tbostock

Last year we had to completely take over tissues; all tissues and equipment was brought to the Blood Bank. You can imagine why without me having to air dirty laundry. We order them, track them in our computer system, issue them, etc. It about tripled our work load. We went from 4 different blood components from one supplier to dozens of bones/tissues with about a dozen vendors. Can you tell how much I love it?

Very generous AuntieM. And congrats on your retirement!

It's 4 hours from the time it leaves a refrigerator or monitored cooler, not when the nurse starts it. Edit: this is found in the Circular of Information

We keep an inventory of irradiated products sent by our blood supplier for our infusion center patients who require it. Much easier.

Those who are using central temperature monitoring(CTM) as their primary method to monitor blood bank storage equipments, I have few questions : 1) Do you still use charts? Yes, as a backup. We recently had the wireless temp monitoring (we use Mesa) go down for about 12 hours, so it's nice to show constant monitoring. But most of the time, it's overkill. 2) Do you take daily recording? Yes. We record digital reading, Mesa reading, and check that the chart reading, just to make sure they correlate. We do not check thermometer temps in the equipment, but have thermometers in there for troubleshooting purposes in case we get a Mesa alarm. 3) If you take manual recording, which readings? See above 4) How do you monitor your CTM? Every morning a Blood Bank tech looks at the list of BB equipment and makes sure everything is "in the green". Weekly we print the graphs from Mesa and staple our charts to it. I really hate printing when we have an electronic system, but we had an inspector who really likes paper (ugh) and pointed out that we could change systems in the future and would not have access to previous data if we no longer have access to the software. We also do quarterly alarm checks and annually we check our certified thermometer against each Mesa probe for accuracy. 5) What kind of reports do you print? Weekly graph showing that temps were in range for the entire week. 6) Do you run into problem where you do not have readings and do not have charts? No. That's why we still do the charts for when Mesa is down. We are super happy we have this system in place. It really works amazingly well and gives you a real sense of confidence that your blood and reagents are safe 24/7.

Sadly yes, we are involved in tissues as our Medical Director is responsible for it. I am now the Tissue Compliance Officer for our hospital after we were cited by TJC and NYS Dept of Health. We now even have possession of all the tissues in the Blood Bank; we track it and issue it just like blood products. It just about tripled our workload.

Some of our clinicians are starting to catch on with transfusing to symptoms, but most are still looking at numbers. And the results from their offices can be wrong; our policy is to always require an onsite lab test (H/H for red cells, plt count for platelets, PT(INR) and APTT for plasma, fibrinogen for cryo) within 3 days of the transfusion. It's in our policy and is approved by the Medical Staff. Example: patient was sent in because he was a 6 Hgb at the doctor's office. We were getting an 11 Hgb. We called the doctor's office and they said "a lot of our patients are coming out low". I asked how their QC was and they had no idea what I was talking about; I explained what it was and they said they never do that. "The vendor takes care of that when they come in periodically". Oh boy. Had we given the 2 units based on their result we could have had a bad outcome. We had a call from that doctor's office later asking if they could send us all of their CBCs for the next few days until their machine was repaired. Eek!

Yes, an MLT can work in BB as long as there is always a bachelor's level tech directly observing them. NY State made it a little stricter than the CLIA requirements.

I tried to find one a few years ago and was unsuccessful. Those few lucky people who own them are hoarding them all...and rightly so. Every Blood Bank should have access to it; it's that good.

The trend at least in NY State is to have only MTs in the Blood Bank because we do high complexity testing. However, in my years of experience, I've had MLTs that were great Blood Bankers and MTs that are terrible at it so it really depends if someone has critical thinking skills and attention to detail or not.

Merry Christmas to all. Especially to those who have to work during the holidays; thank you all for what you do!

Is a D-negative antibody screen acceptable for a facility which does not perform antibody identification? No. You would still need to detect a real Anti-D.

No.

Our hospital is the same size and is not yet designated as a Trauma Center. We try to have 3-4 platelets in-house at all times for all patients, sometimes we go lower though esp on weekends. Keeping 5 on hand at all times JUST for brain bleeds is a little much. It's not like platelet transfusions save every bleed; we started stocking KCentra in the Pharmacy for the bleeds due to Coumadin overdoses. Our indications for platelets are <100K for brain bleeds, or if there is platelet dysfunction (usually due to Plavix).

Welcome aboard!

We only allow 2 units of anything at once if: Massive bleed and using a rapid infuser. Actively bleeding with two IV sites to give units simultaneously. Otherwise, give one and let us know when you need the second.

From the pkg insert: Store at 2-8°C. (no change of expiration once opened) QC: document visual inspection daily, test with known pos and negative daily Maintenance of pump: document weekly cleaning with 70% isopropyl alcohol

We keep a small supply of expired red cells and thawed plasma on our quarantine shelf to use for validations.

When we validated our Tango we put a sample on that looked like heavy cream. It resulted beautifully.

Yes I did.

I believe that this IS allowed, if for that same patient. But we don't do that, we discard all that come back >10°C.

Other than making you extremely awesome , it will open doors for the rest of your career. Crazy; when I put on LinkedIn that I had just enrolled at the school, I started to get recruiters sending me job offers. My most tempting one was at the beach, $100K+ salary with lucrative bonuses. LOL. Seriously though, you should do it. You will have no life for the year that you are preparing for it, but it's worth it.

We have a transfusion guidelines policy with covers most of our Patient Blood Management stuff. We also have an outpatient transfusion policy which also mentions the requirement for pre-transfusion tests and that they have to be performed at our hospital.

Same as pbaker. The CBC has to be in-house and within 2 days. We only give out any blood products without pre-tx lab tests if an extreme emergency. We also require a post-tx test, but not for outpatients.

Does anyone have a good software for flowcharts, or do most of you just use Excel for that?