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Posts posted by Stoogiesfreak
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We do a forward ABO group and Rh type on all Rh negative Mom"s and O Mom's. For positive DAT's we do the LUI freeze technique for eluate for ABO incompatiblity. No other antibody screening is done if the LUI shows an ABO incompatibility. If the eluate is something other than an ABO antibody, then we would proceed with an antibody screen on maternal serum. It has been my experience that the Lui technique is not of much use except for ABO issues.
thanks,
John
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rcollins,
Thanks for the kind words! This should solve your issue. Let me know - always glad to help if I know how. Happy to hear this worked out for you.
Thanks again,
John alias Stoogiesfreak!
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Yes, this should be able to be accomplished. First go the option 94 on the Meditech screen and look for:
18. Cust-Def OE/NUR Params
Enter option 18 and look for this:
LAB OE Pxs MIC OE Pxs BBK OE Pxs
Px Hours Px Hours Px Hours
C 2 BB 72
On page 2 of that dictionary add:
BBK OE Add On Orders
Maximum Crossmatches Per Spec 30
Maximum Hours For Add On 72
Site Device
ML LBPRT16
As long as the order is entered on the correct account number the units of blood ordered will automatically attach to a previous Type and Screen specimen that is still valid. The key is to enter the units on the correct account number.
Good Luck!
John
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We do not charge for reaction workups.
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We do not use a form. We allow 5 days from sample collection with followup from the BBK Super. Any armband removal identification issues and the process starts all over. I also like the idea of a form, but we do document in the LIS the reason for extending the sample time.
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One thing we are working on is patient ID based on barcoding their admission armband. It will be used for all medications including the blood bank products that are given. In our preliminary testing it has worked very well. This will also integrate in the hospitala computer system to document all patient checks during transfusion and alert the nurse to any transfusion reaction criteria, etc. It appears to be capable of helping our entire process. We are very close to implementation. Once implemented, blood bank armbands will be history! One armband will serve all and they will be barcoded so no one will have to write. I will keep you posted!
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One we discover that an armband has been cut off or removed we start the entire type and crossmatch over again. We feel that removing an armband breaks the identification procedures and we prefer not to take any chances. Also, we collect blood bank testing with the MobiLab system which scans two patient identifiers directly from their admission armband at the site of the collection. It has proven to save many hours of duplicate testing.
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Totally agree with that statement!
John
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We are being pressured by our OR department to store bone and tissue in our FFP freezer. The freezer only goes to -30'C and I don't think that is cold enough for storage. I am under the impression that we need a -70'C freezer to store tissue. Can anyone give me some help!
Thanks,
John
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Virginia, Don't get me wrong, I like Biotest's reagents and their pricing. I am also a big fan of their automated system. I just didn't like the way the sales person tried to gain some business by sending a copy of the Immucor/FDA problem by e-mail one day prior to its release by Immucor. I actually have the Tango on budget for the coming year. I do like the system and it has very high marks on those that use it and have rated it. I just didn't like the approach used in sending the e-mail.
John
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John, It is mentioned in the AABB Manual, but it is vague like many thing in the AABB manual!
They do not come right out and say that 30 minutes is the time limit, but they mention something like "most facilities use 30 minutes" or something like that. You are correct in stating that it is not one of their standards - just one of those things they mention in passing.
John
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We have set a 30 minute time frame starting at the time of issue. If a unit is returned within the 30 minute time span we do not take temperatures. Over 30 minutes the unit is destroyed. We are working of a temperature policy for OR, ER and other critical areas.
John
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We accept that type of order, but it is up to the nursing unit to place the orders. Blood Bank does not place the orders, but may inform the unit of the patient's current inventory. Also, how do you handle this when you have a low inventory of blood supply?
John
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rammis2 - I like that procedure. It adds one more level of security. When I was a student - many years ago - I witnessed a reaction due to an ABO discrepancy caused by a lack of checks of MR#, DOB and other factors. The patient died. I never want to witness or go through that again. Even though I was a student and witnessed the events it has left a lasting impression of just how important our labeling and issuing blood bank procedures can be. Thanks - you have given me some food for thought!
