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jayinsat

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Everything posted by jayinsat

  1. jayinsat
    Have you reached out to your vendor? The vendor usually provides an excellent validation guide for this. At least Meditech and Orchard did. It has hundreds of scenarios that test the system.
  2. jayinsat
    South Texas seems to be the vanguard on this issue. It is worth time reading through their information at www.strac.org/blood. In response to Lablion's points: Leukoreduction reduces platelet function drastically on whole blood therefore it is not leuko reduced. Some data suggests that platelet function rapidly deteriorates after 21 days in CPD. However, STRAC's data shows the units are adequate up to 28 days with CPD-A1 Titers on our donors are < 1:250. All of these questions were addressed in depth at the National Whole Blood Summit. I think we will all be feeling the push. I can tell you from personal experience, its use pre-hospital (ambulances, air life helicopters) have been very successful. By the time patients arrive, the transfusion need is minimal if at all! Use in hospital is pretty much for to continue care and rotate out expiring units. Wastage has been > 30% when used pre-hospital alone.
  3. jayinsat
    Does the patient have thrombocytopenia? Could they possibly be treating him for ITP using WinRho?
  4. jayinsat
    We are a 7-in-1 system and our committee meets quarterly. We provide blood usage statistics on a common spreadsheet monthly.
  5. jayinsat
    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.
  6. jayinsat
    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.
  7. jayinsat
    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!
  8. jayinsat
    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.
  9. jayinsat
    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.
  10. jayinsat
    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?
  11. jayinsat
    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.
  12. jayinsat
    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.
  13. jayinsat
    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.
  14. jayinsat
    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.
  15. jayinsat
    We have an antibody "Passive Anti-D" that we report if we have identified a recent Rhogam injection.
  16. jayinsat
    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.
  17. jayinsat
    You state that the patient isn't on any thrombocytopenia meds. Does that include WinRHO or RhoGAM? Is the patient being followed for thrombocytopenia? I'm sure you're aware that WinRHO (which is ANTI-D) is a common treatment for ITP when the patient is RH Positive and has not had a splenectomy.
  18. jayinsat

    Cleanbath

    jayinsat replied to bldbnkr's topic in Equipment

    We don't use anything in ours. Although we are a small 175 bed hospital, we do an inordinate amount of plasma exchanges here. I'm talking 3-5/week with a minimum of 3 liters each! With all that thawing, we are bound to have a unit break about every 10 days making us have to clean it out each time. For some reason, our Heme/Onc prefers FFP over albumin for all his TPE's, regardless of diagnosis.
  19. jayinsat
    What methodology are you using for antibody screening and identification? Is there a significant rate of unexpected positive reactions with this methodology? That helps determine how far down that rabbit hole I will travel.
  20. jayinsat
    Tricore, pathogen inactivation alters the DNA of pathogens AND lymphocytes, which greatly decreases the probability of Graft v Host. It has become an acceptable alternative to irradiated platelets.
  21. jayinsat
    We had a situation like this recently. A patient was sent to our hospital from a near by free standing minor Emergency Room for direct admission and transfusion of RBC'S due to low H&H. The minor Emergency Room reported a hgb below 6.0. I don't recall the exact number. Normally, these orders aren't questioned and the blood is prepared as requested. In this case, the night shift supervisor, uncharacteristically, questioned the order and insisted the floor send down a new CBC for confirmation. The patient's Hgb was above 11.0! That makes you question your policies for sure.
  22. jayinsat
    It's been years since i've worked in a donor center so my knowledge of what goes on today is a bit out of date (1980's was the last time). What is done differently in the UK that allows hospitals and transfusion centers to skip the confirmation of the donor blood type? From my memory, each donor unit was typed by two separate technologists at two separate times before the unit was labeled with a blood type. Those results were also compared to historical records for the donor (if they weren't new). Is there something else that is done there? I don't understand how the donor facilities could be able to affect a change in this policy as long as they are in compliance with FDA, CAP, AABB etc standards. Wouldn't lobbying AABB and CAP be the way to go?
  23. jayinsat
    I hate those things! If I could get rid of them I would. So few facilities are doing them still. Even our regional donor center stopped doing them. Most in this area are done in the physicians office. That said, from my experience, the higher the pre-hct, the slower and more viscous the blood flow, which makes a normal gravity collection very difficult. Combined with poor veins, you have a difficult situation, even for the best, most experienced phlebotomists. I've seen large men with huge pipeline veins that were easy to stick but were impossible to collect a full unit with a normal bag. I truly believe it was the 60 hct that caused the issue.
  24. jayinsat
    If the antibody screen is negative, regardless of whether there is a Lua positive cell on the screen or not, we would give AHG compatible XM units and never look back.
  25. jayinsat
    A single donor platelet pheresis must have a final platelet count between 3.0x1011 and 6.0x1011 to be considered a full platelet dose. If the final count is, say, 6.1x1011, that unit can be split and made into two separate units. If the final platelet count is, say, 5.9x1011, the volume of the platelets and plasma may be too high to assure adequate oxygen exchange in one single bag but the count too low to make two separate units. Therefore, the unit will be separated into two attached bags in a closed unit to allow maximum storage but is still only 1 unit. Hope that helps AMYM1586 To all my BB Guru's here: If I am wrong, please feel free to correct my understanding.
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