jayinsat

SbbPerson · November 16, 2022

And if you are type O, please consider becoming a regular donor, every 8 weeks.

Helpful tip for those who donate regularly, take beef liver capsules to help keep your iron stores up. It is easier on the digestive system than iron supplements. I donate every 8 weeks and hated taking iron because it constipated me or made my stomach upset. Without it, I would have to sit out for a year to replenish my iron stores.

Marilyn Plett · November 8, 2022

@Neil Blumberg, I wish we had you at all of our facilities to educate our medical staff. Sadly, convincing Hematologists and Oncologists (at least here in America) that it is better to postpone platelet transfusions than give ABO incompatible platelets is, more often than not, rejected, especially in light of the fact that many patients are having to wait because of lack of platelet inventory to begin with.

What we really need is a push for better transfusion therapy education in medical school. Along with this, continuing education for practitioners needs to become a priority. It is, however, quite difficult to get time with these practitioners. Even when we convince our laboratory medical directors to advocate for these issues, in my experience, clinicians rarely change.

All that said to say, in the "trenches," the practice will likely continue to prioritize inventory over safety.

Ensis01 · November 7, 2022

On 11/5/2022 at 7:56 PM, SbbPerson said:

Do you do QC on your expired panels when you use them as selected cells? I was just curious. Thank you

Absolutely! It is in our policy in accordance with CAP and AABB standards.

Ensis01 · November 3, 2022

We would label the child rh+. The only problem this might cause is if the child returns to our hospital as an adult (we do not treat pediatrics in my facility) and required blood. The initial blood type might seem like a discrepancy since, conceivably, they would initially type rh negative but their historical record would say positive. Of course, we would simply verify this by looking at the previous testing results stored in our LIS.

October 21, 2022

I keep them 10 years (2 years on site) just to be safe. CAP standards are ambiguous and inspectors have been inconsistent. I feel like our LIS has enough proof but I do not want to argue during inspections.

October 21, 2022

18 hours ago, ESIZENSKY said:

I currently have a generic antigen test code built in Meditech. We are now performing a full RH K phenotype using Bio-rads phenotype cards. Does anyone have a RH K phenotype panel test code built in Meditech? What billing /CPT code is associated. Appreciate your help!

Following.

I currently just charge for each individual antigen (5).

October 19, 2022

I have used saline filled transfer bags. Normal saline is a similar colloidal mixture as blood products.

EmmalynnE · October 18, 2022

We do the same as @MAGNUM. Our database is downloaded daily as a background job. It is also downloaded to a network drive so it can be accessed by anyone that has access privilege to the drive from any networked computer.

Ensis01 · October 17, 2022

I had this very scenario about a year ago and it turned out mom had an anti-Dia. It was not on any of our in lot screening or panel cells. I did as I suggested and ran a select panel against mother's plasma using expired panel cells and identified the Dia. The eluate on the baby was eluted the Dia also.

Ensis01 · October 14, 2022

There could be a number of reasons for this. My first thought is mom could have an antibody against one of the low frequency antigens (Cw, V, Diego, Bg, etc). If you really want to figure it out, you could perform an eluate on the cord blood and a select cell panel on the mom's plasma. You will need to run the cord eluate against that select panel as well.

Of course, by select panel, I mean finding panel cells that are positive for the low frequency antigens.

That's my thoughts

SbbPerson · October 13, 2022

20 hours ago, NancyC said:

Staffing is a nightmare, we are < 100 bed rural hospital in a retirement community and have multiple open positions on all shifts, using multiple travelers and non-registered techs (for micro assistants, send-out dept. processing and covid testing). Losing techs to retirement and traveling (as they say they can't continue to train travelers and pick up their slack knowing the travelers are making so much more money). Most hires are new grads so training is more intensive. Everyone is training fatigued, morale is down, techs are burnt out. We are sometimes training two techs at once! We do offer sign on bonuses (5-10 K) and similar bonus incentives to existing techs to cover the night shifts, but still having trouble. We are doing some 10 and 12 hour shift experimentation with travelers and hired a tech to work just weekends who has not yet started training. We are hiring two international techs who agree to 3 year commitment and obtain a green card at end of 3 years for night shift coverage. Housing is is hard to find and unaffordable here as well. Everyone has gone to vacation rental property (if they had rentals) so now there is minimal rental inventory and housing prices have not come down from the severe increases of recent years. No end in sight to staffing shortages. I can't wait to retire next year! It is time for contract negotiations to start so hopefully there will be some big pay increases to ease this crisis.

Nancy,

I echo everything you said, but I am experiencing the same things in a 400 bed hospital in downtown San Antonio. This is not sustainable and some sort of major intervention needs to happen very soon. After 37 years, I want out of this field.

SbbPerson · October 13, 2022

6 hours ago, SbbPerson said:

There has been quite a few H1B Visa lab techs that were hired from the Philippines in the last couple of years. Most of them are pretty good workers. We also have been hiring travellers. That's basically it. The last couple of years have been pretty rough. At least I have been getting so much over time. I was able to buy a bunch of toys like guitars and gadgets and go on vacations and stuff.

Vacation???? I'd settle for a day off without being called in because we have no staff coverage in the blood bank. :no:

RRay · October 6, 2022

Our situation is even worse now than when I originally posted this thread. We are taking candidates with bachelor's degrees in sciences and no lab training. We cannot keep qualified blood bankers. Everyone is burnt out. I am burnt out. The crisis is here.

SbbPerson · September 29, 2022

1 hour ago, RRay said:

Why give uncrossed Opos WB to a patient you know is Apos (current T&S) just because they're initiating MTP? Only thing I can figure is that it's quicker to issue 2-4 units of WB versus a 4/4/1/ or a 6/6/1 MTP round.

Not only is it quicker to issue 2-4 LTOWB, it is also easier for rapid infusion. The products are supposed to be infused through blood warmers rapidly. This is important to avoid that "lethal triad" of hypothermia, coagulopathy, and acidosis in traumatic bleeds. Whole blood has been shown in studies to be more effective than components in these cases as they can be given quicker and through only one iv access. With 4/4/1, you need at least two lines and possibly more than one rapid infusion pump.

SbbPerson · September 21, 2022

On 5/5/2017 at 11:06 AM, mollyredone said:

My Helmer Quick Thaw manual says you can use tap, distilled or deionized water and gives the advantages and disadvantages for each. We have used deionized water for years. The disadvantage in the manual states that it can cause pitting but we haven't had that problem. We drain weekly and add CleanBath.

I just replaced mine last month. I used to use deionized water on the old one until I read this (taken directly from the Helmer manual):

September 19, 2022

I believe that is a number you establish as part of your quality management program. Ours is less than 5%. Our transfusion committee set that number for our system.

Malcolm Needs · September 12, 2022