Stoogiesfreak
Content Type
Store
Profiles
Forums
Blogs
Events
Frequently Asked Questions
Gallery
Downloads
Glossary
Links Directory
Questions
Jobs
Vendors
Everything posted by Stoogiesfreak
-
Why do we have to administer blood with in 30 minutes?
Stoogiesfreak replied to ElinF's topic in All other topics
I think the AABB manual "suggests" products be started within 30 minutes of issue. It stops short of actually mandating that products be started within 30 minutes. We have monitored this for 2 years and have found that 95%+ of all units issued have been started within 10-15 minutes from issue. We do, however, dispose of any units out of the blood bank and not started within 30 minutes. I think this is one of those "gray" areas in the AABB manual. John -
We went live with our Tango system on May 2, 2011. We use the pink tubes and have not had any sample issues after going live or during validations. I don't have an answer, but we are using Tango with pink tubes and again, have had no sample issues. John
-
We collected a pink and lavender tube with each cord blood. We mixed the samples, checked for clots and sample quality, then removed enough sample from the pink tube for blood bank testing. Sine the samples were well mixed we felt we were taking constituents out of the tube evenly. We then correlated the hgb on both the pink and lavender tube for 100 samples. We had a 95%+ correlation. We do have samples that are rejected, but overall the procedure is working. We have since changed to collecting a pink and sodium heparin as we have several requests for chromosome studies and Quest accepts cord blod for testing. This saves the infants a needless venipuncture. the odd part of this whole story is that this was our QA/QI techs idea! Yes, it does have some flaws, but overall it has shown to be effective. John
-
Fetal Bleed Screening Test collection time limit
Stoogiesfreak replied to tbostock's topic in Transfusion Services
Hi, We collect our samples as soon as possible after the first hour post delivery. We also use Immucor Fetalscreen. We didn't give ou OB department a choice! John -
This is a thing I learned years ago from a Neonatologist. He states that cord hgb of less than 12 is low for an infant and something is amiss. A positive DAT can be the culprit as it may indicate an HDN in progress. I had this bear out once with an infant born with HDN caused by Anti-Kell. The cord hgb was 4.5 and the DAT was 3+. the infant required 3 exchange transfusions, but did survive. Yes, the sample can be an issue. We do reject several due to clots and just poor quality samples, but if we find one with a hgb of <12 there is most often some process going on. I guess it is just on of those things one picks up after 41 years as a tech! Regards, John
-
If I recall both tube have EDTA, but at different strengths. Also, the pink tube is FDA approved for blood bank use and the purple is not, but has been used for years without incident. We have gone as far as correlating Hbg levels with both tubes and they matched almost exactly. We did this because we do hemoglobin levels on all positive cord bloods with direct coombs positive results.
-
Anyone Using Bio-Rad's Blood Bank Reagents?
Stoogiesfreak replied to jhaig's topic in Transfusion Services
Thanks for the information. We just recently had a similar incident with an Anti-C. We had a patient that Immucor was picking up a positive antibody screen and the ID showed an Anti-D. When we were testing with the Tango it also picked up a positive antibody screen, but the ID was both Anti-D, and Anti-C. Immucor did not pick up the Anti-C. Both Immucor, and Biotest antisera were C negative, but we had gone for 5 years not picking up the Anti-C in this patient's serum. We do have one patient with Anti-U, but we refer it to Red Cross Reference for units and workups. We don't have much use for S typing. However, I will certainly keep this information as it may come in handy. Also, the cell that identified the Anti-C reacted at 2+ with the Tango, yet negative with Immucor.?? Thanks for the information. John -
Anyone Using Bio-Rad's Blood Bank Reagents?
Stoogiesfreak replied to jhaig's topic in Transfusion Services
Not only are we using Bio-Rad's blood bank reagents (BioTest), but we are LIVE with their Tango system and it is wonderful. Our parallels and correlation study was better than the Immucor Capture we used to use. Tango picked up two antibodies that Capture had missed. One an Anti-C that has previously gone undetected by Capture. The Tango reacted at 2+. Could not be happier with the Tango. -
Would like to introduce a slightly different topic on transfusion reactions. How does everyone handle blood pressure issues? Systolic and diastolic or only systolic or only diastolic? We have found all kinds of variations on how low or high to initiate a workup. Currently we are using 30mm/Hg drop in systolic to trigger a workup, but would like to change that to diastolic only. ?? Anybody doing anything like this? Thanks, John
-
How long do you hold units after crossmatch?
