We do not use the armbands nor require a current type or screen for plasma/platelet transfusions. We can transfuse from a historic type and in an emergency we can issue type A plasma. We also never transfuse plasma with an antibody.

Any other places using electronic signatures for transfusion medicine documents?

The Galileo is a work horse, but you may want to check out their next generation instrument, Neo. We have three instruments. Two are out in the hospital labs and one in the donor center. We did find a problem during our initial with the instrument not being able to pick up weak antibodies. Visually a technologist could see a sample that was suppose to be positive, but the instrument called it negative. We now visually look at everything to determine if an antibody screen is pos or neg, then follow up any pos with a repeat screen (manually performed) or antibody ID. There were two abstracts written for AABB (2008 and 2010) if interested.

We also use FFP/FP24 interchangeably. We do not extend (to 5 days) the outdate on apheresis plasma as our system to collect is considered open. Our computer system is set to control this so that we cannot inadvertently thaw an apheresis unit with an extended outdate.

Our policy is similar...Blood Bank tech initiates the process, actually our computer system asks a default question with every blood type "Previous type found?". If no, then a Re-type is automatically ordered with a new accession #. We then check to see if we can use a different specimen on hand which was drawn at a different time by a different phlebotomist (usually a CBC specimen, which we keep for 3 days). If none is found a phlebotomist is dispatched to draw ASAP - if it must be a nurse draw then a phlebotomist may witness. For us, this includes the ER as they are especially culpable for mislabeling errors! If time does not permit, we use type O until a 2nd specimen is drawn. Patients with PAT testing have the Re-Type test deleted, as most have a 2nd sample drawn upon admission. Our computer also alerts us if a second type has not been performed when we get to the crossmatch step.

What computer system are you using that does the auto ordering?

I am curious to all that are doing this second sample process, how do you handle this with the computer system if you are using Safetrace TX?

Thanks.

Does anyone use Safe Trace Tx and requrie the second sample? Curious as to how this may work with TX. Thanks.

We use O, irradiated, fresh (<14 day old), hemoglobin S negative products for our neonates. All of our red cell inventory is leukoreduced.

CAP does require panels to be QC'd. Selected expired cells are qc'd again if we have to use them. If anyone would like CAP's response to my email about QC on panels I can send them a copy.

Dawn

Hello,

I would like to see that email too. thanks. coyle.terri@mayo.edu

Hello,

Curious to know if anyone is finding troubles with lot X309. We are seeing an increase in galileo graded false positive results.

Thanks!

We don't wait for issue to actually crossmatch but we are light years ahead now in that we don't "hold" blood any more. We only set up what is going to be transfused unless there is a specific need to have units ahead (MBT, OR Cardiac etc.). I love the EXM.

Does anyone have recipes for manufacturing samples for a new kit validation for the FMB screening test?

For our testing on the Galileo, we also have previous patient history; either a historic type or if the patient is new, a type check before the sample is placed on the Galileo. If someone turns up Rh negative on the Galileo, the sample is repeated on the bench with the Weak D in mind. We have seen this frequently enough, that we now have a code that we add to our LIS that alerts our techs that the patient is a historic weak D and the ABO testing is then done manually. The Immucor D4 reagent is suppose to pick up weak D's better, but we know from our experience that it misses weak D's.

The plasma thawer we have does not have a tray in the bottom. The FFP sits in a bag holder that is on the wall of the device. While the product is thawing, it does agitate (clockwise and counter-clockwise), to eliminate the chance of a hot spot.

Thawing plasma in the microwave takes 5-7 minutes for two units. A far cry from the twenty of the water bath.

Hello,

We do have a microwave in place for thawing FFP. I did a pretty extensive validation that included thawing units of a certain volume. If you would like more information, please send me an email and I would be happy to give you more details. Terri

We do not perform our confirmation testing in Gel, but in the tube with PEG. When we brought the Galileo’s in, we were performing our antibody screens with Gel, and antibody ID with PEG. All data is associated with antibody ID being performed in PEG. Terri

All,

We have been using the Galileo (we have two) for over two years. We have seen many times where it calls screens negative, when visually they appear slightly positive when viewed on an Immucor Light Box. There is an abstract that I submitted to AABB last year that reviews our findings. We continue to collect this data today. One of the main players is anti-E as well as anti-K.

If anyone would like more information, please let me know. Terri

AABB abst from site.doc

Thanks for everyone's input...My question is, how are you doing your actual validation? We load a temp tale into the cooler (we have off the shelf from Target Rubbermaid) and run this for 8 hours with the equivalent of one unit with the coolets. If we stay within 1-10 degrees, we are good. If it fails, we repeat x 2. If any of those two repeats fail, then we throw the cooler away. We, at this time do not take into account units that may have been manipulated and are now above storage temp. Is anyone taking into account those "warmer" units...?

Would anyone care to share how they perform their validation on coolers? We recently had an inspection and they were a bit critical on our validation stating that how can we prove that red cells coming out of our refrigerator are 6 degrees or less. There are times that we irradiate or divide units so the potential for us to manipulate a unit, then toss it in a cooler (while not at storage temp) is there. Does anyone check temps prior to placing in a cooler? Or how do you perform your validation to capture this senario.