ChrisH,

We are currently "doing them" though the only ones we have done in the last 12 months were 2 on transfusion reactions. I looked into doing away with C3 totally but the CAP checklist question about testing for RBC bound complement. I did the math and would save $2700+ dollars a year if I could do away with C3 but I have not figured out how.

I've had techs do that who could hear as good as you or me...

oh definately but how did librarian and hairdreeser finish above medtech??

If this is one of the Least stressful jobs in the US I cringe to think of what would be at the top of the list...Maybe dog walker??

Thanks for the update..Its nice to see how things turn out :cool:

I do that everyday

The compatibility chart went up on the fridge the first week...they still have issues.

I looked back over 2 years and figure based on the past occurances I will get 8-10 calls a month. To me that is a small price to pay if I am able to "save" 1-2 units of FFP or Platelets from being wasted.

Cliff you are great I will anxiously await them...Hopefully I can find another stress release until then.

Thanks..The response I got from most was this is great!! I have just had a couple of people complain that I am trying to "babysit" them...Supprisingly these are also some of those that I have found making errors....

I just needed a little reassurance that I was not really totally crazy.(yet)

Ok as most of you know I just took over as technical supervisor in a small hospital. I am the only dedicated blood banker all others are generalists that float through. We do not do a lot of blood bank/transfusions ~ 200 units a months.

After reviewing the records for the last year I posted some criteria for times I would like called.

-Anytime you get a FFP order (There have been several instances where A units were already liquid when an order came in on an O patient and O units were thawed, wasting the A units) (also several with normal coag and <20plt where the order was actually suposed to be platelets again wasted units)

-Any platelet order in plt count >20 (pretty much same as above plts ordered when count is 450 but INR is 15)

-Any positive antibody screen. (we only get a total of about 10 a month so we're only talking maybe 5 calls a month) I would like to hold some like the clearly RhIG anti-D and the Anti-E guy that has 45 hct and send them out in the morning saving the $100+ stat fee. Also if the order is just a TS on a pt with a positive screen I would like to make a decision about ordering in units(we do not antigen type).

Do you think I am being unreasonable? Some of the stuff I have seen on review has really scared me and let me know that the off shift techs do not have a firm enough grasp of blood bank to make these decisions.

FYI no pathology on site - on call for issues but he normally just tells people to call me.

Thanks

Trish

Cliff,

Are you gonna give us something to take the place of the lights?? Please?? They really saved the poor nurses life last evening when I wanted to climb through the phone line and strangle her...By the time she walked the already spiked unit that they tried to transfuse to the wrong patient back to the blood bank I had killed all of the lights (several times) and was able to be civil to her......

I would be more apt to believe that it was a low freq and would strongly suggest monitoring the baby closely for hydrops. Better to err on the side of caution.

I remember having a screening cell once with Jsa on it....We identified a couple that month.

Though very rare it would not be inpossible for the baby to be making the antibody himself...But I agree that it is much more likely to be something other than this anti-E that is causing the problem.

It could even be something totally unrelated to immunohematology that is causing the increase biliruben...diet? liver problems??

Having the anit-E still detectable in the baby at 6 weeks would not be that unexpected. It sometimes takes several months for an antibody passed from mom to become undetectable in baby. I do have a couple of questions (excuse me if you have already answered them). Did you do an antibody screen on baby right after birth or just the DAT? also did you antigen type baby for E?

Excellent suggestion Malcolm! Having worked for many years in pediatric blood banking I have seen this many times. Mom's antibody screen is negative at the referring hospital and then we have a positive screen and identify a low incidence antibody.

Happy New Year all...guess I'm not special enough to get champagne bottles either...I didn't even sample last night as I had to be at work this morning. In bed by nine..

I constantly say that blood bankers should trust no one. Sometimes not even yourself. Double check everything

I know that Arkansas Children's runs cultures on the heparin solutions that the pharmacy prepares.

Just proves that there are no absolutes....

;( I miss having a medical director with a blood bank background......

We require two blood types,from different phlebotomies before we issue any blood product.

It is truly amazing to me sometimes what will give us pleasure..... I will really miss them when they are gone....

Cliff,

The lights are all that kept me sane yesterday.. 14 hours worked for my 10 hour shift. By the time second shift finally showed up I had "Killed" them about 30 times..

Thank you, you allowed me to be civil when they finally arrived.

My techs are a little paranoid about missing something (not always a bad thing but sometimes they go a bit overboard). I tell them that we can only test to the best of our ability and let God take care of the rest.