David

We also do one a month, locations chosen randomly. Last month the tech doing them happened to go to a unit leased to a long term acute care facility. Issues began when the administering nurse identified the unit as a 'zero positive' and headed south. After I filed a variiance report for another one of the events, the nurse manager called me, very incensed, mainly because we invaded her turf to do an audit without her permission. Apparently the 'unannounced' inspection idea hasn't come to LTAC's yet. Congratulations to you who always have 100% performances.

We've been instructed to issue type O's (Rh depends on patient gender). Our institutional Ebola task force decided opening the tubes to get plasma and cells to test and crossmatch created too much risk for the staff. Other lab testing will continue because both Hem and Chem have automated track lines that do not require human handling or opening tubes.

To those who do not send any paperwork with blood when dispensing to a nursing unit: How do you capture the physician's signature when issuing blood that is serologically incompatible?

Other that TBOSTOCK, no one specified how you treat transplant patients. Is use of CMV safe in place of CMV sero-negative common to everyone for post-transplant patients?

The case referred to took place long before HIPAA had been invented, but you make a good point.

When talking to patients also be sensitive to their situation. Many, many years ago as a young BB'er I found an anti-D in a 30 year old woman which, I thought, was likely a passive anti-D. According to our policy I went to her room to collect a history. She had a couple of visitors but I went ahead and asked about recent pregnancies or situations that might have called for RhIg injection. She denied everything. I returned to the lab ready to document it as an active sensitization. Shortly thereafter her nurse called and said the patient wanted to talk to me. I returned to her room and found her visitors gone. She admitted to a recent pregnancy, it's termination and subsequent dose of RhIG. The visitors present at my earlier visit were her parents and were unaware of the situation, so she had lied. That taught me to be a little more discrete with my interrogations, and reinforced the realization of the value of patient interaction.

You can fix paperwork, you can't fix exsanguination. I repeatedly tell our staff not to let paperwork interfere with patient care. While recognizing the value of correct, complete and timely records, sometimes you just have to shovel the red stuff out the door.

Does anyone have a reference that dictates how many points in a blood storage unit have to be monitored daily? If it's recorded on a chart and monitored continously by a monitoring system, does anything additoinal have to be recorded manually? We're a Transfusion Service but do get FDA visits regularly.

Everything from Pharmacy.

Despite my dislike of people who feel everyone else wants to know their opinion, you're gonna get mine, finally. i have been an advocate of BB banding for most of my med tech career, which started when some of you were in diapers. If you want stories where they prevented a mistransfusion let me know. We band everybody that has BB orders, with a (very) few exceptions. I understand the K.I.S.S. argument and when you find a system that everyone uses as intended every time, we can talk. Until then I'll like some redundancey. The fact that the band is labeled and applied to the patient at the bedside at the time of draw greatly increases my, and my staffs, comfort level that the unit of blood we return to the nurse will be given to the patient bearing the same number. Can the system be 'jobbed' and not provide any benefit? Sure, but since we've not had any transfusion accidents here in my 12 year tenure I think it does something good. We transfuse 20-22,000 units/year so we have able opportunity to screw up. As Mabel points out, though, any system is only as good as the people using it.

Is anyone using a Tango?

We've been on SoftBank for 6 years and find it as good as any. Obviously every system has it's good and bad points. I personally think it's light years ahead of the Cerner it replaced. We do not use the donor module.

Has anyone done recent comparisons of the automated BB testing platforms recently, such as the PRoVue, Echo, or Tango?

'Fundamentals of Nursing' by Perry and Potter

www.plasmathaw.com/aboutus.html Tropitronics, Inc. is the United States distributor for the Microwave Plasma Defroster manufactured by Ark Bio-Medical Canada Corporation. Tropitronics, Inc We didn't buy one, we're just wishing!

Exactly our experience.

Ditto to AMcCord. Our detection rate for passive D's has increased 10 fold since we switched to the Echos.

My microwave quote was about $12,000, only does 2 at a time, and can't do any unit under 140 ml (i.e. no cryo), but dang, they're fast!!!!

Helmer. We got some GEM's in another department, and when the compressor failed it had to be shipped from Germany.

Haven't used them for 20+ years.

Be ready to function at both sites while you move if at all possible. Last time we moved we had just moved one refrigerator and one work station and then got a Level I Trauma. Fortunately we had enough stuff at the new site to handle it there while we moved the rest of the stuff. We also had scheduled it around shift change so we had more staff available.

What country are you in?

Depends on the malfunction. If we had to replace the compressor it's 24 hours for sure. If it was just a fuse, we'd check the alarms and reload.

Our OR wouldn't let us use any with a fabric covering because of cleaning issues. We found some smooth, hard ones from Market Lab with much better closers than the old Igloos we used to use. They have 2 sizes, but I'm not sure they'll hold 10 units.

They can work without previous types just like you issue uncrossmatched units now, you give only O's. Cedars-Sinai in LA has lots of them in use. With the right computer system set up right they are just as safe as people doing all the transactions. The identity of the person removing the blood is recorded, along with date, time, unit number, all those details we so love. If your OR or ER finds out they can have blood to hang in seconds rather than minutes they might encourage you to get some.