phouck

You should understand that it is ALWAYS our fault if something goes wrong. Doesn't matter if they wait until 30 minutes before surgery and then the patient has an atypical antibody. Don't you know that WE gave it to them, we are delaying the surgery and WE are responsible for the patient being kept under so long.

Rashmi, We put a small label from Meditech on a 12 x 75 tube and put the crossmatch segment in it. We retain these for 3 days after crossmatch. The ones that are retained at entry into inventory are kept for a couple of months and then destroyed. We always have the current month and 2 months back in the refrigerator. We are not a big hospital and we give most of what we crossmatch either the day it is crossmatched or the next day. Forgot to tell you that we attach the small unit number from the bag to the segment. This makes it easier to find the segment. pat

When helping out in Hematology, the floor was called to recollect a specimen because the one we had was clotted. We we told to "just pull out the clot and run the specimen. I do this all the time and it won't hurt anything". Needless to say, we sent one of our assistants to redraw the patient. pat

We do not retain the blood bags. The transfusing locations properly dispose of the bags when the transfusion is finished. We do, however, retain the segment from the unit that was used for crossmatch and we also retain a segemnt when the units are entered into inventory. pat

We use complement control cells, too.

In your institutions, how long do you wait before drawing a CBC or other lab work from a patient that has just received blood? We used to tell them to wait at least an hour, but I cannot find any reference for that time frame. I have been questione about this a whole bunch lately. Thanks

I just talked with Immucor about this today and told them that if I could find someone else that manufactured a Fetal Bleed Screening test, I would buy it in a second and leave them behind. We, too, are a small facility and would never use 20L before the expiration date. They told me that they had thought about putting the buffered saline in the kits but that it would not work because of the volume needed. They also told me that it was the small hospitals that were having the problem. We have not had a problem with false positives (Hematology does the KB). I think that it is a bunch of "horse hocky". There has to be a better way to fix the "problem". We use saline with a pH of 6.0 - 7.5 from Thermo. The person at Immucor told me that the pH would drop way below that once the cube was opened. He said that by the time it was 3 weeks old the pH would be 5.0. I am not so sure about that. I believe that we will use what we have for as long as we can. Of course, when the new package insert comes out, we will have to figure something else out. I feel that it is a shame that we should have to use our financial resources for something that is not our fault or for something for which we do not have a problem. phouck

We keepn the segments for 2 months in a small biohazard bag labeled with the month. These are kept in the refrigerator. We remove 2 segments when the units are entered into inventory. One for testing and one to keep in case it is needed later. We put one of the small DIN numbers on the segment. phouck

How did you get them to just do it on those 3? I have a medical director that is interested in what I am doing and will most likely talk with the physicians after I get some data. Of course, the other hospitals around here are doing them on all moms. When I asked why? the answer was "we have always done it this way".

The hospital in which I am newly employed performs routine cord blood testing on all babies born regardless of the mom's blood type or antibody status. I am trying to change this to where we only perform this testing on Rh neg moms, and moms with significant antibodies. I'd like to gather information from y'all on articles or any form of communication that would help me accomplish this task. I will need good documentation for this project. I believe that there will be cost savings to the hospital if this "just 'cause we have always done it this way" thinking can be changed. I am in the process of determining how many cords were done in a year and the cost and how many would have been done if we only did them on Rh neg moms and moms with antibodies and the cost savings. Has anyone else done this and what was the outcome? How many of y'all's hospitals are still performing this test on all babies? Appreciate your help with this. Pat Houck

We have not experienced any problem with our kit (pos control is just fine). What lot number are you using now? I have been here since July and have not had a problem. Take that back, did get a CAP survey negative when CAP said that it was postitive. Repeated the sample and it was positive. Very weak on the KB.

Hi I am Pat Houck and have been a blood banker for a very long time. We did majors and minors when I first started out and there was no automation at all. Needless to say, there have been big changes. Just wanted to say hi and I am looking forward to visiting with y'all and picking your brains. pat