jcdayaz

Malcolm, That's why the rest of us Blood Bank nerds carry laptops with us when we travel! Even in the midst of vacation, there are normally some moments to SNEAK onto BBT! Wait for the wife to doze off and you're home free! :) But you're right, divorce can get expensive and ugly...VERY ugly. Have a great trip!

I REALLY need to learn to read all the responses before making a post myself!

We will not infrequently say, "I am working on a problem patient. I need to concentrate." None of us are ever offended--as we have all been there. We also know those of us who talk problems out to ourselves outloud as we are working through them. It is not an uncommon occurrance to hear a coworker say "Let me know when/if you are talking to me and when/if I should respond." We all just know that sometimes it helps to hear our thoughts/logic/plan/whatever out loud. I would suggest NOT using the "QUIET IN THE BLOOD BANK" sign idea. It seems really offensive. I have always been an advocate of open and honest communication--it works the best. I would suggest putting the "blame" on yourself the first time or two and admitting that you are not able to concentrate with all the chatter when you have a problem patient to work on. I think people will get the message. We just hold a hand up and say "Not right now" if someone tries to chit-chat while we are deep in thought. No one is ever offended. We know the deal. Obviously, you couldn't just start doing these things out of the blue without offending most people. I think, however, after a meeting or something of the sort explaining it all to everyone you should be just fine.

We are currently looking into doing PEG adsorptions. Do you have a procedure for that you can share? Thanks in advance.

You crack me up Malcolm. Did you get my private message about the HrB or hrB antibody patient we thought we recently had? Thank goodness it turned out not to be, but I would still love to have the information.

OOPPSS! I guess I should have scrolled down a bit more in this post before making my reply.

I believe David was referring to performing a PeG autoabsorption. That is different than a regular antibody screen/crossmatch. We are currently investigating this procedure to replace our current W.A.R.M absorption procedure. You are correct in your statement that PeG generally enhances reactions more than LISS in a regular screen/antibody panel situation--but not more so than gel. Gel is the most sensitive technique I've seen.

How true your comment is. We had a surgeon actually write a letter to the CEO of our hospital complaining when one day he had to delay surgery because he waited until 30-45 mins pre-op to have a type/crossmatch done. Guess what? The patient had an antibody! In the letter, the surgeon said something about the Blood Bank not opening until 8:30am.!? Thank goodness we had appropriate documentation of all the notification phone calls we had made and the times the calls were placed. The kicker of this story is the CEO tried to come down on us hard about it. Our BB Pathologist backed us 100% and the CEO backed off. We now make jokes among ourselves that the Blood Bank is closed for breakfast from 6-8:30am and closes again for lunch from 10am until 2pm. Ha! How ridiculous!

Happens all the time here also John. Once we tell a DR we can provide him with O Negs, he will just have to sign an emergency release form, the "emergency" typically becomes not quite so life-threatening.:confused:

"Out of the mouths of babes"... I love that saying. They say it like it is!

I am going to use the timer idea one day! Fellow coworkers--BEWARE!!!! That is a great one!!!!!:D:D:D:D

I won't deny having been tempted to "jump ship" to a physician's office lab before. I have two young boys and the hours and no weekends/holidays sound appealing. However, I am not willing to work in a lab that is unsafe/not following and/or exceeding protocol, etc etc. It's just not worth it. I'll take my weekends/holidays over a physician's office any day!!!!

Good thing. I wouldn't have taken my dog back to that pediatrician.

When I worked at my reference lab, we made our own red cell stroma to do adsorptions (absorptions--I always get the grammar wrong). We would do two different ad/absorptions and based on what the stroma was positive/negative for we could rule out/in whatever (pretty much) we needed to. It worked really well. I wish I still had the "recipe" for making the stroma. Is there perhaps anyone out there who has such a "recipe"? How do other people do ab/adsorptions? We have tried the WARM (Ortho, Immucor, don't remember just now) Auto Absorption method and I find it lacking...in several areas.

This is another great story! We once played a practical joke on a fellow co-worker who, if I were honest, none of us liked. We got Security involved...planned it all out, etc. We placed in his personal drawer a small zip-loc bag with powdered sugar in it. None of us knew what actual cocaine might look like and that's the best we could come up with. Anyway, we called our security friend after we put the powdered sugar in his drawer and the officer came and did a "random inspection". Well, guess what? He pretended that he had found cocaine in the drawer. The Tech went Ballistic!!! Although a very mean prank..a lesson he apparently took to heart! He was much more tolerable after that.

hahahaha! I just arrived home last night from a 10 day vacation (Malcolm might call it a "Holiday"). I had to be carried a couple times to a bed! Oh well, work hard, PLAY HARD!!!! That motto has gotten me through life. :D:D Back to work tomorrow. ICK!!!:mad:

And not one of you ever sampled said "Very high Christmas Spirit"!! Do you think any of us are buying your story John?? :D:D:D:D:D:D:D:D:D

Yes, in most cases the spleen is the organ sequestering the platelets. In my experience in this area, which is admittedly minimal, that is why they sometimes remove the spleen in platelet disorder situations.

We still work hard and PLAY hard. It is not an infrequent experience for one of us to shoot a rubberband at another and/or throw a rubber stopper out of some sort of control vial at another person. No biologically hazardous projectiles are used obiviously, and it really makes for a less stressful environment. Is it correct practice? Of course not...but sometimes you improvise for sanity's sake..

This is a GREAT STORY!! Thanks for sharing it. This scenerio should be a lesson to us ALL in the healthcare field. Unfortunately, we all too often stereotype patients based on what we perceive their strengths/weaknesses will be. BIG APPLAUSE is deserved to that DR who left the room and started over. What a GREAT life-lesson this is for us all also. Recognize when you mess-up---the DR in this case, and make it right--- like it sounds like he/she did. Another big applause for that DR!!!!

Oh my, John. Sounds like a fun scenerio to me. Almost like the time I was performing phlebotomy on a very "practiced" drug abuser who essentially had no veins left. I tried twice, missed both times of course, and then she grabbed the syringe with needle and drew her own blood from behind one of her knees!! It took me several minutes to realize what had just happened..that's how stunned I was by it. I guess the "good" drug abusers know where they still have a usable vein. :eek::eek: How scary is that?????

I had a new one the other day. Irriatable blood--it was pronounced EERIA TABLE blood. Sometimes not laughing right in the ear of the nurse calling is quite challenging!! I'm glad I wasn't having dinner at that EEERIA TABLE!!!

[b I was going to ask you what a BLOOS film is.!!!!!:D:D:D;) I've posted a couple of misspellings myself Malcolm. It is always horrifying to me to go back to one my posts and find a misspelling. I guess it proves that we are all human. Although, I will admit it is refreshing to see that even you are!!:D:D:D:D:D:D

And as far as the MD wanting FFP for volume replacement; that is also an MD call. I am not meaning to be critical but I would just caution you about questioning a physicians orders "too" much. Yes, there are absolutely times that they order inappropriately and it should be questioned (like the new MD at my hospital who ordered 10 platelet apheresis 1 night; but he had come from a place that had used the whole blood donor individual platelets; but the RN said that is what the doctor ordered so that is what she wanted; so my staff called me at home and I had to intervene), but you can get yourself in hot water if you end up inappropriately questioning their Orders. Anyway, just something to think about... Brenda