[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.

[Weak D Testing - Cord Blood Evaluation]

Currently, we test for weak D's on Rh negative babies of Rh negative moms, and units from the ARC that are labeled as Rh positive but testing Rh negative. 

[ARC Packing Slips? Keep? Trash? HELP!]

To keep or not to Keep, that is the question. My answer is to review the guidelines for your accrediting agency and follow their rules. I personally keep them for approximately 2 years because that is about how long it takes to fill a storage box. Once filled, I send to an offsite storage for another 2 years then they are destroyed.

[Tube holder for reading DAT or IAT under microscope]

On 5/7/2020 at 11:22 AM, Malcolm Needs said:

True, but both the original question, and the question that resurrected this post were referring to antibody/antigen reactions.

Actually, the original intent was looking for the reader itself

[Tube holder for reading DAT or IAT under microscope]

There is also the Fetal Rosetting tests that require microscopic viewing

[EDTA Specimen]

No, I do not accept tubes that are less than half full, The reasoning behind this is should we need to perform ID's and crossmatches, we want to insure that there is enough specimen to go around.

[DRY ICE STORAGE AND PROCEDURE]

Thanks, this helps alot in trying to fulfill this CAP requirement. Although we do not keep Dry Ice in the laboratory and Blood Bank especially, we do receive it and have to handle it when we get shipments of FFP and Cryo in from the blood supplier.

[DRY ICE STORAGE AND PROCEDURE]

Does anyone have a policy and procedure that they are willing to share as it pertains to Dry Ice. This is the CAP checklist question that I am referring to.

**REVISED** 09/17/2019 GEN.77500 Liquid Nitrogen and Dry Ice Phase II

Adequate policies, procedures, and practices are in place for the use of liquid nitrogen (LN2) and dry ice.

NOTE: Practices for the safe handling of liquid nitrogen and dry ice include:

1. The mandatory use of appropriate gloves, shielding of all skin, and the use of a face shield or safety goggles when decanting or entering an open container of LN2

2. The mandatory use of insulated gloves, dry ice tongs or scoop, and safety goggles/ glasses when handling dry ice

3. Storage and use of all containers of LN2 and dry ice only in well-ventilated areas. Do not use or store dry ice or LN2 in confined areas, walk-in refrigerators, environmental chambers, or rooms without ventilation. An LN2 or CO2 leak in such an area could cause an oxygen-deficient atmosphere.

4. Availability of a Safety Data Sheet

5. Training on the safe handling of LN2 and dry ice

6. Signage displayed in areas where LN2 is used and/or stored

7. Plan for immediate treatment for individuals overcome by toxic or oxygen-displacing fumes

REFERENCES 1) OSHA Quick Facts: Laboratory Safety Cryogens and Dry Ice. Occupational Safety and Health Administration Website. https:// www.osha.gov/Publications/laboratory/OSHAquickfacts-lab-safety-cryogens-dryice.pdf. Reviewed October 2011. Accessed 12/8/2017.

 

Any and all help is greatly appreciated.

 

Scott

[Units being returned from isolated patients]

What about any coolers that might have been taken into the isolation room? Who is responsible for cleaning the cooler prior to it's return? Plus if it has been in an isolation room with COVID-19, who is going to go into the isolation room and retrieve the cooler and clean it appropriately prior to it being carried thru the hospital halls?

[Blood Product cooler thermometer]

You could use a Data Logger, they take temperatures at specified intervals then you can download the data into a spreadsheet.

[HEMATRAX PRINTER VALIDATION]

I forgot to mention that we are using Meditech.

[HEMATRAX PRINTER VALIDATION]

Our tried and true Hematrax printer has finally just about bit the dirt and will need to be replaced. We will probably go with the updated Hematrax printer as a replacement. My question is: Once the printer is installed, what validation processes do we need to complete prior to being put into use? The labels should not change, so what is required?

[Alarm Checks and Chart Recorder Readings]

I

20 hours ago, DebbieL said:

I am also interested in how others are checking the Platelet incubator. Our probes are incased in some metal protective shield that makes them very difficult to get to. There are only some little nubs sort of sticking out about an inch or so.

I removed my probe from its cover left it that way so that I could access the probe as needed. When completed, I just replace the probe in its cover but do not "lock" it into place.

[Recommendations for Plasma Thawers]

I have a Helmer DH8, thaws 8 units in about 18 minutes.

[Issuing plasma based on historical type]

I prefer to have a current specimen, and that is what our policy reads. 

[Neonatal Syringe Transfusions]

We filter the blood for them when making the aliquot, further filtration is not necessary.

[TAT Quality Monitors]

For true traumas - 1 hour from receipt in laboratory.

Cord bloods are batched and run at least once per shift except for night shift who are exempt from doing cords. I only require them to be done once on day shift and evening shift, but a lot of time they are performed 2 or 3 times depending on the number of specimens.