Everything posted by MAGNUM
On each subsequent Crossmatch ordered, if the Antibody screen is positive, we perform the identification because we do not ag type each unit for all antigens and although the patient received antigen negative units for the original antibody, we cannot guarantee that other antigens are present that could cause the patient to create new antibodies which happens more times than you might think. Better safe than sorry and have a delayed transfusion reaction.
Since you will not be aliquoting or making components, the transition will be a breeze. We do both here and the transition was easy. Our division (HCANT) scripted all the products into the blood bank dictionaries, all we the site users had to do was to activate what we needed and not activate what we felt we would not need. We tested the ISBT system for about 6 months prior to going live, so it was a seemless transition, one day were using Codabar and the next we were using ISBT. The biggest hurdle is the training of the nursing staff on what they could expect to see happen once we went live. Training of the laboratory and other blood bank personnel was really a easy, since we are used to change.
I have found that by sterile docking pediatric aliquot bags to the mother unit, the integrity and life of the mother unit is maintained. You can also sterile dock your pediatric filters directly to the unit if all your aliquot bags are used.
At my last posting, I failed to remember that we do have one stay ahead protocol and that is if there is a massive transfusion going on. But this is the only time, and it is very delineated in my policy about what and when.
At our hospital, we tell the nurses that thanks for the information, but that it is their responsibility to order more units if desired. My Medical Director nor myself respect these "stay ahead orders". It is our opinion that by having the blood bank personnel order the ahead units that constitutes them writing the order and we do not feel nor do we want the responsibility for ordering the units.
Here in our facility, we do the ABO/Rh and a DAT on all cords. If the mother has a significant antibody and the baby has a positive DAT then an eluate is performed, written into our policy, the doctor does not even have a say in the matter.
Here at my hospital, if it isnt complete, it gets filed in the red filing cabinet and the collector gets to revisit the patient and redraw the specimen. We do use a red armband, but the armband is wide enough to permit use of a hospital label that contains all lthe patient information. I also require the person collecting the specimen to date time and intial the specimen and armband. If they do not match, then filed.