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April 2024 Challenge

jayinsat

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Everything posted by jayinsat

  1. jayinsat
    It could be. My lab LIS coordinator is also off. I'll try to remember to check with her next week.
  2. jayinsat
    16th Edition is the highest I have. I guess my powers-that-be don't see the necessity in keeping up to date since we are not AABB accreditied.
  3. jayinsat
    There's a 28th edition????:-O
  4. jayinsat
    From my main menu it is: "86: MANAGEMENT REPORTS" and "60: BLOOD TYPE/AB REPORT"
  5. jayinsat
    Interesting. That seems to be in conflict with the AABB technical manual 16th ed. pg 958: "Prepooled Cryoprecipitated AHF may be prepared by pooling 4 to 10 units at the time of initial preparation.....Pooling can also be performed with the use of a sterile connection device. However, the expiration date cannot be increased when the pooling is performed with the sterile connection device. Prestorage pooled Cryoprecipitated AHF has an expiration time 4 hours once thawed." I would love to be proven wrong on this. We changed from 6 hours to 4hours based on this manual and critique from inspection.
  6. jayinsat
    We use MEDITECH 5.6.4. I download weekley the BLOOD TYPE/AB report. That gives me a complete blood type and antibody/marker/antigen history, overwriting previous info on the file saved the previous week. I usually put my begin date at 11/11/88 and end date today. Hope that helps
  7. jayinsat
    Curious: being that it is a pooled product, albeit prior to freezing, shouldn't it have a 4hour expiration upon thawing? In response to your question, our policy would be that the product could be reissued and transfused as long as it was done prior to expiration. That never happens though. We usually end up wasting the product.
  8. jayinsat
    I believe I was told that thumb drives, or any re-writeable drives were not approved for a number of reasons. One of the biggest was the possibility of introducing a virus in the software that could affect patient results and cause great harm. Don't quote me on that
  9. jayinsat
    TVC15, I apologize for the tone and aggresivness of my last post. Emotional responses lend nothing to good academic discussion. I would simply edit or delete the comment but, as you can see, It would still remain under Scott's post. I also apologize for the negative light it puts you in. I'm sure you have a lot to offer to our career field and truly wish you the best. I hope this does not turn you off to this site or great group of people that contribute here. While I stand by my arguments, I am ashamed of the way I've made them. Peace to you my collegue. James
  10. jayinsat
    agree to disagree. I can't convince you that there are times when this practice has proven itself, even though I've seen it in over 25 years of experience. I don't need a study that proves what i've seen in practice. Maybe with a few more years of experience you will gain some wisdom that will give you practical application to your knowledge. I've seen 6mo old babies drawn whose platelet counts read on the analyzer 200,000 and flagged for plt clumps. All indicies were normal. Said sample was vortexed and reran, generating a count of 240,000. Indicies relatively unchanged. Do I restick this child? What benefit would it serve in said childs care? Consider the patient and families point of view. Even dropping the platelet values 100,000 would not affect treatment or diagnosis. I'm done. Peace Sir. Train on and keep inquisitive. It will take you far, yet be willing to think outside the box.
  11. jayinsat
    http://labmed.ascpjournals.org/content/32/7/361.full.pdf This is the original study that led to the article you linked earlier. It is written by Gabriele Mues, MD, Frank H. Wians, Jr, PhD, MT(ASCP), DABCC, FACB, and Steven H. Kroft, MD, FASCP From the Department of Pathology, University of Texas Southwestern Medical School, Dallas, TX. "1. Vortexing of blood specimens has been reported to be successful incompletely breaking up platelet clumpsin approximately half of EIPA cases.10Either the entire tube or an aliquot ofblood may be vortexed for 1 to 2 minutesat the highest vortex setting withoutadversely affecting CBCparameters. A postvortex peripheralblood smear should be examined to determinethe efficacy of this procedure before reporting the platelet count." the study may have been performed in 2001 but that doesn't mean its outdated. I would venture that these individuals are intelligent and knowlegeable even if i'm not.