John
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I did forget to mention that we also use the Hollister armband system in addition to the name and MR#. We totally take the DOB out of the process. We have had no issues with CAP over our last 4 inspections using this process. We have our Crossmatch/Transfuse cards and Issue card all are also printed without the DOB.
John
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I was interested in trying Biotest products until they started sending e-mails about Immucor's issue with the FDA as a tactic to bring in new business. I didn't like that and have decided not to try their products based on the tactic used of sending the Immucor/FDA issue as a marketing tool.
There has been no official recall by Immucor and the issues are apparently being properly addressed. Shame of you Biotets!
John
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I have not heard of any push to use DOB for a blood bank identifier. Over my 35 years I have seen patients with the exact same name and same birthday. So, the DOB is not foolproof. We also use the MobiLab system for all blood collections. MobiLab combined with our Meditech system forces the phlebotomist to barcode the armband and a second identifier of your choice at the time of collection. We do not use DOB and have no plans to do so. We do not use billing numbers either as they change for each hospital visit. We keep our identifiers as MR# and name as these are the constants that do not change.
Good luck!
John
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Thank you Malcolm. Once again I learned something! I was not aware that hyperhemolysis could take place without a Warm Auto being present. Thanks for this valuable piece of information.
John
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Brenda,
Thank you for the added information. We recently ran into a similar situation with hyperhemolysis. The patient started with a 5.4 Hgb and ended up with a Hgb in the 4.5 area after two units. This continues to make me think that a Warm Auto is one of the most dangerous of the antibodies! Again, thanks for the added information. Our patient also had a Warn Auto-e which is not that uncommon when working with auto antibodies. They are great copy cats when they want to be.
John
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Thanks Malcolm. I think you just gave me what the answer I had overlooked! Our reference lab is using LISS/IgG and/or PEGG/IgG tube methodology. That would explain the difference. Anway, we did change from Gel to Capture and it is working nicely for us. We do have a faily large population of Sickle Cell patients and the antibody screens and ID's have been reliable by this method. We only have one patient that is a real "problem child" and she has a Warm, Kell, Fya and U. Also, I am trying Immucors W.A.R.M raagent working with Warn Auto's and so far it has been helpful. You just never know what might be lurking underneath that Warm Auto! Thanks for your information, you certainly answered my question and I look forward to more of your knowledge sharing. I am new to this site, but already have learned things and that is good!
Thanks again,
John
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Hi Malcolm,
Your volume surpasses ours by a mile! I can see where Gel would be beneficial to you. Since you obviously have more experience with Gel why did we run into so many positive reactions in Gel and nothing could be found in a panel by our lab or by our local ARC reference lab? We ended up going with Immucor and the Capture methodology and have not had the problem since. Would appreciate your thoughts. We also in our comparison studies fould two samples with antibodies that Gel did not pick up, but the Capture did??
Thanks,
John
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Malcolm, I totally agree with you about Gel and Warm Auto's. In fact we gave up Gel totally in our BB due to many false positive reactions and two cases of antibodies not detect by Gel that the Capture system was able to detect. We do our crossmatching for patient's with Warm Auto with LISS/AHG and have had no issues. As a side note I think the Warm Auto is probably the "scariest" antibody to work with. As far as Gel goes I have sent many a workup to our ARC Reference Lab only to find out that there was nothing present in the serum. Bye, bye Gel! John
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In our area, the majority of hospitals are charging for FFP and Thawing. Apparantly, the thought is now that FFP should have the thawing charge built in to the FFP charge. We have started to get rejections for thawing charges. So, we have removed the thawing charge and adjusted the FFP product charge to make up the difference. I have not seen anything formal from Medicare, but now the area hospitals are dropping the thawing charge and adjusting the FFP product charge.
According to the ARC billing people this is the correct interpretation of the rule. FFP thawing is assumed to take place since the product FFP is frozen. Good luck - I think the water is still a little murky on this one, but that seems to be the latest thoughts from ARC billing experts.
John
Cord blood testing
in Transfusion Services
Posted
We have another facility in the area and we trade samples every 6 months and use that as our proficiency samples. CAP has always approved this as a way of proficiency since I don't think it is offered in their kits. If it were not for the fact that another local facility does the LUI, then we would have to re-evaluated doing the test.
Thanks,
John