jschlosser

Not a possibility since we are very rural. Already mentioned increasing O negs but since there's usually a shortage that was not happening

Thanks so much Malcom. That makes sense and eases my mind!

A physician at our small rural hospital has commented that in a situation when a trauma is bleeding out he would give all the blood that we stock. We stock only 2 O negs, 2 O pos and 2 A pos. I however feel uncomfortable giving our A pos to anyone not typed because if the patient was stabilized and the the A pos was still circultaing I feel that that would be a significant problem. It may never happen but I would like to be prepared. Thanks much in advance

No idea why. I was hoping someone on this forum might know! I only know the mother's CK was very high and her urine was brown (myoglobin?) predelivery.

Today an ER physician asked us to perform flow on the mothers urine to detect fetal hemoglobin in the case of fetal demise. Is there a scenario where urine will give them answers where the maternal blood sample won't?

A. We stopped using seperate blood bands this last January. Our admissions department will identify the patient and band them with their pre-op wristband. Once we have drawn our pre-op sample and labeled it with the name, date of birth,account number for that admission and medical record number, we cut that wristband off. They are rebanded the next day by admissions following the facility policy of always asking for the patients name and date of birth. B. If the patient still has crossmatched units available and the patient is identified again by asking their name and date of birth and have a matching medical record number we would transfuse those units. C. Our recurring transfusion patients have a card they are given to present to the lab when a sample for crossmatching is to be drawn. We ask them to verify their name and date of birth with every draw. The registration is usually used from 1-3 months and includes their medical record number and account number.

How are the disposable hemocytometers working for you? I have been trying to get our lab director to buy these but she insists the 2 glass hemocytometers we currently have are sufficient!

We perform a manual diff on any flagged differential and NP the auto only if it's significantly different. Our oncology department has to wait on these until we can report out the correct ANC.If the manual differential matches the auto we just have a comment that the scanned results correlate with the auto but they still have to wait until we scan the slide.

We stopped using a seperate blood bank band when we went live with TAR.

We went live with TAR in January and I'm quite disappointed. The only advantage is the barcode scanning of the patient identification to product. In the lab we have delta checks and other flags that ask us if we need recheck an abnormal value but in TAR nurses can enter a 0 blood pressure or a 500 degree temperature with no checks or alerts. Why isnt there criteria that if a temperature increases by a certain amount TAR alerts the nurse that a transfusion reaction may be happenning or if the oxygen saturation declines think TRALI? Is this something that is possible with TAR and our IT just hasn't included?

Thanks much!

Where do you purchase the hyaluronidase from. Rabbit or sheep or some other animal....

We recently started running our body fluids on the Sysmex XN. We haven't been able to get much help from Sysmex on running the more viscous fluid through except the statement that some places add a few flakes of hyaluronidase. Any help with what kind of hyaluronidase, how much to add and even any written procedure would be greatly appreciated.

We are interfaced and we don't get the demographics either.

We are a small hospital that didnt have the option of investing in an ISBT label printer so we cant aliquot units for pediatric transfusions. What are our options if we have a trauma involving a child needing blood? Can we hang a unit with the option of stopping the transfusion at the recommended volume for the child's weight and waste the remainder of the unit? Any other suggestions? (Our blood supplier is 4 hours away)

I'm curious on how many labs only perform the dipstick on a routine urinalysis and if there is a positive protein, nitrite, leukocyte esterase or blood then reflex to a microscopic?

Our facility transfuses only about 200 RBCs a year so we are small. I'm a generalist who works three 12 hours days in the lab and in my "spare time" am considered the blood bank supervisor so I visit this site a lot for answers. My question is how archaic are we because we perform AHG(gel) and IS(gel) crossmatches on every RBC transfusion despite a negative antibody screen?

Yes.

Our phlebotomist will sometimes draw samples from an artery with a butterfly when ABGs are ordered along with other labs. We are concerned with the empty space in the vacutainer tubes even if filled to the recommended draw volume. Just wondering what other labs may do in this situation?

I have a question concerning platelets only. Since we are a very small hospital our supplier can rarely get us type specific platelets. Because of this, some of our techs think we really don't need any type on the patient and it is a waste of money to perform one. I feel it's still important to at least get a historical type but am not smart enough to explain why. We recently had a patient visiting in our area who was going to receive platelets as an outpatient. We didn't get a blood sample at all on her and obviously didn't get a blood type on her. This seems wrong to me. Thanks in advance for advice.

We have been conforming every positive dipstick result for bilirubin with the ictotest forever. The ictotest is sometimes difficult to read and we're not sure which one to go with. Is it a requirement by Jacho? Is it still needed?

Is it normal practice to identify every organism in an eye culture (four organisms) and charge A MIC for each organism. The culture turned out to be 600.00 and was probably viral anyhow?

Sorry Donna. didn't see that question on DAT but it was negative.

Thanks to all of you. Very helpfull feedback.

Our reference labs explained it that their policy is to only use the rule out on all the significant antibodies and never go to antigen typing because the antibody may be an auto which would confuse the whole situation.