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tkakin

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Everything posted by tkakin

  1. tkakin
    We use a tagging gun. I don't think it takes any more time to use then sticking a label on the product.
  2. tkakin
    I am looking to bring DTT treatment to our small lab. This forum has been very helpful, but I have a few more questions. It looks like Judds Methods in Immunohematology is using 0.2M DTT and the Technical Manual is using 0.1M DTT. Is anyone noticing a difference in testing with 0.1M vs 0.2M? I researched some of the reagents. It appears the powder form is considerably cheaper. I was wondering what you use for a solvent? Once you put it into a liquid form can you freeze it up to 5 times for up to a year or is that just with the pre-liquid reagent? (when does it expire)? How long does it take to work up a patient... I have heard 2 hours for negative screen after DTT treatment? Thank you for your help
  3. tkakin
    I validate my coolers with 1 unit (needs cold pack to validate for 24 hours) and 6 units at room temp and in a refrigerator (OR is very cold). Transport coolers go through the same thing, but I also validate them for extreme temps (1 and 6 units) usually only good for 1-3 hour. I generate a very cold environment by putting the cooler in the freezer. The very hot environment I put the cooler in my car on a hot summer day. This is done every 6 months.
  4. tkakin
    Yes I do believe you still should have a contract even if it is within the same organization.
  5. tkakin
    We provide blood products for smaller hospitals as well. I recently had an AABB inspector go through our records and the one question that kept coming up was "Do you have a contract?" If your facility is providing the testing/blood then your Medical Director is ultimately responsible, even if there is no contract. I think this can become a muddy process in that the labs follow the "rules", but they have different procedures.
  6. tkakin
    In my experience if the patient has anti-K, I will see reactivity in all hetero cells tested. If you experience variable reactivity (some hetero reacting and some not) then I would say you have support for testing multiple cells. How many of you that test multiple hetero K cells to rule out anti-K have found anti-K with variable reactivity?
  7. tkakin
    I do a live audit, and would say most of the time all is well. 2 times I have observed staff that had literally no idea what they were doing, it was frightening. My form does not include the competency of the staff only if the checks were made, and with help the checks were made. We do 2 observations per floor per year. It is very difficult to observe at remote sights, I am going to have to look to out source the observations at those sights.
  8. tkakin
    Hi Jalomahe, We are considering changing. I was asked to inquire as to why you were dissatisfied with the Greiner tubes? Are you still using them? Are you having any trouble? Thanks Teresa
  9. tkakin
    We report the interpretation only.
  10. tkakin
    We use Holister banding system with the same idea as you. We have our phelbotomists remove the bands at midnight on the day they expire,
  11. tkakin
    Hi Mabel, You bring up some really good points. They are repeating the crossmatch but I heard from a coworker that had a phone conversation that they do not do the ABO portion of the xm only the gel. yikes. I have had to use a disclaimer on pretty much every test they have asked us to do because of specimen issues. If they want us to crossmatch we do the full workup.
  12. tkakin
    Thanks R1R2, I did and they asked me to reach out and see if others have had similar challenges. Maybe someone has already found a good way to resolve this issue. From what I have read this is the best place to go I suppose I am really looking for a way to present this "challange" to the Pathologists' with a solution. I realize in the end it is their call on what, when and who we do it for. If there is no contract do you not provide the service? Do you provide part of the service such as ABID and antigen typing only? Do you provide the full workup with crossmatching and products? Mollyredone do you have a contract with the VA? David Saikin do you do full workups for them? Thanks
  13. tkakin
    Thanks
  14. tkakin
    Thanks for your replys. Sadly no there is no contract and as far as I can see they have no intention of signing any contracts. They refuse to share procedures. From experience of receiving specimens from them we have very different policies/procedures which is causing me migranes. They also use ARC and we do not. So is it best to write them a procedure for sending us specimens for work up and outlining what testing we will or will not perform? I am nervous to do any crossmatching for them because of the lack of contracts/procedures/trust. Would we still be responsible for the transfusion if we did the ABID and antigen typing of units/ patient?
  15. tkakin
    Do any of you use specimens that have been run on a hematology analyzer before testing abs/abid's? Thanks Teresa
  16. tkakin
    I am working on creating a policy to create some guidelines for doing testing associated with transfusion to hospitals that are not a regular customer. They are remote and use us only when they have to transfuse stat and patient has an antibody. I am asking for you to share some policies on how you would manage a hospital that needs your help I would appreciate any ideas, guidance, and policies you could share. Thanks Teresa
  17. tkakin
    Ohhh my, This keeps getting more complicated. 1. Where do I find this information on the FDA requirement? 2. Does FDA trump AABB? I appreciate all your help, I do want to do this according to the rules.
  18. tkakin
    Hi BankerGirl, I am with the understanding that it is acceptable to do EXM with a clinically signinficant antibody . I was informed that at an ask the standards committee they decided to..... Changed title of 5.16.2 from “Computer Crossmatch” to “Use of Computer to Detect ABO Incompatibility”, to allow the use of a computer to detect ABO incompatibility in lieu of serologic testing when requirements are met. Effectively allows a computer method for ABO, which could be used in addition to an AHG serologic crossmatch for patients with antibodies. If this is incorrect please please please correct me. I want to be clear I am not saying techs are not completing the work up. They are just not generating the report the ABID in the computer. They are updating HX!
  19. tkakin
    Hi Dan, Yes I do mead ABID- antibody identification Yes the the ABID would be reflexed due to a positive antibody screen
  20. tkakin
    I am starting electronic xm's as well with MT 5.66. I am in the very beginning stages where I haven't run into your problems yet, but am glad you wrote about them, so I can resource it when it comes up. My issue is that I have a DTS LAB 10471 that says "An electronic crossmatch does not take place if there is a pending antibody test (ABID type test) a current specimen or on another specimen for the patient's medical record. Electronic Crossmatch is not available: A pending Antibody test has been found on specimen: <specimen Number>. " We have a staff that does not always report the ABID's. Do you have a work around for this, or do I need to push staff to do the report? I just don't see how not reporting the ABID should hold up the electronic xm??? YES I do AHG xm with it! Thanks
  21. tkakin
    galvania sorry I am not commenting on the ABO aspect of your post. I just wanted to share that we have recently implemented a blender in the micro dept for prep of transplant specimens. Poor girl doing this task will never look at a blender the same way. If I am not mistaken I heard they are comming out with a pill for establishing normal flora. For the miro aid the sooner the better.
  22. tkakin
    all from pharmacy
  23. tkakin
    Our supplier used to do it for us. We ran into some trouble with TJC, but it was accepted when we received a letter from AABB saying that it only matters that it was done. The next TJC they said no the transfusion service must do it. And oddly at the very same time our supplier stopped providing the service. Hmmmmm. I do think it is a very valuable service for the blood supplier to provide.
  24. tkakin
    I was told I cannot go automated but I have been looking anyway. I like the tango, but the rep was supposed to send me some reagents and hasn't been able to get them to send them out when she requests, a nd she said they keep changing the web site around making it diffiult to find info. do you find getting reagents and using the web site to be a problem?
  25. tkakin
    I was wondering what you guys are doing in regards to drawing specimens for patient who will be receiving or potentially receiving blood products (Type /Screen/ crossmatch) . 1. Do you allow IV/Port draws...flushed of coarse? Thanks Teresa
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