tlorme

Can anyone tell me if they require a patient to sign a Transfusion Consent for RH Immune Globulin and/or Albumin? We are trying to standardize our practice and I don't know of a regulation that requires a Transfusion Consent for these plasma derived products. Thanks, in advance, for your input.

Can anyone tell me if they know of specific transfusion requirements for Thalassemia patients? We have 2 patients who are receiving frequent transfusion support, and the MD is requesting CMV neg, Irradiated, Double-washed PRBC's. I can't find any info on-line that speaks to this requirement for the patient population indicated. Thanks!

AMEN, Brenda!!! One of the first things I did after taking over as the BB supervisor 14 years go was to implement a coversheet for all antibody workups or testing 'problems' (+ DAT, etc) (we are a large university medical center with a regional trauma center, active OB, Oncology and Open Heart programs to name a few). I find myself constantly reminding my younger techs (and some seasoned ones too!) of the invaluable nature of obtaining an accurate and complete history on a patient. I've modified my form many times over the years to include prompts for the techs so they don't forget to ask more than the basic "has your patient ever been transfused?". I take evey 'learning opportunity' presented to educate all of my BB techs how important this information is, whether we have issued uncrossmatched blood to a trauma or are just starting a workup on a Pre-op patient. It never ceases to amaze me how difficult it is to obtain this information from a direct patient caregiver (MD or RN). Thank you for your comments....I concur!

Yes, I too would love to have a copy of your form if you are so willing tlorme@meridianhealth.com

Can anyone tell me why you would use a 3-cell screen vs a 2-cell screen when performing a manual (non-automated) antibody detection?

Same as BBK710 with the exception of time frame: new-hires are given 2 years to pass the exam before termination.

Thank you all for your responses.

Can anyone tell me if they routinely perform an elution on a cord blood when you know the mom's plasma contains anti-D due to RhIg and/or there is an ABO incompatibility between mom & baby (ie: mom's group O and baby's group A)?

WE issue coolers all the time to our cardiac and trauma OR's. The coolers contain only a sticker identifying them as belonging to the Blood Bank, and a biohazard sticker. The coolers are all numbered so we can keep track of which coolers went to which OR's at what time. Inside the cooler is a 'tracking sheet' that contains the patient info, location the cooler was issued to, and the unit numbers for the products inside the cooler. When the cooler reaches it's destination, the receiving RN must verify the tags on the units and document a visual inspection as well as date & time the unit(s) is taken from the cooler on the tracking sheet, which comes back to the BB with the cooler. This tracking sheet is a requirement of our state DOH.

I'm totally wiht you!!

Hi all...a quick question: When working on a new patient antibody ID, you obtain information regarding past hospitalizations at another facility. Do you routinely (or ever) call that facility's Transfusion Service to gain information regarding previously identified antibodies and/or compatibility testing problems and transfusion history? If you DO call another facility, has your request for this information ever been denied? thanks!

Thanks Malcolm. I should have clarified: this would be for simple neonatal transfusions to replace iatrogenic blood loss: no maternal antibody or special circumstances involved.

Hi gang: another question for you all regarding neonatal transfusions: Can you tell me if you accept type-specific directed donors OR do you only accept group O, Rh compatible directed donors for neonatal transfusion. Thanks!

Many thanks to all who have responded. We had a situation recently which prompted my medical director to call upon a "blood bank expert" (his words, not mine) in the US. That individual indicated that it is standard practice to wash PRBC's for neonatal transfusion. I disagreed, and wanted to hear what my peers had to say....so thank you all for confirming my suspicions that washing is not standard practice!

Can anyone tell me if their standard practice for neonatal RBC transfusions is to provide WASHED PRBC's (in addition to CMV (-) and irradiated product), and if so, do you wash the cells in-house or does your local Blood Center provide the washed units?

My nursing education department recently posed this question to me: Is it appropriate for an RN to collect labs during a blood component transfusion? My medical director has asked me to discourage the practice, but has not offered any references to back the request up. Does anyone know if it is, or is not, appropriate to collect labs durign a transfusion, and if you have any references supporting either way I'd truly appreicate. Thanks!!

Interesting you should ask this question: we currently work in an environment where the BB medical director is readily available for consultation, unless he is in the gross room or reading a frozen section. All of our pathologists rotate between clinical, gross room, cytopath & frozen sections, in addition to taking call. Only the BB medical director has the BB expertise, so I go to him as long as he is available. Just recently, our lab coordinator (aka secretary) announced that she will be posting a schedule identifying specific times when we can approach each pathologist for consult. I have a problem with this. We are a regional trauma center and NICU with an active CT Surgery program. I don't think limiting access to the BB medical director is in the best interest of our patients.

Nothing is 'foolproof', but.....Annual SOP review is tied to our Performance Review tool. I give the techs 2 months to review and sign-off on policy review each year. Anyone who has not completed by the deadline receives a zero for that category in their annual performance review. Last year was the first year that I had techs not complete on-time and I reflected this in their performance. This year everyone completed ahead of schedule. Apparently $ is a motivator