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Posts posted by tkakin
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We do not draw a post transfusion specimen on platelet or plasma transfusions, when a transfusion reaction is initiated. I was wondering if others have a specimen drawn for DAT testing? Or if it is standard practice to do only the clerical check?
Thanks in advanceTeresa
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We use ice/water for quarterly temp checks.
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I do not use either of those computer programs, but we do have a procedure for emergency issue without patient ID that we use when a trauma is called that is likely to use blood...and w do not know who it is. Basically we send 2 uncrossmatched units to the ER, and find out who they went to when the specimen is received.
Once we have patient ID we always emergency issue through the computer and label the units. A paper request slip is received each time products needed.
However with an MTP we require only 1 initial paper request form for product then we auto fill the coolers with product...also all emergency issued with patient ID. MTP's can get pretty confusing, so we use a checklist to keep track of what we have sent out the door.
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On 11/14/2018 at 8:18 AM, SMILLER said:
Will the other facilities be using HCLL? If so, you will be able to cross reference each others data bases even though they use different patient ID nos.
Scott
No they are using Meditech. We are the primary lab for 2 different hospitals.
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We are currently moving from Meditech to HCLL. We are a unique situation, because we are 1 facility, however we do provide services for other facilities. this means our HCLL is set up as one location doing testing....only likes 1 medical record number. Sometimes we provide service for Hospital A and they transfer that patient to Hospital B. 2 different medical record numbers.
Is there anyone else in this type of situation? If yes how do you manage patient histories. I was told we cannot merge them because it would archive one of the MR#'s and it would no longer be usable.
Thanks
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For those of you who still use the Blood Bank armband. Can you give examples of how the Blood Bank banding system has stopped patient identification errors? Thank you in advance for your input
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Congratulations. I appreciate you and all you know. You have helped me enormously to make good decisions in patient care.
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I use log tag and I am very happy with them
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52 minutes ago, DEDE said:
We are also looking at a new cooler system. This does sound promising. Does anyone know what the largest size is? Our MTP cycles require 6 RBC and 6 FFP. We place these in the same cooler. Our trauma team requested we do this rather than using 2 coolers. We use Rubbermaid and Credo. The only issue with Credo is the time for conditioning the cool packs. We are a level one trauma center with 6 helicopters , so time is not on our side. We only allow the coolers to remain out for 4 hours because of the AABB standard (5.1.8.1.3.1) that temp shall be monitored continuously and recorded every 4 hours. If you consider your coolers as transport I guess they would qualify based on your validation. And on that note how do most of you classify your coolers (storage or transport)? Our last inspection we had to tell the inspector how we classified. I know the temp range is also different (1-6 storage and 1-10 for transport).
Would your freshly thawed plasma warm up your red cells, if they are in the same cooler? I am in the process of changing coolers from transport to storage.
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2 hours ago, R1R2 said:
I agree with you and don't they keep the line open with saline or is that old school?
Yes our policy states to leave the line open with saline. Thanks for your input, much appreciated.
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I have a Pathologist who is requesting that all transfusion reaction workup draws be done peripherally instead of through a port/line draw. The concern by the Pathologist is that the product was transfused through the port, so the transfused product could be contaminating the draw. I have done a little research and have not found any info to support one over the other. As long as the port/line draw is done properly there should be no more contamination line draw vs. peripheral draw to influence the work up testing...right? The entire patient is "contaminated" with the transfused product.
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We save segments
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I was wondering how other labs manage crossmatches with patients that have HTLA antibodies.
I understand that if you had pan reactivity in the ID you would not expect there to be much chance of finding crossmatch compatible units and may give least incompatible and have the Dr. sign an increased risk form.
But if you have variable reactivity including negative reactions in the panel and you are able to find crossmatch compatible units (but you have to test many units to find 1) would you try to find them or would you not look and just give Least incompatible and have Dr. sign an increased risk form?
Personally I would test my entire inventory to find one that was compatible but I am not a blood supplier/reference lab.
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On 4/11/2006 at 6:10 AM, John C. Staley said:
At this point in time we perform an eluate if the physician requests it once they are notified that the DAT is positive. I can't remember the last time we did one.
ditto
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I recently had an issue with this. How many bubbles is too many bubbles. I contacted our blood supplier and this is the answer I got.
There is no gauge on bubbles. What they explained was the protein content in platelets can cause all the bubbles. If there is nothing else abnormal about the platelet (discoloration, distended bag, etc.) then it would be acceptable to use it. If this were me and I had any questions about the quality/safety of the blood product I would send it back.
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I wrote a procedure following the FDA reporting website instructions and by creating a report (not saving it at the end) in order to have step by step instructions. I also copied the list of FDA reportable offenses to the back of the procedure.
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How do I know when a lot to lot correlation is needed? Is there a standard that says a lot to lot is required? If yes what is it? I could not find anything in the AABB standards, CFR, or The Joint Commission. I could have missed it or misinterpreted it.
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I am looking to purchase a new plasma thawer. I have the Helmer DH4 water bath. I read your reviews on the microwave and it will not be a good fit for us, because we do not thaw enough plasma to warrant having a water bath and microwave.
I read Aunte D's post that you use the Sahara III and I am intrigued. I looked it up online, but it doesn't give much info such as maintenance, limitations to products like the microwave has. I would be most grateful if you could elaborate on your thoughts on this plasma thawer and some of the problems you have run into with its use. I didn't see that it was FDA approved??
Does anyone use the Cytotherm if yes same questions as above.
I appreciate your help
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I have seen a vast improvement in physicians ordering unnecessary crossmatches by having the crossmatch to transfusion statistics, with a goal c:t ratio, reviewed at the Transfusion committee meeting. The hospital provides an anonymous list of physicians (they know who they are, but no one else knows who they are) so they can compare the data (competition). There are still a few physicians who order unnecessarily. We know who they are, and we set up units with long exp dates.
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I could not get my igloo coolers to maintain temps between 1-6 C. I found these really neat coolers from Camp-Zero. I am going to use the mint green for plasma and the pink ones for red cells. 2 Down falls
1. The latches are meant to keep the bears out! I figured it would probably keep the Dr.s and nurses out too, so I validated them for 24 hours with the lid closed, not latched. They maintain temps beautifully with the lid not latched.
2. Stickers don't stick to the plastic very good, so I am gluing the stickers on.
- John C. Staley and amym1586
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wow! Great explanation thank you
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just realized only cells available to titer e homo are also C pos. So if the patient does have Anti-C at least it will be included in the titer result. Just won't know how they titer individually.
Cold case?
in Transfusion Services
Posted
I frequently see cold auto's with negative gel....The gel is negative because incubated at 37 then spun. We would then detect the cold in the back type and/or immediate spin crossmatches.
Sometimes I do detect colds that carry over into the gel and they are nonsense reactions. I tell all my staff, if you get crazy reactivity in gel try doing a short cold panel.