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Posts posted by PAWHITTECAR
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Wow, So basically it might contain anything....
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The dabates are what got me interested in this site in the first place. The wonderful information that I find is what has made me stay.
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Phil this just proves that great minds (or just real curious ones) all think alike.
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I think testing a vial of the Rhophylac is a fantastic idea.
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Every where that I have worked just do the saline replacement. No AHG XM required. I would say if the antibody screen is negative and there is no history of clinically significant antibodies you should be okay.
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I think I've got our pathologist convinced to just do the poly and if its positive send out the c3. Not going to change till after CAP gets here. Sometime before March 19
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Mabel it may be remote but it is one of the most beautiful area in the country.
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Still seems like a waste
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Just curious.. The small hospital I am now at doesn't do titers, antibody work-ups, antigen typing or other "complicated" testing. I'm am moving to change some of that but even some of the larger labs around here do not do titers (though the one I came from did them in gel). So titers will not be high on my list, but I have convinced the higher-ups to let me get a panel so I am making progress.
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Mabel, do you use gel? Why not do the titer in gel?
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Mabel,
I checked the package insert of the RhIG that we administer (Phophylac) and it says "Rhophylac can contain antibodies to other Rh antigens (e.g. anti-C antibodies) which might be detected by sensitive serological tests following administration." I would find out what product was used and check the package insert. I do think that the RhoGam insert says something similar.
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No insult taken! it is a beautiful table that I plan to use, Thanks!
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That is what we do but the cost comes from keeping compliment control cells that are not expires. Many months I throw my $200+ bottle of compliment control cells away without ever even opening them. I just feel that it is a huge waste.
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We are a small facility and issue very few platelets (~1-2 a month) I do no time of issue testing. I feel that the small number I transfuse would make the cost too high. If it does become required I am afraid that we might have to look at not offering platelets.
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YES the second senario really scares me too. I know of many issues in the 11 years I've been associated with them. The answer I get when I question it is that its O neg blood so if they do give it to the wrong patient "no problem".
In senario 1 we either print an emergency issue form directly from the computer with the "name" and "number" already printed on it. Or we have blank forms that we write in the numbers. I personally find it quicker to print them. In a trauma a few seconds can matter.
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I have worked at two different level 1 trauma centers and they both do it differently.
The first one requires two identifiers before any blood is issued, even emergency release. When a trauma comes in they put a green "typenex" armband on them and that number (MKZ 1234) is one identifier then they give them a "name" MKZ 1234, White male. When they get an actual name they merge the accounts where you can look up the "trauma name" and it will take you to the correct patient.
The second has a 2 "trauma boxes" with 2 units O neg that they keep on ice and a tech or RN can walk in and get the trauma blood at any time and you never know who it is going to. After given you get the forms back with who it was given to. It can get really confusing when both trauma boxes are out at the same time.
I personally like the first best. It is less confusing and easier to track. The second hospital is CAP inspected and have never been cited for this practice.
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Deny,
We did extensive correlation prior to going live with the gel testing and determined that a 1+ in gel would not show up in tube at all, a 2+ in gel was microscopic in tube, 3+ was 1+ in tube and a 4+ was 2+ or greater in tube. We use these guidelines when we make QC specimens and go our comparison studies. I try to "make" an antibody that will give me ~3+ in gel then expect to get a 1+ in the tube.
My current QC gives me a strong 3+ in gel and a weak 2+/strong 1+ in the tubes...
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My previous employer did cold antibody screen, SC1& SC2 at 4C on all Cardiac surgery patients. If the 4C was positive you did 15C (Ice in water with a thermometer) If that was positive you did RT. A lot of work but luckily very few were positive at 4C.
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ACD - perservitive in yellow top
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We unfortunately are not associated with any other hospital but we do use one of the larger hospitals nearby to do most of our "reference" work as they are much cheaper. I will run this by Dr S again and see what I get.
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I feel your pain with no transfusion commitee, we don't either.
It never hurts to revisit the protocals but I would go into it armed with all of the numbers. # of surgeries with no blood use..those that used what was set up and those that needed more. Also education on the time frame to get blood if type ans screen is already complete. When I tell them 5-10 minutes if the screen was negative they are normally ok. One surgeon I was talking to about it laughed and said it would take them nearly that long to get to the blood bank.(must walk really slow).
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I would think that any kind of surgery that has the potential to wrong fast (brain, heart) would have to be given some leeway. All of our are well below 2 but we only do minor surgeries.
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That is what I suggested but the "pathologist" that floats through once a week wasn't convinced.
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HELP!!
Ok so I am having some billing issues with an antibody workup. The initial order was for a Type and Rh performed the evening of 1/2/13. Then the next morning 1/3/13 I spoke with the MD who wanted the antibody screen and ID performed. I billed for the antibody screen and ID with a service date of 1/3/13 because that was when it was completed. Well patient in question was readmitted the morning of 1/3/13 with of course a different billing number.
Accounting is saying that I should be billing this with a service date of 1/2/13 because that is when the testing took place OR bill it on the account number from 1/3/13 which is different from the one that the specimen was collected under.
Citing CMS rules on date of service and such.
I have always been told to bill stuff on the date that the testing was performed but cannot cite a CMS rule to back this up?? anybody have any ideas of how to handle this??
C3 testing on Positive DAT's
in Transfusion Services
Posted
I did that yesterday and they are about $20 a bottle less but I still think that I will try to do away with this testing in house.