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April 2024 Challenge

jayinsat

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Everything posted by jayinsat

  1. jayinsat
    From a pure common sense standpoint; the same reason you can't refreeze thawed meat, cooked or not.
  2. jayinsat
    I train high school students on ABO grouping using leftover bacti cards from kits like strep or influenza. They are disposable and easy to come by. Works just fine.
  3. jayinsat
    We have the ECHO and use Gel only as backup. If we want to run something in tube, the 0.8% cell suspension must be concentrated to approx 3% for tube testing. That is rarely done here. We would send it to our reference lab for further investigation.
  4. jayinsat
    Just started using TempTracker here and it's nice. There was a acclimation period where we got a lot of erroneous high/low alarms. We still chart and physically record temps daily but, maybe soon, we will eliminate that. Alarms still active too,
  5. jayinsat
    One blood type per admission. We've had our admitting department mis-register a patient leading to a transfusion of incompatible FFP.
  6. jayinsat
    Blood transfusions are a risky procedure, but less so than exsanguinating. Our blood supply is as safe as the person donating it and transfusions are as safe as the policies and knowledge of the staff administering it. This article could have been written with less incindiary and made to be more informative.
  7. jayinsat
    Don't even get me started! The things i've had to deal with over the last 5 years have left me wondering how have we remained acredited. I have had to learn how to apply the serenity prayer on a daily basis. It's especially unnerving when the incompetence comes from the department manager. To have to daily correct your managers errors and oversights, while not appearing to challenge their authority is quite an interesting environment.
  8. jayinsat
    It seems that the most adamant protestsors to safety measures are the ones who are most prone to making the very mistakes that lead to the policy changes: ER and OR! They never have time to do things right or careful.
  9. jayinsat

    Echo users.

    jayinsat replied to BBCLS's topic in Equipment

    We do not use the Pediatric reflex nor do we reflex weak D testing. We have disabled all Reflex testing at our facility. We do not perform weak D testing at our facility at all (with rare occasion to confirm a blood type on a unit from our supplier labeled rh Pos when we get rh negative initially). We are a 175 bed, predominately geriatric hospital that has absolutely no pediatric or maternal patients. We do export our results to MEDITECH 5.6.6. The ABORH exports but not the SCREEN since the reactions must be entered in a secondary result screen.
  10. jayinsat
    Not to be argumentative but we blood bankers tend to be overly paranoid. What is the percentage of units you recieve from your supplier that are incorrectly labeled aborh? How often does units get mistakenly placed on the confirmed shelf, picked up by a tech, crossmatched and released for transfusion, all before your LIS is back up? I think if you really look at the odds of a negative outcome situation that would be averted by the use of a sticker, you'd see that your fears are really unwarranted. Risk is never truly mitigated completely.
  11. jayinsat
    My experience has been that a DAT is a normal part of a hematology workup. Our Hematologist order a DAT as part of their anemia and auto immune disorders for new consults.
  12. jayinsat
    From a strictly practical approach, I don't understand the quandry. Since it's reacting at 37 degrees, just crossmatch using M ag negative units and move on. Why was all the additional testing necessary?
  13. jayinsat
    In the States, we are constantly trained on the matter of HIPPA security. If, on rare instances, I go to speak to a patient directly, the first thing I ask is are you comfortable discussing your care with visitors in the room. I don't begin any discussion if they answer no. That may not prevent this type of issue mentioned above but it covers my butt from and inadvertant HIPPA violation.
  14. jayinsat
    For reasons such as this, whenever I have a positive antibody screen on a new patient, I call the floor and ask if the patient has been transfused before and, if so, where. I then call that facility and get their history. In transfusion medicine, we have to be investigators who are willing to turn over every stone.
  15. jayinsat
    From my experience if I understand your description of "hazy reactions" correctly, is how Anti-M (IgM) often react. A lot of the Anti-M's that I get are not your normal gel positive reaction. Rather, they are a fuzziness up the gel column, usually on the Homozygous cells only. I think I have seen this with some other colds as well.
  16. jayinsat
    Very common problem. The best we've found to do is to search using Social Security number or Name, DOB. It is not just a blood bank problem. Allergies and Special nursing notes are attached to medical records as well. If that patient is given a new MRN, Nursing staff won't have those important warnings. I see this problem magnified with a national medical database. Imagine how many times a person can be duplicated on a nationwide scale.
  17. jayinsat
    While I agree with your statement about ruling out with 1 heterozygous cell is risky business, In this scenario, the risk is minimal. If we were talking about Jka, that would be another story! The fact that C and E will be absent on rh negative units at least 99% of the time and the unit is required to be crossmatch compatible through AHG mitigates whatever risk there might be. Ruling out C and E with 1 r'r and r"r cell in the presence of Anti-D is time efficient, cost effective and safe. The real issue here was the tech did not perform an AHG crossmatch. That is a competency issue.
  18. jayinsat
    The frequency is low, I believe less than 1%. Some labs, like mine only require 1 heterozygous C+ and E+ cell to r/o C,E in the presence of Anti-D. If that is your procedure, and your panel cells r'r and r"r were both negative (usually cell #5 and #6 ORTHO), then you should be fine. That said, the crossmatches should be repeated through AHG. Maybe time for some competency refreshers?
  19. jayinsat
    The FDA point alone would put an end to my speculation. I worked in a lab where we irradiated our own products. We did a higher volume than you. We already qualified as a manufacturer under FDA because we washed products. It was worth it for us.
  20. jayinsat
    We use the ECHO with Gel/tube as a backup. The ECHO (Capture SPRCA) tends to give more "warm auto"/non-specific reactions that are completely negative in gel/tube. We don't use the manual capture station.
  21. jayinsat
    Well, let me tell you, I have! I don't know what it is with me but just about everytime I drop one it bursts into a red, yucky pile. The bags we get from our donor center seem to have weak corners or something. If you drop it just right, it will explode. I seem to have perfected the "just right"
  22. jayinsat
    When I first look at my antibody screen and ID panel, the first thing I do is go to my negative reactions and cross off cells that are single dose "homozygous" for the antigen group. Next, I look at the double-dose "heterozygous" cells and, if I have 3 or more, I will cross those out as possiblities. Normally, I have a clear cut answer at this point, which is then evaluated to make sure I have 3 positive cells that reacted and 3 negative that did not. If there is more than one possibility, I do "rule-out" panels to either prove the existence of the addtional antibody or rule it out. I believe Mabel Adams had an excellent power-point that perfectly illustrated this approach. It has been very helpful. Of course, there are often "stray" reactions or cells you would expect to react that don't. You just have to use technical skills and techniques to investigate these reaction to a conclusion that your pathologist will accept.
  23. jayinsat
    EGA is Ethylene/Glycine Acid and is used instead of Chloroquine treatment.
  24. jayinsat

    Love the new look of the site. Keep up the good work Cliff.

  25. jayinsat
    The new site looks awesome! I love it. Keep up the good work Cliff.
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