BankerGirl

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That is a similar scenario to my most recent nightmare. The nurse had given the patient multiple units of blood over two days so she "knew" he wouldn't have a reaction. Then checked nothing and bypassed the computer transfusion program. An aid came in the room when she was getting ready to transfuse unit #2 and noticed the blood type wasn't the same as the one she was discarding. Fortunately the patient suffered no harm.

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We use it and it is the RNs documenting. Unfortunately, Anesthesia refuses to move their documentation away from paper.

We require one blood type per registration for all of the reasons stated above. We also have encountered a few patients with identical first and last names and similar dates of birth that kept getting merged together. We caught it each time because of their different blood types.

If it is from the same supplier we use and packed appropriately, I have no problem accepting the blood into our inventory. I contact the transferring facility for a transfer form if they did not pack one.

I agree with the above statements. Our nurses usually get two units infused withing 4 hours so they don't have to use a second blood administration set.

I'm sorry, I didn't actually look at the article since I was searching for another topic, so I don't know if this is it or not. It sounds like it might be.

First question is what version of Meditech are you on? Second question is are you printing the Crossmatch/Assignment cards or the IT (Issue Transfuse) Cards? We had this problem with the Crossmatch cards when we first started with Meditech, so our analyst had us use the IT cards instead and we have not seen this problem since. I have recently seen a KB article on their website that addresses this with the Crossmatch cards, so you may want to check there.

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I had one reaction report early in my career that was only "bleeding tongue" and when I took it to my pathologist, he just rolled his eyes and waved me off. Just yesterday I read the information sent by ARC regarding allergic reactions to psoralen in platelets and they had this to say: "...no cases of psoralen or amotosalen hypersensitivity have been reported to Cerus, the manufacturer of INTERCEPT (psoralen-treated) platelets. Psoralen-treated products have been in routine use in patients in Europe (15+ years) and USA (3+ years) with over 5 million psoralen-treated components administered with no hypersensitivity reaction to psoralen reported to date." Not saying it is impossible, just not previously documented.

I don't know about all Rh Immune globulin preparations, but Rhophylac cannot be given IV for Antepartum prophylaxis. It is cleared too quickly if given IV and doesn't protect the mom through to delivery. For our postpartum patients, however, the IV administration is huge for patient satisfaction.

Have your blood types been mapped? The Echo sends back blood types differently than Meditech accepts them. I believe that your Meditech instrument specialist needs to do the mapping for you. I don't remember the exact term, but he or she should know what needs to be done.

Thank you Baby Banker. I always wondered but never took the time to investigate.

I realize what you say is correct Malcolm, but that is what my supervisor called it and that is the way it was reported back in then.

When I was a very young tech, our supervisor had us carry every Rh negative result through "Du" as it was called then. I also had an O Neg labeled unit test O "Du" positive.

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We accept them as long as they don't have a really nasty antibody history (Warm or multiple antibodies) since we perform electronic XMs. Sometimes we have to get samples redrawn due to unexpected issues, but that is the exception, not the norm, so we try to work with what we get if possible.

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We used to require this as well, but as you said, we rejected many samples due to missing initials, mispelled names, missed numbers in the MRN, etc. When we went with Electronic patient verification we had to change that policy for phlebotomy to use the new system, and things improved dramatically. No one has the Mobilab scanners except our phlebotomists, so the number of people we have to educate is kept at a minimum. This is not to say they never cheat the system--they have--but it is much easier to manage 20 phlebotomists than 1000 nurses, specialty techs and anesthesia staff, so we feel pretty confident in our system.