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Everything posted by DPruden

  1. 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!
  2. 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.
  3. 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
  4. 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!
  5. 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!
  6. 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.
  7. https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173
  8. 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.
  9. 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.
  10. 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.
  11. That is what we all said at my facility, none of us could figure out why anyone would think that was necessary!
  12. 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.
  13. 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.
  14. 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!
  15. DPruden


    I was fortunate to attend a talk from John Carreyrou sponsored by the CU Business school. His take on the business side and the board was very interesting. I had already read his book Bad Blood, and personally I hope she rots in jail. I am fairly convinced that she is a sociopath.
  16. I just answered this question. My Score PASS
  17. TAT's for STAT T&S: 1. How many beds in your facility? 700 2. What is your TAT? 58.33 minutes for 2018 jan-sep 3. Is the TAT calculated from order to result or receipt to result? receive to result 4. Who collects your specimens? RNs, phlebotomists, others? We have mostly RN collection, only the morning run by AHTs (allied health tech-predominately MAs not phlebs) 5. Do you have any automation in your Blood Bank? Yes Previous supervisors threw out most of the outliers so that the goal of 90% within 60 minutes was met. I exclude very few data points, thus our TAT hovers just under 55%. for the same time period as the TAT given, we averaged 68% of stat T/SC within 60 minutes, I do throw out a few outliers, I take any T/SC under 20 minutes and remove those and the same number from the top of the list, under the assumption the both the extremely short and extremely long are probably computer artifact in some way, I usually have about 10 that I take off of the top and bottom.
  18. We start with A plasma for our traumas, so our MDs review for any adverse events if the patient ends up typing B or AB. And we have that written into our policy.
  19. We do this too. in addition, if we don't have 2 types, the blood bank orders the retype and sends the floor a short pink top to use in drawing the retype, and we don't accept standard 7 mL pink tops for retypes (because people were drawing 2 upon admission and carrying them unlabeled in their pockets until they got the retype order).
  20. I have seen facilities that attach the peer review to the Trauma Committee (if you have one) or the P&T (pharmaceuticals and therapeutics) committee, which I think every hospital has in some form or another.
  21. There is a huge price difference between cryo and fibrinogen concentrates, maybe that has something to do with it.
  22. which method number? I didn't see it when I searched
  23. Whew, thanks for that, I thought I had lost my mind briefly (or my sight!)
  24. We do have a NICU and have still had cases where they couldn't wait for the aliquot to be prepared, so we gave them the freshest O Neg that we had on the shelf.
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