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BB1956

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  • Country

    United States

About BB1956

  • Birthday 10/04/1956

Profile Information

  • Gender
    Female
  • Interests
    Learning to play Mountain Dulcimer, knitting, crocheting, reading, travel
  • Biography
    Over 30 years laboratory experience most in Blood Banking however I have worked in Hematology and Microbiology as well. Have worked in Germany, S Carolina and Virginia.
  • Location
    Augusta Medical Center
  • Occupation
    Blood Bank Supervisor

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  1. The microwave's have improved since 25 years ago. They now have safe guards that automatically shut down if the temperature in the bag increases too much to avoid the cooking aspect. The temperature is monitored constantly throughout the thawing process to ensure it never gets to high.
  2. We got caught up in the FDA issue over two years ago. We had a microwave on order for over a year. We finally got one from the distributor in Florida but it was a demo model. I think that is the only distributor in the US and the manufacturer in Canada has submitted the paperwork to the FDA but it has not yet been approved. Since our demo model was manufactured prior to the changes it was acceptable for use and FDA approved. Good luck. We actually contacted the manufacturer in Canada and were in discussions with them. Perhaps they have more information on the FDA hold up. We do like our microwave plasma thawer and it has been a cost saver. We were thawing plasma and discarding it just so it would be available for the ED.
  3. We very rarely transfuse neonates and when we do it is emergent. We give the entire unit of O neg for babies and they transfuse what is needed . We also do not label products and do not have an ISBT printer.
  4. We have had similar issues with nursing coming to get the product for transfusion but not checking the physician order to transfuse. We now have it on the check list which they have to approve in the computer prior to transfusion. This change did make a difference however we still had one nurse check the box and they did not confirm the order. There was a great deal of discussion about why the blood bank released the unit when there was no order to transfuse, however I explained we often do not have access to physician orders. I suggested a solution was for nursing to bring the printed order down each time a unit was released. This would ensure they checked and had the order and we could then easily verify it. Needless to say nursing did not go for that solution.
  5. We are a community hospital and frequently transfer patients to a larger facility. We also have had issues with dialysis patient's needing a blood transfusion during dialysis where there sample has been collected at another facility. We do not crossmatch or transfuse blood from a sample that has not been collected within our hospital system governed by our patient identification and labeling policies. The larger hospital where our patients are transferred does not crossmatch or transfuse based on any tube we have collected at our facility. There is far too much risk in patient safety in my opinion when you loose control over collection and identification of the patient.
  6. Sorry I am just checking in but your question about do we enter orders through OE or LAB. We enter the orders through LAB and IT set it up so the physician would be prompted to sign the order if we enter VERBAL instead of Written
  7. For years we have been using our QC antisera and rotating one cell from the panel each day and testing it with our routine daily tube QC. It was not so overly burdensome( one additional cell) and even though we are testing only one cell each day we make it through the entire panel at least once during the month. This way we are testing the "panel" if not every cell each day of use and we have some quality control. Everyone is correct there is no way to check every antigen so we felt this was a good compromise.
  8. We are able in the blood bank to receive verbal orders and to place them into our LIS system which is Meditech. We realized this could cause issues so there is a field in Meditech when you place an order that defines whether the order is written or verbal. Up until this time it was set to default as Written. We requested a change from our IT department and now we have the option of selecting Verbal with the default setting of Written. When we select Verbal the ordering physician is electronically prompted to sign orders. It worked much the same way verbal physician orders to the nursing units worked at our institution. It seems to be working well.
  9. I appreciate your responses. Does anyone have any references supporting the protocol to use the same line for administration providing procedure and guidance?
  10. I am looking for the answer to this question posed by one of our physicians. Can FFP and RBC's be administered through the same line at the same time in a trauma situation? This has never been the practice where I have worked however when I checked for standards that might apply I could only find AABB 5.28.9 Addition of Drugs and Solutions which really did not seem to answer the question. Looking for any input with regard to this question and making the assumption the FFP and the RBC's would have to be compatible.
  11. I ordered a microwave from Ark Bio-Medical in 2016 and waited a year to receive one. It is true they have had a manufacturer of some of their parts go out of business and it has taken time to find another. They have found a new manufacturer and are in production, however now all the paperwork must be re-approved by the FDA and that is where the problem lies. They have complied with all FDA requests but are awaiting approval. In the mean time the distributor just installed one he had in stock for us and we love it! It works very well. We were instructed to make sure the sensor in the microwave was not placed on the side of the unit with a bubble. We are a small hospital and it has saved us over $3000 dollars a quarter in wasted plasma. Now we thaw on demand and it takes about 8-10 minutes to get a fairly large size unit ready. We still have the Helmer water bath plasma thawer for cryo and units that do not fit the carrier but the microwave is great in a trauma. We are also taking the temp of every unit we thaw upon completion at least for a while. I am an old blood banker and I was very skeptical at first but so far we love it!!
  12. Could you have the community hospital inoculate the Blood culture bottles used by your main Microbiology laboratory and transport those instead of the bags themselves. When we wish to culture a blood bag we inoculate the blood culture bottle here at our facility as well and set it up on the Bacti Alert.
  13. We reported the patient as a weak D positive patient. Due to cost cutting we no longer have a different Anti D sera on site. We use the same reagents on the ECHO and for Tube typing. That is why I was concerned when we were able to pick up the D in tube testing using the same lot number of Anti-D typing sera and we did not even see a ? on the original ECHO run. We are a community hospital and most of the time there are no problems. Cost vs Benefit indicates the few patients that have typing problems are more cost effective to send out for resolution. Gone are the days we can do our own work ups I'm afraid. In this case it was safe to call the patient Rh negative for transfusion purposes. Since she is prenatal the physician can order molecular studies to get a more accurate picture. Thanks for all of your help. Some great ideas!
  14. Does anyone use a FDA approved Microwave plasma thawer? I have read about them and inspected a hospital that had purchased one in the past year. They seemed to be pleased with it. It would be great for trauma situations allowing us to provide plasma very quickly.
  15. I have the initial EHCO printout which does not look grainy for the individual reactions but I will go back and check the reaction strength on the instrument for both runs to see how that compares. You could be absolutely correct. There has to be a break point somewhere and it could be that these samples just might have fallen into those areas. I do have techs review the reactions before reporting and I don't see anything on the printout that would have caused much alarm. Unfortunately it is difficult to explain all of this to a physician or mid-wife to get them to understand why you "mistyped" their patient. It is good to keep in mind the probe sampling position in discrepancies with transfused patients. Should this occur again, it will be one of my considerations. In this case my patient had not been transfused. We learn much from each other and I do appreciate this forum.
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