sgrassley

I would pull the unit from inventory and contact the supplier. They should have the resources to investigate the problem with the donor.

We use the 6ml Pink EDTA tubes. We require the specimen be up to the bottom of the manufacturer's label. (~2 ml) That way we won't run out of plasma if the patient needs a lot of units crossmatched. (No electronic crossmatch yet!) If the patient happens to have an antibody we may need to have the patient redrawn, but it usually work out. Back in the day, the tubes contained liquid EDTA and we required 1 ml to avoid over-dilution of the specimen for Hematology testing.

If the total inventory is only 6 units at a rural hospital, I would stock 4 O Pos and 2 O Neg. I'm not suggesting every hospital should stock only 'O'!

I would probably switch my inventory to stock only 'O'.

We are around 100 beds...We have 1 blood bank tech on days and afternoons, and 2 techs for the lab on midnights. The plan is to notify the shift lead of the Massive Transfusion who will assign a 2nd tech for blood bank to assist. For midnights & weekends, we have a list of the blood bank tech phone numbers to call. We have 2-3 MTP events a year.

Back in the day when we had a whole blood inventory, we would just express the plasma from the red cells after they had settled out in the refrigerator without centrifuging. The theory was there was enough plasma left with the red cells and hematocrit wasn't too high.

We've seen this problem in the past. It can easily happen if the tech uses the 'patient' bottle instead of the 'crossmatch' bottle. There is no barcoding to help 'catch' this as there would be if it was an actual crossmatch of the unit of blood in the computer.

When I addressed this with our facitlity, I pointed out the reaction happened because of the transfusion that was ordered. Our policy is the doctor and the blood bank are to be notified. (Yes, sometimes they forget step 2.) A specimen is collected. We review the records & perform the workup. It is up to the doctor if transfusion is continued after the workup is finished, but they cannot 'cancel' the workup.

Mabel, Did you have a resolution to this problem? I'm seeing the same problem with lot # 030615001-55.

We are looking at a Communication Order form that would accept the Unit information. We could barcode information from the unit in Blood Bank when we issue it directly into the form. Then this information would be available at the bedside when the transfusion was starting. I wondered if any one was already doing something like this.

We have Allscripts. We have flowsheet that we built. It is very cumbersome. Our Blood Bank system is Cerner Classic and doesn't link with the hospital system. Maybe when we upgrade. (It's on the wish list!)

We are currently using the EMR for all of the bedside documentation. Right now the nurse has to type in all of the information, including the entire ISBT unit #. (They are better at this than you would expect. ) We are looking at improving the process and exploring all options.

We are looking at entering (barcoding) the specific information about the unit (Unit #, Blood Type & Expiration of the unit) when we issue it directly into a Communication order in the EMR. This would pre-populate the record and be available when the 2 nurses do the bedside check. Is anyone doing something similar to this currently?

We have Cerner Classic. I created a Product specifically for the Cap Unit: CAP-U. I turned off all compatibility checks for the product - since sometimes the Unit is not ABO Compatible. And I can easily exclude this unit in the monthly reporting.