knelson

Does anyone require patients to sign a consent prior to administration of RhIG?

We have two Sartorius ABO-M pipettes. We use the tips from Ortho: MTS9632 bulk tips. Our Otho rep confirmed with Ortho that these were the correct tips. We used these same tips for our old Biohit pipettor.

We get ours from Medline. 800-MEDLINE. Ref# MLABTP5NGRAD

We were told by the Ortho rep that trained our staff that you need to have an air gap between the patient plasma/reagent rbcs and the liquid on top of the gel in the column for the same reason described in Arno's post. Years ago we had a tech that always got weaker reactions with daily QC and we finally figured out that after she pipetted the rbcs and patient plasma into the gel columns, she would tap the card until the plasma/rbcs mixture touched the liquid layer in the column. Her reactions were always 1-2 grades weaker than everyone else. Once she stopped doing that, she got much stronger reactions. We use a Biohit pipettor and hold the pipettor at a slight angle and pipette towards the side of the well. This works well. Should the rbc/plasma mixture touch the liquid layer in the well, we discard that well and repipette using a new well.

How does everyone bill for an LUI freeze eluate performed on cord bloods? Do you just charge CPT 86860 for the eluate? Do you charge for 86860 and the ABID CPT86870 or ABSC CPT 86850? We test the eluate with 3 screening cells and A/B cells. Thank you for your input!

What is considered to be an acceptable level? Are there any benchmarks or studies available for reference?

Does anyone use a infared thermometer to take surface temps of blood units upon receipt, return to the Blood Bank, etc? If so, do you have any recommendations on a particular model? What sensitivity is required? Do we need to correlate the surface temp with the internal temp of the unit? Pros/cons?

We do the saline replacement after the tubes have been incubated at 37C, just prior to washing.

Hi, everyone! It is way overdue, but we are finally preparing to switch from red top serum tubes to pink EDTA tubes for patient samples (for antibody screens, xmatches, etc.). We currently separate the serum from the red cells and put the serum in another labeled tube, which is then rubberbanded to the mother tube. I would like to get away from separating the specimen to eliminate labeling errors, if possible. Labeling errors are not common and are usually something like the tech omitted the time, phleb initials, or BB# on the separated serum tube. However, they are still errors that I would like to not to have to deal with. For those of you that use EDTA patient samples, what is your practice for handling the patient samples? Do you separate the plasma from the red cells? If not, do you respin the tube every time you add on additional testing, such as additional xmatches done two shifts later, etc.? How long do you respin the tubes? Your input is greatly appreciated. Thank you!

We attempted to validate a "prewarm gel" procedure, but did not have much luck. As you say, it is not truly a prewarm method due to the 10 min centrifugation at room temp. It seemed to work for patients with weaker colds, but if the cold ab was strong, the prewarm gel would usually still be positive. We dropped it.

Hello, everyone! I would like to know how other Emergency Depts order blood. Our ER Director wants the Lab to build different order codes so that they can simply click on a test code and it will communicate to the Lab what blood is needed and how emergent (instead of calling the Lab). For example, he wants to have the following as choices: --Type & cross for __ units RCs (non emergent) --Type Specific for __ units RCs (Lab would perform the ABORH and issue type-specific RCs before the ABSC is completed when they can't wait for the ABSC to be done, but have enough time for the ABORH to be done) (even though we will not issue anything but type O units unless we have two ABO types on record) --Emergency issue of __ units O Neg (or O Pos) RCs Currently, the ER just calls us when they need blood urgently or emergency release. They may or may not have already ordered a Type & Screen or Type & Cross for units. We then determine what testing has been completed / is in process and issue units accordingly. I feel that that will still be the quickest and least confusing way to do it. I appreciate any input. Thank you!

We perform antibody screens/ panels primarily in gel , but use tube occasionally. I have my techs run CAP survey samples (antibody screens, panels, auto control, crossmatches) in both gel and tube once per year. Thus, the method correlation actually gets done three times a year because we get three surveys a year, but this also serves as a competency for both methods for each tech. We report the gel results for the CAP survey because that is our primary method. I have been doing this for about 5 years now and CAP inspectors have been OK with it. I have a form that the techs use to record both sets of results. I review the results to make sure they correlate as expected (tube is typically 1-2 grades weaker than gel), that the same antibodies are found, etc. Both I and the Medical Director sign off.

We require vitals pretransfusion, every 15 min during the first hour and hourly afterwards during transfusion, then 15 min post transfusion.

Hi, everyone! We are revamping our transfusion reaction investigation procedure, going from a totally paper report to SoftBank entry/reporting. What do you report to the patient's chart? Do you report everything you have done (clerical check, DATs, hemolysis check, etc.) or just the pathologist's findings/interpretation? I don't think most physicians care about all that is done in the Lab, but only want to know the final interp. Thank you!

CAP Transfusion Medicine Checklist question CAP TRM.32350 states: Records QC "A process in place to verify that copies of records are complete, legible, and contain the original content. Note: This item applies to both electronic and paper records. Laboratories converting data onto another medium for storage and retention must have a process in place to verify the accuracy, legibility, and completeness of the records before original documents are discarded. This checklist item would apply to any situation in which the lab makes a copy of an original." I have spoken with CAP about this item and am still a bit confused as to what they want. We have used SoftBank since 2008. Prior to 2008, we used a manual paper system so we have not converted patient data from one computer system to another. CAP said this does not apply when you print a report from a computer, but applies anytime you make a Xerox copy. I would appreciate any input on how other labs are meeting this requirement. Thank you!