[Transfusion Reactions:Hives]

We stop the transfusion and initiate the transfusion reaction procedure. And until the workup is complete (minus any micro), the patient is unable to receive any other products. Normally it is just something with the donor plasma and Benadryl should cover and propholactically thereafter prior to transfusion. Normally the physicians order Tylenol before the transfusions, so adding Benadryl is not an issue.

[Barrier method]

I use BCTA also with the checks online.

I have looked at the Blood Locks but have not decided as of yet

[Thermometers for taking temp of returned blood products]

I use the temp-chek, if they are issued in a cooler, otherwise 15 minutes.

[Abnormal result flags]

yes, all of the above

[Transfusion Errors]

On 2/21/2021 at 9:56 AM, John C. Staley said:

I had always found it difficult to convince nurses that we were working with a person/patient and not a room/bed!  This became even more difficult after all the privacy rules and regulations came about.  It was almost as if they were terrified to say a patient's name aloud!

I have even gone so far as to tell the nurse taking care of the patient that when they learned the patient's name and not the room number to give me a call back and we will discuss the patient at that time.

 

[Kleihauer Betke Help]

We send our KB's to another hospital in our division and get nice 2-4 hr turn around time. They use flow. We started using them because the local ARC does not perform KB's, and with only 6 or 7 a year we couldn't justify the cost for performing them inhouse.

[ISBT-128 Diamond Symbol]

I have wondered that myself, it just suddenly appeared when we bought our new hematrax printer. 

[Neonatal RBC "top-up" transfusions - to irradiate or not?]

1 hour ago, Neil Blumberg said:

No one knows for sure, but very fresh blood (<7 days storage) is totally unnecessary in terms of proven benefit and may actually be more dangerous, for reasons that are largely unknown.

Is there a reference for the non use of very fresh blood?

[Convalescent Plasma Tracking]

1 hour ago, jayinsat said:

When the FDA issued the EUA on August 23, 2020, we started stocking convalescent plasma in house from our supplier. We fill the orders once they come in. Before that, it was a pain.

Are you able to make a stock order with ARC for, say, 5 O's, 5 A's, and 2 B's? Our supplier prefers it that way here in South Texas.

 

ARC does not allow stock supplies of the COVID plasma.

On the somewhat same note, how do you take care of your AB patients when the blood center cannot or will not supply AB convalescent plasma?

 

[Convalescent Plasma Tracking]

We too use ARC. The pack slips have the order number on them so that you can match up the order numbers. When we get orders for the convalescent plasma, we order the plasma and on the order printout, we note the patient name, then once the plasma arrives, we match up the pack list with the order printout. In the meantime, we keep all the orders and their respective printouts on our metallic white board, that is basically the only way that we have found to somewhat keep abreast of the orders.

[COM.40700]

I marked it down as N/A since it has to do with AMR's and such. At least that is my thinking. During our CAP inspection in September, my inspector didn't give it a second thought.

[Meditech-TAR]

As of yet, we have been unable to migrate BCTA into the OR. But our division is looking to force the issue and put it in the OR regardless.

[Blood Bank Record book vs Meditech]

I use Meditech and do not have any paper. As to histories, we look up each patient history when we get specimens on the patient.  Normally on Monday, Wednesday, and Friday, I download a copy of patient histories onto a DVD in case of Ransom Ware Attacks. The file is downloaded and saved as a Word file that is accessible from any PC.

 

[Request a book]

I am not aware of a free PDF download of the TM. I guess you will have to purchase the TM.

[Order requirements for components (plasma, platelets, cryo)]

TS FOR PACKED CELLS, PLT COUNT FOR PLATELETS, PT/PTT FOR FFP, AND FIBRINOGEN FOR CRYO. THAT ALL TYPICALLY GOES OUT THE WINDOW WHEN IT COMES TO TRAUMAS AND MTP'S.

[Special Care nursery-do you have a pedi unit on site at all times?]

Issueing a full unit for approximately 30 ml and discarding the rest is such a waste. Surely there is some other alternative.

[Addition of sterile saline when pooling cryo]

I purchase 5 unit pools of cryo from the blood supplier, no more pooling. The physicians seem to appreciate the pools. I do keep 1 or 2 units of AB cryo for emergent situations such as liver lacs and such to be used as emergent glue.

[Special Care nursery-do you have a pedi unit on site at all times?]

Since we have the only Level 3 NICU in our county, we keep a pedi unit at all times. We have our blood supplier sterile dock aliquot bags onto the unit. The unit is irradiated, CMV negative, Sickle cell negative, and Zika negative. I order a fresh unit every 14 days, if it lasts that long. 

[Historical ABO used for plasma products?]

Let me play the devils advocate when it comes to using the historical type. What happens if the patient is not really the patient that the original ABO was performed on? What about the times when the ID number is bought and used by multiple people especially where there is a large community of people who are not necessarily legal to be here?

For these reasons and a few more, we require a current type.

[ABO Confirmation, 2nd Draw]

I copy my histories to a file on the desktop of all of the PC's in the blood bank on Wednesday of the week. They are also copied to a flash drive. It may take a little time to look up the history of a patient, but it saves the patient a stick.

[Life Membership of IBMS.]

CONGRATS MALCOLM!!

[Lui Freeze Elution]

32 minutes ago, AMcCord said:

I've got an OLD OLD procedure that adds 3 drops of 30% albumin to 0.5 mL packed red cells prior to freezing. The reference is the 10th edition of the Technical Manual.

The procedure is so old and so bare bones that there isn't any other information included - just the step by step. Looks really odd compared to current procedures.

All the albumin that I buy is 22% not 30%. 

[Lui Freeze Elution]

I have never added albumin to my Lui Freezes.

[LOT TO LOT ON FMS]

We run old reagents with new controls, and new reagents old controls. I also run old CAP survey specimens with both also.

[Donor re-typing]

We retype the units as they come in because like CSP0102, I have personally found units mislabeled at the blood center, so better safe than sorry I like to say.