DPruden

I would say have compassion and flexibility, but don't let people walk all over you. Don't be afraid to ask for what you need, like 5 minutes to finish a task before addressing their issue. If people are complaining, I will often ask them to come up with a solution. I definitely agree that stepping into a leadership position internally is more difficult than starting as a leader in a new facility. One of the most helpful things that I was told early in my career was to vent up, personnel management can be frustrating, but go vent to a supervisor or manager away from the lab, this can often help bring perspective to the situation. Good luck!

Technically, it is only indicated for treatment of patients who are undergoing massive transfusion. because of life-threatening trauma/hemorrhages. We use it for MTPs in our OR as well as trauma patients coming into the ER.

We have a BloodTrack in our ER, we have it built only for MTP packs. The interface is problematic with SafeTrace Tx, mostly due to the time it takes for the admissions info to cross into BloodTrack and Tx. We have also had some challenges with training the nursing staff in the ER, but we monitor the errors and follow up with the ED educators

Decades ago, one of the night shift techs thought that doing a type confirmation on autologous units was stupid, so she would routinely "sink test" the ABO confirmations on autologous units. this was during a time when many people were donating autologous units and having them frozen (early 1990s). There were 2 auto units being deglyced at the same time at the blood center, and through an honest mistake by the donor center staff, the units were switched during labeling, one was OPOS and one was BPOS. To further complicate the error, the patient didn't really need to be transfused, 30-something healthy guy in for jaw surgery, very minimal blood loss during surgery, but the unit was on the shelf and it was autologous, so they decided to transfuse it! So, he got an entire BPOS unit and he was OPOS. The patient spent about a week in ICU and his kidneys shut down for a while, but he survived with no long term consequences. I will never forget that one!

My argument would be that blood bank testing is qualitative and not quantitative. We have run into this a little bit in the US as well, they re-organized the federal regulations and starting using chemistry and hematology requirements for blood banking. Our method comparison requirement in particular has never made sense to me. Of course LISS, PEG, solid phase, and gel methods give different results, they are designed to!

21CFR606.151(e) states "Standard operating procedures for compatibility testing shall include the following: Procedures to expedite transfusion in life-threatening emergencies. Records of all such incidents shall be maintained, including complete documentation justifying the emergency action, which shall be signed by a physician." We keep them regardless of whether or not the units are transfused.

https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

We are not currently billing for convalescent plasma, we built them in SafeTrace Tx will a billing holder code so that all of these products end up in a, Epic billing workqueue. I'm not sure that you should be billing the patients for these anyway seeing as the products are investigational products for research use only.

We use extra copies of the face label of the units to help us not handwrite everything. The techs pull the extra copy so that someone can be emergency issuing in the computer while someone else is packing the units in a cooler.

I know! But I still want a copy

I attached our algorithm, the two codes translate to the following: PABO: Positive DAT presumably due to ABO incompatibility (external comment code). PALLO: Positive DAT presumably due to maternal alloantibody (external comment code) we will do elutions if specifically requested by the physician, but most of the time they don't order them.

That is what we all said at my facility, none of us could figure out why anyone would think that was necessary!

Good news if anyone is still looking for a copy! AABB Press will republish the fourth edition of Applied Blood Group Serology, the influential reference book for blood bankers last published in 1998. This landmark publication is widely considered to be one of the most influential books for professionals in transfusion medicine and continues to be used as a reference for blood bankers throughout the world. AABB, in partnership with authors Peter Issitt, PhD; and David Anstee, PhD, will reissue the fourth edition prior the 2019 AABB Annual Meeting for a limited time only. Annual Meeting attendees may preorder Applied Blood Group Serology by contacting AABB Member Services (+1.866.222.2498) before Oct. 4. Those who purchase the publication prior to Oct. 4 will be able to pick up their orders during the Annual Meeting, to be held Oct. 19-22 in San Antonio. After Oct. 4, the publication will be available for the public to order. The publication will also be for sale in the AABB Bookstore during the 2019 Annual Meeting. To celebrate the rerelease of the book, AABB has added a special book-signing event at the meeting. Issitt and Anstee will participate in two book-signing sessions on Sunday and Monday afternoons from noon to 2:30 pm. The book-signing will take place in an area near the bookstore at AABB Central. Additionally, the upcoming October issue of AABB News includes an interview with Issitt.

Standard 62. Transfusion therapy. Infusion therapy standards of practice. (2016). Journal of Infusion Nursing, 39, S135–S137. (Level VII) and AABB. (2012). Primer of blood administration. Bethesda, MD: AABB. (Level VII) these are the references that our blood administration policy lists.

I just ran across someone who thinks that a patient who has an anti-M needs to have antigen typed S- RBCs (the patient is S-). I have been scratching my mind trying to figure out where that thought process came from!