[Blood product issue time]

We have an electronic time stamp when we issue the blood or blood products. Also, since we use BCTA we have a time and date stamp of when the transfusion was started as well as who started the transfusion. We also have a record of all the vitals performed during that transfusion.

[What do you call an 'unidentified' antibody?]

We report as "Unidentified at this time"

[Transfusion reaction culture]

Since transfusion reactions are a rarity here, we plant all units from suspected reactions and they are generally planted by the blood banker who just so happens to also be a generalist.

[Irradiating blood products for mod size hospital]

We order our irradiated products from our blood supplier as needed. I don't relish the government running around here.

 

[Blood bank Samples]

6ml

packed

yes

 

[Procedures stored electronically]

We use compliance 360 for our procedures, and in order to sign off on a procedure you must have access to the procedure and then once myself then the pathologist clicks ok then his electronic as well as my electronic signatures are affixed.

[Pre transfusion hemoglobin for outpatients]

We had a problem with the clinics not sending their results then sometimes when they did send them they may be old results, so when we as the transfusion committee rewrote the transfusion criteria I included in the procedure that we require "X" testing for "X" products and that to insure that we had that testing performed, that testing would be ordered for each outpatient transfusion, such as if the patient was to receive packed cells we automatically order a H&H, for platelets we order a Platelet count, FFP a PT/PTT, cryo a fibrinogen.  We then took the policy to the Medical Executive Council and the hospital Policy and Procedure committee.  At both places I pointed out the requirement and they approved the policy and changes without question.  So we now have an unwritten written order for the pretransfusion testing that we need.

[testing cord bloods]

We only do cord bloods in tubes, so YES we do wash at least 5 times sometimes we will rewash if the results look funky.

[CAP Proficiency Testing for Blood Bank]

I have been splitting up all my surveys between techs for the last couple of years. Each tech is assigned one red cell specimen and its corresponding serum specimen. The tech completes "ALL" the testing necessary for that one "patient". If it is the automated survey, 5 different techs each are assigned 1 of the samples. Not only does this share the wealth, but it shows competency in performing unknowns. DAT's and Fetal Hemoglobins are treated in the same manner just with fewer techs. Then I rotate the surveys that the techs receive. Sometimes the tech gets lucky and has a negative ab screen so their testing is short and sweet and then sometimes they get to play detective because their ab screen is positive so they get to determine which ab it is.

[New CAP survey being offered]

I agree with everything that i have read. We have very little call for subgroups, so that being said I will not be ordering this survey. Plus, I have a reference lab for subgroups.

[Reaction Workup]

We do the whole thing. Being as we use Meditech we have a test built for the transfusion reactions. It includes the retypes, the rescreens, the DATs, etc. Plus it includes the clerical checks and the interp.

[Antibody Screen]

_{We ALWAYS run a screen first, why expend the time and reagents to perform the ID when there is nothing to ID.}

[RhIg Dispensing]

When we went live with BCTA in 2008, all of our hospitals in our division moved the RhIg to the pharmacy. The injection is ordered by the floor, after we perform a fetal screen/KB. So far we have not had any problems..

[Unexplained Anti-C]

Whilst it is immensely flattering to have a question posed directly to me, I should point out that I am only one of many, many people who contribute to this site, and my opinions are no more valid than any other person who may reply to posts.

 

But we sooooooooooooo rely on your infinite wealth of knowledge.

[CPOE Order Entry with Meditech and Transfusion Criteria]

what version of meditech are you using Bankergirl?

[Echo Users- seeing huge tube vs Echo discrepencies?]

Eddible, any chance of getting a copy of your flow chart? it might save me some time since I am working on building one now. Thanks

If at all possible could get a copy of your flow chart also.

[Cold screens and panels in frig- OK to do?]

I would get rid of it immediately.

 

What antibody, apart, perhaps from an anti-P in PCH, that reacts only in the cold, is clinically significant?

 

If you find an auto-anti-I, are you going to give units of Adult ii blood?  No!

 

If you find an auto-anti-H, are you going to give units of O_h blood?  No!

 

If you find an anti-HI, are you going to give units of O_h that are also Adult ii?  No! - partly because they don't exist!!!!

 

So, if you can safely give I+ blood to someone who has a cold auto-anti-I, and H+ blood to someone who has a cold reacting auto-anti-H, why can you not give, for example, M+ blood to someone with a cold reacting allo-anti-M?  The obvious answer is that you can.  It is only when these antibodies have a wide thermal amplitude that they become remotely clinically significant (and that is very rare), and if they do, you will detect them in the warm.

 

The cold technique, in almost all cases, is a complete waste of reagents and time (both of which equate to a complete waste of money).

 

Put the SOP through a shredder!!!!!!!!!!!!!

Amen brother Malcolm. Preach on.

[Microscopy - what on earth is this?]

As a student long ago I was taught that these were squishacytes, but I also immediately thought of Billy Gibbons from ZZ Top.

I was thinking more on the line of Dusty Hill.

[Non-RBC transfusion reaction]

I treat them as I would any other reaction.

[Clinically Significant Anti-M]

When I was using gel and suspected that I might have a M playing around in my plasma, I would actually prewarm the gelcards and actually inoculate them while in the incubator that way, the card was hopefully at a constant 37.

[Acceptable temperature range]

TEMP RANGE FOR ECHO REAGENTS IS 1-30 C. ROOM TEMP IS USUALLY CONSIDERED TO BE AROUND 22-26 c.

[Blood Products - Defaulting to wrong Req (Meditech 5.6.6)]

 

Hi Everyone!

 

 

 

The issue I'm having (Meditech 5.6.6) is with blood products defaulting on the wrong requisition. We have an ABO confirmatory test that reflexes for patients without blood bank history. This test creates a completely new requision. When a physician goes back in to order blood products, the product itself and the crossmatch are being attached to the ABO confirmation test (instead of the original type and screen). In effect, we're having to go back in, cancel the blood product/crossmatch, and add them manually to the original type and screen requision. How can I set up all blood products to default only on the type and screen requisition?

 

 

 

I know that you don't want to hear it, but unless you have your confirmatory test reflex onto the original accession number, you will be unable to fix things. Meditech attaches any new blood bank work onto the most recent active blood bank accession number, i.e. your confirmatory accession number. I have my confirmatory types to reflex onto the original number that way any crossmatches or product orders will attach there.

[Second ABO/Rh sample]

Post 4 months of age, we require a confirmatory sample.

[Platelet Agitator and Platelet Incubator]

DEFINATELY GET HELMER. I have had the same rotator for 10 years with NO problems.

[Separate cells from plasma within 2 hours]

We have recently begun not separating the plasma from the cells. We had a mix up that resulted in the patients from that chunk of time that day being recollected and repeated. Since then, no problems.