BankerGirl

Melvolny asked about a rule on starting blood within 30 minutes, not returning blood. I don't believe that you will find anything other than what R1R2 stated.

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What is your primary test method? We tried the Bio-Rad blend several years ago and didn't like it. We were using gel at the time and initially had good correlation between our results, but shortly after we switched it out, we had many patients who were Rh positive in gel and were Rh negative in tube (we used the tube reagent to perform retypes on new patients). Inevitably, they would be positive after incubation at 37, but our techs were very frustrated because we were getting so many discrepancies between the two methods. We switched back to the Immucor monoclonal blend and were much happier. We have since switched to the Echo for our routine testing, and use the Series 4 reagent in tube if needed to save from stocking a third anti-D reagent, and we are again getting a few discrepancies with testing previously performed in gel, but that is much less frequent.

I think that this is very possible. We have seen some thawed plasma look like egg drop soup after several hours in the refrigerator. If you place it back in the water bath for about 5 minutes, cryoprecipitate will go back in solution and should be fine to transfuse. If it still looks the same after warming, then you shouldn't use it.

Was the inspector referring to the ISBT label or the IT form? If it is the IT form, look at KB article 27704. This will change the number that prints on the card so it matches the ISBT format. I think that may be what was troubling the inspector, although what he said doesn't make sense. I'm just guessing that he heard this previously and didn't remember the correct reason that it troubled him. If that is not the case, then I don't have any suggestions other than to plead your case with CAP after the citation is confirmed.

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Thanks LAS! We have been on Meditech for 10 years and I couldn't imagine that this would change. This really makes me wonder what this person was talking about.

We are in the process of building our Meditech 6.16 system and I have a couple of questions for those of you who have already been through this. I heard the following from a site that recently went live: "...you cannot look up a unit of blood by number and see which patient got that unit. It makes look backs for the Red Cross very, very difficult." Is this true? Thanks in advance

Susan, Which pp of 5.67 are you on? If it is high enough (maybe pp24 or so) you can utilize the barcode verification at issue option. If not, then the only way I know to do this is by adding the product code to your compatibility tag as ESIZENSKY stated. That is what we did originally.

I really don't know what kind of drugs they were giving. We didn't think to ask.

I have also seen neonates with strong reactions to anti-A and weak reactions to anti-B. I did additional testing to confirm that it was a true anti-B reaction and not something non-specific but never was able to obtain a later sample to see if the strength of the reaction was any different. Case 2: unless I missed something, there is no evidence of hemolysis, correct? I would hesitate to call a hemolytic reaction without evidence of actual hemolysis. Was the pre-transfusion sample drawn prior to the chemotherapy? We have had two cases where the patient was sent over for type and cross after chemo for RC transfusions and pre-transfusion testing showed pan-reactivity. When we brought the patient back in the next day to draw additional sample for our reference lab the reactivity was gone. We never performed an eluate since the second sample was negative so I don't know what to thing about the anti-Lua reactivity, other than what Malcolm said about it possibly being from a different product.

We do the same as CSP0102 unless the physician specifically orders one, usually if the baby is jaundiced the next day.

I built it. I just saw a demo for version 6.16 that we will be changing to next year and it has the scanning verification that will be very nice!

It is built in Issue Component. I initially built it in Component Processing but wasn't happy with it for some reason that I can't remember at the moment.

It is simply a statement that says "All labels applied to this Component have been verified" and they have to answer Yes to proceed.

Hi Susan, I have only been able to get it somewhere between 2301 and 2359 based on rules. Meditech was not helpful at all. If the specimen was collected exactly on the hour, then it will expire at midnight. However, if it was collected any time after the top of the hour, it is 23xx (coll time = 1220, then it expires at 2320; if at 0501, then it expires at 2301).

We have one form for both Emergency Release and Incompatible transfusion. We have a blank line that we fill in with the reason for release and then the tech, ordering physician, and pathologist must all sign and date the form.

I just looked at ours and they do not have this statement anywhere on the box. We use Cat. SP1290-2 and Cat. SP1290-3 from Cardinal.

This is how we do it also, except for platelets. We don't require a blood type prior to platelet transfusion unless the physician requests type specific and we do not already have a blood type on the patient. For neonates, we use type AB if we don't already have a sample to type. We would not stick for this patient population.

Yes, Malcolm, that is what I meant. Even when we are trying to do things right, they sometimes go wrong...with blood bank typing AND message typing.

All of our outpatients are banded, even for routine testing per lab protocol, with the exception of our satellite lab at the cancer center across the street. If the patient is often anemic, however, they will band them as well and we have that positive ID trace. Yes, banding patients is no guarantee that accidents will occur, but I would not want to go back to handwritten tubes. The number of redraws due to manual errors was much greater and it didn't stop the nurses from labeling at the nurses station, before or after collection, or copying the wrong patient's info from the wrong paperwork left in the room.

In my opinion, "unique" does not equal "independent". We used to require handwritten blood bank tubes but switched to allow computer generated specimen labels. The impetus for this change was the acquisition of hand-held phlebotomy scanners which printed the labels at the bedside after scanning the patient's wristband, however we had surgery personnel begging us to allow pre-printed labels for years because they cannot generally access the patient's wristband once the procedure has started and they often misspelled, copied, and omitted information. Additionally, some people's handwriting is atrocious! We have so many fewer headaches now that we made this change!

We just added a required customer defined screen that asks if we verified all labeling. Being able to scan it as a double check would be WONDERFUL!

I had all of the same questions as DebbieL regarding spreadsheets. We keep our Automation QC electronically, but the manual reagents are all still on paper.