DPruden

We increased ours from 50 to 55 for the upper age. Look at Table 2 in this division of vital statistics report, only 677 women between the ages of 50-54 had a live birth in the US in 2013. http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf

We release partial units to general inventory for adults if they are above 180 mL. We took the minimum volume of a whole blood that would be produced by our blood supplier and multiplied it by the minimum allowable Hct for donation. The logic being that we could receive a "full" unit of RBCs made from a 474 mL (minimum from blood supplier) whole blood donation from a donor with a 38% Hct.

Dickson has a wide variety (and price ranges) of data loggers, but you need to be careful about the +/- on the temperature ranges!

Our current cesium source irradiator is nearing its end of life. In looking around, I have seen the standard Cesium137 irradiators and I know that would be fine and it would work for 25 years or more, but I was wondering if anyone had experiences with a Cobalt60 irradiator? I would assume that all of the ridiculous homeland security rules would still be in place because of the radioactive source, but they appear to be 10 times faster than cesium. And then there is X-ray technology, about which I have heard bad things over the years. I would appreciate any input on the topic: good, bad, or indifferent.

We use a similar process to David's. Mocked-up units with a validated thermometer inserted that are left on the counter. We actually took digital pictures of the Safe-T-Vue indicators next to the thermometer.

We use bleach to decontaminate our cell washers and then run a pH before putting them back into use.

The medical director can delegate (in writing, we have an SOP) QC review.

I would love to start using A plasma in trauma/emergency situations, but I'm trying to come up with a justification to contradict the statement in the Circular of Information that states "Plasma must be ABO compatible with the recipient's red cells." And since the FDA considers the Circular an extension of the blood product label, I'm a little wary of implementing. I would also be curious if any of the faciliites using A plasma are in areas with high Asian populations.

We only do eluates on an IgG positive DATs if the patient has been transfused in the past 3 months.

You might be able to use this CAP standard as reason to stop overriding the interpretation. I wouldn't think that you would have that defined in your procedure for interpretation of negative results as a positive. I'm not sure you will find a concrete regulatory reason to change the practice, but personally I wouldn't want the techs to get in the habit of overriding QA failures in the computer system. And you do need to credit the antibody ID charge, if you don't do one. TRM.40050 Agglutination/Hemolysis Criteria Criteria for agglutination and/or hemolysis are defined. NOTE: Criteria must be defined in the procedure manual to provide uniformity of interpretation of positive and negative agglutination and hemolysis results.

I would contact someone in your finance department to see if they could pull reports that have transfusion data combined with a case mix index.

I remember that day!

If you use a paper log for emergency uncrossmatched blood, you could add a column for 'crossmatch completed date/time' or something to that effect. If you are using your computer system to perform the emergency release, I would see if there is a way that the computer can order the crossmatch, some systems can do this easily.

Our techs only do the clerical check and unit/tubing inspection on reaction investigations for non-RBC components, they will send the product for a culture if directed to by our medical directors, but the medical directors do the investigation to determine if TACO or TRALI or some other non-hemolytic reaction occurred. AABB is pretty vague, just states that you have to have a policy. And CAP requires post-transfusion DAT and ABO on potential hemolytic transfusion reaction investigations. So, I suppose if you thought you had a hemolytic reaction involving a non-RBC product, then you would have to get a post-transfusion specimen.

My impression from the Emory webinar was maintaining fluid balance and electrolyte levels in their patients was their biggest concern.

We are doing emergency release O neg RBCs and AB plasma. Our blood bank isn't in the same building as the main lab and we don't have a hood, so that would be a lot cumbersome. We talked about doing slide testing for the ABO type if there were the need (multiple patients, etc.). I listened to the webinar from Emory and they did not do any blood bank testing, they had a very limited test menu that was done in a dedicated point of care lab that was adjacent to the isolation unit. I totally agree with the hysteria comment, I'm really annoyed with the US media and all of the fear mongering!

You might want to check the specifications. We had the analog version and couldn't validate the heat blocks and then later discovered that the analog control has a 37°C: ±3.5° range. So, if it is set to 37C, you could get a temp anywhere from 33.5C to 40.5C!! We had to return them and buy digital models.

I might also question the initial collection technique for the cord bloods. You might want to ask the L/D nurses what their process is for collecting and labeling.

What is the advantage of doing a titer in gel? I would think that it would be confusing to a clinician, given the increase in sensitivity. It is certainly cheaper to use tubes and saline.

Now if I could just get my friends to read it!

We use Coleman coolers. We validate them with a specific packing arrangement, so that would make me uneasy as well!

You might also check the CMS reimbursement rules and the diagnosis codes for the patients. That could give you more information about whether or not the testing is considered routine for the patient's condition.

Maybe, I will ask Pat if he would be amenable to giving me his presentation to post! He is also presenting on Sunday late afternoon at the disaster presentation.

AABB Open House Flyer and invite.pdf Here is the real flyer. thanks, Dianna

If you are attending AABB and will be there on Friday evening, we are having a tour of our facility and a presentation about the hospital's response to the Aurora theater shooting last year. RSVP to the email below if you are interested. Thanks, Dianna UNIVERSITY OF COLORADO HOSPITAL TOUR AND OPEN HOUSE FRIDAY, OCT. 11, 5:30-8:00 Tour the hospital grounds and the blood bank Followed with a presentation addressing the 7/20 Aurora Theatre Shooting presented by Pat Conroy, Manager, Facilities Management and Hospital Safety Officer Transportation and light food and refreshments provided Shuttle will leave the convention center at 5:30 Please RSVP to laura.rowe@uchealth.org