jayinsat

Please! It's hard enough just gettting techs to wipe down the countertop.

I remember Dr. Welby well....that means we're both old!

what kills me about the medical shows, especially HOUSE!!!!, is that these doctors do everything! How many times have any of you seen a Physician perform his own MRI, microbiology culture with id and genetic testing, go to someones home and collect environmental samples and bring them to the lab and analyze them him/herself? How many times do you see a physician even collect blood? On that show, the doctors do EVERYTHING! I've even seen them doing brain and spinal surgery and they are not surgeons! It's amazing that I don't think i've ever seen a lab tech, radiology tech (or radiologist), or any ancillary services rep. They do it all. Love the show though.

Labgirl, I think the question thant needs to be asked if what the new tech is doing is causing harm. I realize that there is a discrepancy between you two as to how best to work up these situations, however, in blood banking, there are often several routes that can be taken in complex antibody identification. Perhaps your new tech has found specificity on the elutions despite negative liss reactions on tube in the past. Is there harm (outside of cost) in doing the extra testing, or even calling it a warm? What if an autoadsorptions does allow an underlying allo to show itself? Yes, in most cases she is probably chasing a rabit trail but her experiences may show her the importance of chasing those trails so she can rest at night knowing that she gave the best product for the patient. I don't think it's ever a good idea to supress someone for going above and beyond. Yet she should have the right attitude and not be arrogant in her approach. Just thought we should look at it from a different perspective.

Perhaps the patient is reacting to something other than RBC's. Could be a reaction to residual plasma or anticoagulant on the unit. Maybe other plasma proteins. Washing the unit (maybe even a double wash) may help and give you additional clues. We once had a patient similar to yours that reacted to everything (FFP, PLT PHERESIS,RBC, CRYO). The cause was determined to be plasma proteins. We had to double was all cellular products (RBC,PLT) and could not give plasma of any sort. She then tolerated transfusions well. Hope this helps.

same here. we only use A,B to retype O units we receive in inventory from our supplier.

same here. we only use A,B to retype O units we receive in inventory from our supplier.

at my system, we do the the BLOOD TYPE/AB report and instead of printing, download it to the desktop of a computer that everyone has access to. The cards will remain in the blood bank for another year so they can always refer to it.

This looks like a passively acquired anti-D due to rhogam. If she did not receive WinRHo(D) she probably got RhoGam. Yea, I know she's Rh+ and not a candidate for RhoGam, but obgyn offices make those mistakes all the time! We work closely with a hematology/oncology group and we see a lot of their rh+ patients with auto-anti-D due to WinRho(D). You call the office and half the time the nurses don't have a clue what you are talking about when you ask them if the patient received WinRho(D). Only when you speak to the treating physician (the one who ordered it) do you get straight answers (if you can figure that out). I'm willing to bet that your patients received WinRho(D), Rhogam or IVIG. A D variant is very possible but with a positive Direct Coombs, it's probably passively acquired. BTW, you can get passively acquired C and E with WinRho too! Hope that helps.

thanks for all your replies. Since we have been doing both concurrently for more than 5 years, all our antibody patient histories are already entered. I think I just needed some outside influences to help convince my managers to "cut the umbilical cord";) James

Hello from San Antonio. I'm new to the BBT community and have been reading a while and think this is a wonderful tool! My question today is, at my facility, we are still using manual transfusion record cards. All this information is adequately stored in Meditech (which we have been using forever!). The current lead tech has been hesitant to "cut the umbilical cord". We are the only facility of 5 that has not phased out the cards. The others phased them out more than 5 years ago. 1) Is it necessary to manually enter the many years of blood bank history into meditech before we can phase out it's use. Because we have been doing it concurrently for over 5 years, most of our patients histories are already there! 2)Can we just leave the cards in place for, say, 2 years for records checks and then move them offsite. I'd like to know how others have done it. Thanks, James