nursing was that they did not pick up a unit before transfusion could be started. Pre-issue vitals, consent, orders, or any other requirement should be complete before the call for the blood. The blood should then be started immediately so that they have the maximum 4 hours to infuse it. Every minute that passes is a minute faster they have to infuse the unit. That may be a problem for someone who cannot tolerate a rapid infusion. We do not want nurses letting the unit sit on a counter somewhere for an hour while they do other things.
  24. Have you asked the vendor who is providing the automation line for a Six Sigma or Lean evaluation of your lab? They may be able to provide recommendations for furniture and storage.
  25. We order and perform ABORH confirmations as needed. In your situation, I would probably discuss with the preop team that any ABORH confirmation drawn that is not required will be cancelled by our blood bank team to avoid wasting reagents and time. If they insist that they want it done on all patients, perhaps a discussion with the person driving that decision is necessary. It could be that the person had an experience at another facility where a mistype happened and is now being overly cautious. That may not be a bad thing.
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