Stoogiesfreak replied to Stoogiesfreak's topic in Transfusion Services
This is pretty close to our procedure. We have tweeked it a little to have sample and units expire at 72 hours. We tried the 3 days rule, like you mentioned, but found that less than 0.5% of those units were ever used past the 72 hours until release at midnight. So far our 72/72 has worked fine. We also feel a little safer as we are in a resort area and have a lot of residents and "snowbirds" come for treatment and we have no BBK history. It is surprising how many have antibodies and without histories we feel safer with 72 hours vs. 3 days. -
Anyone Using Bio-Rad's Blood Bank Reagents?
Stoogiesfreak replied to jhaig's topic in Transfusion Services
We are in the process of switching to BioTest and have had good success. The pricing is great and we can save a lot of money and our comparison studies were 100% in agreement with Immucor. So far it has been a good move and look forward to the Tango. -
No, we aliquoted into a syringe. After that inspection we went to all O Neg frozen deglycerized PRBC, and then aliquoted into a bag after they were washed. The bag was automatically assigned a 24 hour expiration due to the washing and that seemed to satisfy all the inspectors. It still confuses me to this day, but both AABB and JCAHO were satisfied with that resolution. ??? John
-
You have all made me curious. We did this practice and assigned a 24 hours expiration date/time for RBC's. During a JCAHO inspection we were made to stop doing RBC syringes. Did we have an inspector that wasn't up on the regs or what? We were AABB accredited at the time.
-
Is the transfusion hang tag disposable after tx?
Stoogiesfreak replied to STEPHANIEF's topic in Transfusion Services
I have worked at three hospitals in my 42 year career. Two of the three toss the unit and card after transfusion. The third - the hospital where I trained - had the bags returned to the BBK, but the cards were thrown away by nursing. We do retain a copy of the nursing transfusion form for QA and after 30 days all of those forms are thrown away and the data is stored and can be retrieved through the BBK module in our LIS. -
How long do you hold units after crossmatch?
Stoogiesfreak replied to Stoogiesfreak's topic in Transfusion Services
Thanks Liz, We are currently trying to employ the AABB 3 days rule along with the LIS 72 hours and it is rather confusing. The AABB 3 day rule and the LIS going in hours is making this rather confusing. I like the blanket 72 hours as you suggest. Thanks! John -
We are having discussions about how long units are good once crossmatched. We are using 72 hours for using the sample sample, but once the blood is crossmatched how long can we keep it on the shelf to be issued. We are currently holding units 48 hours past crossmatch if no blood products have been given. Thanks, John
-
We have a patient with Anti-U. We get our blood from Red Cross and they have done a nationwide search and found U negative units when needed. It may take a few days, but they have always come through! Since this can cause HDN we always try to obtain U negative blood for transfusion. The percentages are less than 1% of the population, but we are fortunate to have a couple of U negative donors in our area. good luck, John
-
for issueing platelets -should we type the pt?
Stoogiesfreak replied to lalamb's topic in Transfusion Services
We require a ABO/Rh before platelets are given. We follow the back typing in cases where non-ABO specific platelets are given to assess the need to change to ABO specific units. We have set a volume of non-ABO specific platelets to 300ml and then do a back typing to monitor the patients status and switch to specific ABO types when necessary. Also, all patients under the age of 15 get ABO specific platelets. It has worked very well for us. John -
Thanks Deny, We have gone over this from all angles - I hope! We have decided to continue with A Negative units for transfusion until we can prove otherwise. Thanks again for your input - I feel like we have made the best decision so far, and I am glad I am getting agreement! John
-
Good Morning! I took the patient's cells and did a Du on the sample. The immediate spin is still +/- to 1+, but the IgG phase is 3+. This tells me that he is probably a true weak D (Du) and it was possibly masked by the chemo or the cancer. My thought process is that if this patient had been transfused with D positive cells the weak D (Du) would not have increased in strength. Any thoughts? Thanks, John
-
Malcolm, Good thought - I will check today. I appreciate the help! John
-
The DAT is negative with IgG and Poly. John
-
This patient was scheduled to receive platelets, but they reduced his chemo dosage and his count responded and platelets were not given. Our Anti-D sera is a mixture. I also checked and he has not been at any other facility. There is no record of IgG being given. Sorry, I wish I had more information. Also, the patient's antibody screen is negative and an ID panel was performed just to rule out anything and we did not pick up anything on an ID panel either. ??? Thanks, John
-
Hi Malcolm, This particular patient is in end stage lung cancer. Thanks, John
-
We currently have a patient that we have crossmatched and transfused many times over the past year. This patient has been typed as A Neg by six different blood bank techs and received at least 16 units all A Negative. He is receiving chemo, but the dosage has been lowered. Last week he came in again and this time he is typing as A Positive - very weak +/- to 1+ on immediate spin. This in on four different sample all collected by 4 different phlebotomists. I am lost for an explanation. In the meantime we have decided to leave him as A Neg and give A Neg if necessary. Any ideas? I am starting to lean in the area of something to do with his chemotherapy. Help! Thanks, John