  12. jayinsat
    Did you read the CAP article? "Based on these data, it seems reasonable to attempt to vortex samples as a first-line attempt to resolve platelet clumping." This is from CAP. I'm pretty sure that the people working at M.D. Anderson are M.T.'s. Theirs is just an opinion. The article, produced by CAP (I believe they are still reputable) says that in 50% of the cases it works. Here, i'll link it again: http://www.cap.org/apps/cap.portal?_...geLabel=cntvwr Again, we have to agree to disagree. I don't believe any harm is being done to the patient. I would argue that, at least 50% of the time, we are saving a patient from an un-necessary recollect.
  13. jayinsat
    Excellent power point Mabel. I was trying to put something like this together. You saved me a lot of work!
  14. jayinsat
    Thanks. I just realized that the version of Internet Explorer on our work computers are so old that there are a bunch of tabs that don't show up on this website. I pulled out my iPad and, there it is!
  15. jayinsat
    can someone link it for me. I can't seem to find the "Library" forum and there is so many posts in Education that I can't find it there.
  16. jayinsat
    Typically, you vortex after you've run the CBC initially and found the platelet count to be suspiciously low. You simply compare the pre-vortex results to the post-vortex result and make a technical judgement as to whether or not the results are valid. This is another one of those scenarios where each individual lab, and tech, has to do what's comfortable practice for themselves. Just because M.D. Anderson despises it doesn't make it wrong.
  17. jayinsat
    where is it?
  18. jayinsat
    I have vortexed. It works
  19. jayinsat
    Each one of those incidents would have been FDA reportable errors since the wrong blood was sent out of the department to the bedside. How did FDA respond to these errors?
  20. jayinsat
    Wow! Honestly, I feel this is overkill. As a patient (presumably, without a line) I would NOT want my finger stuck 4 times if I were getting 4 units of blood and the nurse was too slow to hang the subsequent units before the prior was taken down. This is especially irritating when you consider all the other times the patient is stuck for other lab tests. I could see doing this before the 1st unit is hung and that be the only time for that admission, but every time? Too much! I would much rather use a band system or something to prevent abo htr's than this. I have worked in the blood bank for 25 years and have never experienced an abo htr either. Not one hospital has ever gone that far. The cost of the extra staff, in my opinion, outweighs the benefit. I'm not sure what size hospital you're in but in a major medical center, this will never work. Just my opinion.
  21. jayinsat
    From a practical stand point, you have to weigh cost/time vs. risk. Like John said, how would you know if an AB patient was immunosuppressed? Do you do further testing on every AB patient? The way antibodies against low frequency antigens (Cw, V, JsA) are detected usually is via a reaction. Should we crossmatch every negative antibody screen through AHG so as to completely avoid this? Because the risk is so low in all these cases, consensus says proceed as if there is no significan alloantibodies.
  22. jayinsat
    I'm glad I'm not the only one who thought those questions were poorly worded.
  23. jayinsat
    I am an ECHO user and have seen a significant number of what I like to call "anti-ECHO antibodies". We have maintained gel as a backup for the ECHO. When we see these panagglutinins on ECHO, we repeat them on the GEL. If it is negative on GEL, we call the screen negative and carry on. The ECHO seems to have more false positives than GEL.
  24. jayinsat
    TRALI? Isn't that what you ride in San Francisco?:confused: Maybe you can have a TACO while you ride the TRALI.:cool: Anyway, dabigatran is not reversible so really, transfusion medicine should not even be involved in overdose cases. From my understanding, Dialysis would be the best option.
  25. jayinsat
    I was always under the impression that once you start making aloquots from units, which is what you'd have to do to remove a sample for testing, the FDA considers you a manufacturer, thus opening you up for FDA inspection/regulation. Using a sterile docker/tube sealer would throw you into that catagory wouldn't it?
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