MAGNUM

We find a lot of our positive antibody screens are due to the 28 week Rhig, then again we have those with true antibodies that happen to pop up occasionally.

I agree whole heartedly with Peter and Malcolm, without clinical symptoms all you have is a delayed serologic reaction.

We perform a Type and Screen on ALL OB patients, even those that come in and the physician decides to send them on home, so when they do come back in (usually the next morning), they are admitted under a new acct number so all gets repeated again.

I dont understand you either, and I have been at this for pert near 30 years.

I still use both terms as do 99% of the blood bankers that I know, and I will probably still use it. My medical director still uses the terms, and if they are good enough for him, then they are good enough for me.

Why dont you just move the UL sticker to the outside of the box. In my opinion they are being tooooooooooooo picky, plus it is only a light box. And the plug, it is very easy to change out a plug and put a grounded plug on even if you dont use the grounding prong. There are always ways to bypass people like your BioMed who are being too picky.

Recently when I had to replace my 20 year old Jewett freezer, I actually looked at Follett, but they did not have anything that suited my purposes. The only freezer that they had was an undercounter freezer, and I do not know how big some of your blood banks are, but 1 undercounter would not suffice for me. I then looked at Sanyo, but way overpriced. Ultimately I went back with Jewett, after all I got 20 years out of the other one.

All coag factors and Rhig were removed from the blood bank at all hospitals in our division and are now dispensed thru the pharmacy.

As part of the transfusion process, the nurse scans the barcoded bracelet on the patient. In order to get the barcoded bracelet, we had to get the stickers for the units with barcodes also, but by scanning the hospital band then the patient blood band the two are tied together and if the wrong product or unit number are issued, flags go up and the blood must be brought back before transfusion, works wonderfully.

I recently put a new plasma freezer into use, the other one was 21 years old and finally died, but I used plain old brother labeling tape from Staples and I have had none come off or even lift in the -30 temp. Just a thought, sometimes the office supply places are cheaper in the long run.

I found one this morning also.

As far as I know, BCTA is a meditech product. What platform are you using?

I am in agreement with David, we wait until the morning H&H to collect the fetalscreen, and YES I have seen positive FMH with the way we draw them, so GiLTphoto your statement is incorrect that we will NEVER find a FMH with the morning draw.

Simple. The barcoded bands act in the same manner as the Hollister bands that most everyone is used to. The Typenex barcoded card includes the band that is labeled at the time of draw, labels for the specimen tubes, and individual labels for the units. The phlebotomist collects the specimen and labels it with the barcode and armbands the patient with the band that has the same barcode number. When received into the meditech blood bank module, the barcode number is entered into the system and is now not reusable. Once we have completed the xmatch, we tag the unit with the crossmatch tag and affix one of the smaller barcoded labels to the unit. When it is checked out to the nurse, they go to the patient room and start scanning using BCTA (Barcode Enabled Transfusion Administration). They scan the patient hospital band, then they scan the patient blood band, then they scan the unit label in sequence of unit number, unit product, unit type, and unit expiration date. If any of the above scans is incorrect, the nurse gets a prompt to return to the blood bank. The computer system tracks the unit transfusion for starting time, plus the nurses are forced to perform their vital signs at appropriate times. Then when the transfusion is completed, the nurse MUST end the transfusion in the computer system. All this data is automatically sent to the blood bank module. Anything further, email me jeffrey.leeper@hcahealthcare.com.

There is nothing written that says that that particular nurse or physician has to pick up the blood. In fact the nursing supervisor is available 24/7. The OR nurse manager is also available to pickup. I just dont allow medics, unit clerks, nurse aids or any other non licensed personnel to pick up blood, and it works fine. In a true emergent situation one of the techs from the lab/blood bank will play runner also. So to answer your question I am not really pulling that nurse or physician away from their patient.

I will answer these by number also: 1. The OR staff NURSES come to the blood bank to pick up their blood. Only nurses (or physicians) can pick up blood. 2. Specimen collection in the OR is performed by the nurses and hand delivered to the laboratory. 3. We do not have a phlebotomy team, but the only collections from lines are done by nurses, respiratory, or physicians. 4. Nursery specimens and NICU specimens are collected by the nurses in their respective units. Second NBS's collected post discharge are done in the lab. 5. I request that the patients come in the day prior to their procedure and for the most part the patients comply. We have them come in the day before in case there are antibodies, and they can be identified and blood available. All the pre op specimens are collected by nursing, unless there is a problem and then they cry for the lab to help.

This one may sound gross, but several years ago in a clinic where I worked one of the doctors was trying out a new method for occult blood called the HemaWipe. It was just as it sounds, a square piece of occult blood paper that the patient wiped with upon completion of their BM. They then put the piece of paper in the provided envelope and mailed it back to us in the lab. This one patient was not totally with it and picked up the whole thing wrapped it in the paper, put it in the envelope and put it in the mail. Imagine our disbelief when we received the envelope in the mail with postage due. The post office actually sent it thru their machine and cancelled the stamp.

Dont you just love all the hairdressers

Jennifer, We too have instituted the use of BCTA for our transfusions. If you are having problems with nursing basically thumbing their thumb at you, you can always enter an Occurance report thru MOX. What happens with the occurance report is that when you enter the report and input the managers names, they have to respond, plus all the occurance reports go to the quality risk department who have to follow up and fix the problem. A few times of nurses having to come back during their off time and finish their transfusions (unpaid at that) actually fixed my problem of their noncompliance, who wants to do the work but not be paid for it. If you continue to have problems, there is always your ethics and compliance department.

At this time we are trying to decide whether to perform cord blood workups on all babies born at our facility or not perform them. Also, whether to perform select workups such as babies from Rh negative mothers and O mothers. What are the comments and concerns out in BB land about this? Do you perform them or not? Do you only do select testing for select babies?

The intent of the CAP question is to compare testing methods between your platforms. If you do Gel testing with tube as a backup, you must test both. But if you are only using tubes there is no comparitive testing to be done. I actually called CAP to inquire that since I use the same QC for both gel and tubes why cant that suffice, but because the QC specimens are "manufactured" you cannot use them, the CAP wants true specimens including CAP survey specimens. I developed a policy that states that every quarter I will retest samples on both methods and the samples include both Rh+ and Rh= for A,B,O, and at least 1 postive Ab screen and 1 negative Ab screen. I got popped on my last inspection on this and this method that I developed satisfied the CAP as a correction. To think that because you use a cell washer you must wash manually is overzealousness. As I stated before it is your testing platforms that you are comparing.

CRP is naturally occuring in the body and rises during inflammatory processes, so unless it is markedly increased I cannot find anything that says that a donor should be deferred.

So can anyone point me to a reference for this.

So Malcolm you mentioned immunocompromised patients, but what about our oncology patients who have never tested as CMV positive do we give them leukoreduced products or CMV seronegative products?

The PEG is great, I use it for all my ID's, but you cannot "lose" the antibody enhancement since PEG does destroy certain antibodies invitro such as your Duffy's, so you need your regular enhancement also.