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DPruden

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Everything posted by DPruden

  1. 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.
  2. 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).
  3. 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.
  4. There is a huge price difference between cryo and fibrinogen concentrates, maybe that has something to do with it.
  5. which method number? I didn't see it when I searched
  6. Whew, thanks for that, I thought I had lost my mind briefly (or my sight!)
  7. 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.
  8. I would read the actual OSHA regulations, there are a lot of statements in there about "reasonable expectation of exposure". https://www.osha.gov/SLTC/bloodbornepathogens/bloodborne_quickref.html Be sure to read the definitions and don't implement rules for a research lab or micro/viro lab that don't apply to blood bank. This whole subject is one of my pet peeves, I would vote for common sense and don't lick anything in the lab!
  9. I used to use a 10mL tigertop tube, it was an excellent brake!
  10. Our cell salvage program uses Tableau and it is pretty nice, but it is all dependent on the data source, blood bank can't use it because we can't get access to the database. We evaluated HC1 and Qlik, we really liked both of them, but couldn't get senior mgmt. to give us the budget for it. We have an analyst working on writing some reports for us in PowerBI, but I am not holding my breath!
  11. I would check your package insert for the reverse cells. If it states something like this "The ABO antibodies of most group A, B or O adults agglutinates A1, A2 and B cells strongly (3-4+). Reactions of 2+ or less may indicate the reaction is due to an antibody other than anti-A or anti-B. Thus, weakly positive reactions should be evaluated carefully to ensure no ABO discrepancy exists and the correct ABO group is assigned.", then I think you need to do more work at least initially. Maybe not every time you see the patient, if your medical director is ok with having a know weak backtype not being worked up. We start with a 5-15 minute room temp incubation, if that doesn't work, increase the plasma/cell ratio and if you still can't get 2+ reactions, go to a 1-6 C incubation with controls. Our computer system has limitation on the reaction strength in the ABORH test, so if we have to result <2+ and call it positive, we have an ABORH discrepancy test that has different rules.
  12. I think the FDA has changed their position on coolers again, it seems like they flip flop on storage/transport every few years.
  13. Our inpatient consents are good for the length of that admission and our outpatient consents are good for a year. We've never had any issues, but you might check your specific state rules.
  14. Brilliant!! Congratulations for a well deserved honor!
  15. We validate our coolers for 6C and use 10C Safe-T-Vue's, under the assumption that if the unit is in the cooler, 6C is maintained, if it is out of the cooler it is in transport. Haven't had any problems with FDA or AABB. We tried using the 6C Safe-T-Vue indicators, but they changed before we could even issue the products sometimes.
  16. You might try a different vendor for saline. Surprisingly, many of them have different expirations.
  17. I just answered this question. My Score PASS
  18. I just answered this question. My Score PASS
  19. The INR was never intended to predict bleeding risk, it was intended to normalize PT results from lab to lab in order to provide physicians a more standard indication of their patient's anticoagulation status. There was a good presentation at AABB by Dr. Mary Townsend about this topic in the Blood Bank Mythbusters session.
  20. Don't let the Beaker/Epic people tell you that only one day of training is sufficient for SafeTrace Tx. And ask to have the Beaker training and Tx training environments interfaced because the steps are much different when the information is interfaced as opposed to being just typed into Tx. Also, have someone verify the ADT/visit setup, when we went live, Epic would send a "discharge/transfer" notice across the interface whenever the patients were moved, to OR or radiology, for example. then Tx would discharge the patient and inactivate the sample, not the most ideal scenario when a patient is going to OR... We didn't see it during the validation because the test patients stayed nicely in their rooms the whole time!
  21. thanks! I found it in the Technical Manual, both European and US references.
  22. From the fact book: the occurrence of haplotype r' (Ce) is 2% in all population groups listed (Caucasian, Black, Native Americans, Asians) haplotype r" (cE) is 1% Caucasian, 0% Black, 6% Native American,0% Asian and ry (CE) is essentially 0% in all populations, of course that includes D+ populations. r'r' and r"r" are rare across all populations. r'r is 0.8% occurrence for Caucasian, rare for Black, 0.1% for Asian. r"r is 0.9% occurrence for Caucasian, rare for Black, rare for Asian.
  23. Does anyone know if there is a maximum dose for irradiating blood products? I have looked all over the FDA/CBER website and can't find anything.
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