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mjshepherd

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About mjshepherd

  • Birthday 01/06/1976

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  • Location
    South Carolina
  • Occupation
    15 years as a blood bank technologist, with the past five as lead technologist for a moderate sized hospital.

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  1. Thank you all for your input, I will be showing this to my transfusion commitee. I still think any error in specimen labeling should be discarded. I will do my best, wish me luck.
  2. I am interested in how other facilities handle specimen labeleing errors. Do you allow corections to mislabeled or incompletely labeled specimens? If you do how do you document the errors? I have alway been very strict on labeling errors rejecting anything recollectable submitted with incorrect or missing information. However, several nurses, including the CNO, have stated that other facilities have allowed them to relabel specimens if they "certify" the corrected information. Thoughts anyone?
  3. We buffer all of our saline as recommended by our Immucor rep, its easier that way. One bottle of pHix per cube of saline. Never had any problems with it.
  4. My question is not when to do a blood culture, but what plates to set up. I have heard many sugestions but can find nothing in the way of regulations. We currently just inoculate a Aero/ Anero blood culture bottle for the Bac-T, but have heard that plates should be set up as well.
  5. The 15th edition of the AABB Technical Manual (page 549) "at < 20 weeks, the fetal blood volume is rarely more than 30 mL, small enough that a single dose of 300 ug RHIG will be sufficient for prophylaxis for any feto-maternal hemorrhage. Therefore it is not necessary to quantitate fetal red cells in the maternal circulation before 20 weeks of gestation." Also, "When the gestation age is less than <20 weeks one 300 microgram dose of Rh Immune Globulin should be sufficient to cover a fetal-maternal bleed since the expected fetal blood volume is not likely to exceed that which is covered by the standard dose." Trauma During Pregnancy, by Haywood Brown, MD and Thomas Luley, DO
  6. I love the new Helmer cellwasher I bought last year.
  7. I am of the paranoid blood banker variety. I would prefer having to justify the added time and work of continuing to give antigent negitive blood if there was any question of an antibody being present, than to have to justify transfusing antigen positive blood to a RCA board if a reaction occured.
  8. Malcom, I have no other ideas for the RH enigma than those that have been posted. However as a hobby painter with my own lovely monsters I can make a suggestion for the paint in hair delimma. Mineral oil always seems to work for me. Saturate the hair and then put a shower or bathing cap on for about an hour.
  9. Here is a copy of the form I designed for use at our facility. We require a copy to be submitted to the blood bank before units are issued then I review them monthly for appropriatness, this makes my utilization review much more effective then randomly selecting a percentage of patients. [ATTACH]496[/ATTACH] Blood Product Order Form 3.doc
  10. I installed and validated our Echo over two years ago and overall the Echo is a good instrument, the mechanical operation is relatively simple with quick and easy maintenance. For facilities with moderate to large volumes of routine testing it does free up a lot of bench time. The patient data organization is cumbersome for facilities that are not computerized. However, when interfaced with a Blood Bank computer system the Echo will download worklists and upload patient test results fairly seamlessly. The functionality of the analyzer is also somewhat limited to ABO, RH, Antibody Screen, IgG DAT, and Antibody ID panels. While it is capable of running other functions such as forward typing of donor units and crossmatch testing these are more complicated and time consuming than manual testing. One of the best cost effective features that I have found is that many of Immucor's tube typing reagents are used on the Echo as well, reducing the number of reagents need to maintain two methods. We did have some issues with validation. The analyzer will only detect IgG antibodies, which led to us removing the crossmatch option from our testing due to incompatible blood types being reported as compatible. This also prevents the analyzer from detecting cold reactive IgM antibodies, which could be clinically significant in surgical cases where the body temperature would be lowered. The much increased sensitivity for IgG reactivity can cause problems when starting out as you may notice and increase of positive antibody screens with no identifiable specificity when tested against ID panels. We have found through experience that many of these patients with non-specific reactivity actually develop identifiable antibodies when tested at a later date, leading us to believe that the Echo may be picking up very low titers of certain antibodies. I would recommend this analyzer for any facility with moderate to high volume of routine testing that could be batched, and had the ability to have an interfaced computer system. If you have any questions fell free to contact me directly.
  11. I use a K3 EDTA for the Immucor ECHO, I'm not sure why but it seems to cause less artifact over the K2, although Immucor states that any EDTA is acceptable for testing.
  12. I am so glad to know I am not the only one who is addicted to this site. They laugh at me here checking in everyday to see whats new, but this has been a great source of info and amusement.
  13. If it is due to a broken plasma bag believe it or not I had great luck with Dawn dish soap. I drained the waterbath, and put the Dawn straight on the "crud" let it sit for 15 min. then scrubbed it with a nail brush. Let me know if this works for you.
  14. At our facility I perforn the initial appropriatness review by randomly selecting a a percentage of total patients transfused and reviewing the chart. If I see anything that falls outside the transfusion guidelines I forward it to our pathologist for the final say. If the path feels it truely falls outside acceptable practice he drafts a letter to the physician. If a physician receives 3 letters in a 2 year period he is asked to appear before the review board.
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