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velliott

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Everything posted by velliott

  1. We have changed from serum to plasma, using manual tubes, for anticipation of automation with Tango. We seem to have improved our issue with specimens that don't clot and replaced it with a lot of rouleaux. We also are using pink tubes and did see a few specimens when we were validating but now it seems like we see several a day. Is this just a given when using manual tubes and an issue we would not see if we were using manual gel?
  2. Your CSO can help with trying to figure out if something is reportable or not. If they don't know the answer they can point you in the right direction. It might also be good idea to start a dialogue with your CSO. You don't want to put too much attention on the past but having them as a resource can be positive.
  3. I've gotten a contract price, you know how those things go - someone else is making decisions, and I hadn't ever heard anything about this vendor. Seen alot of good testimonies about Helmer. Which the CytoTherm is cheaper...
  4. Anybody have any experience with this plasma thawer Thanks
  5. Does anyone have a SOP for homemade check cells that you could share? I've changed vendors and may not get my check cells in time.
  6. Has anyone had any issues with accreditating agencies regarding non-hospital personnel monitoring transfusions during transport? We have always required that the patient cannot be handed off to the EMS and that a nurse from our facility must accompany the patient. The Joint Commission standards state that persons who transfuse must be competent in recognizing transfusion reactions and with the wide variety of skills in EMS and with our group being volunteer it would be difficult to provide records for an inspector. But, it presently is met with many obstacles in having available nurses to ride in ground transport. If patients are air transported those folks have this type of documentation.
  7. You need to reference your manufactures recommendations. Usually your vendor is very good in helping you get the process started because they have done a lot of validation and they have many clients that they can help you network with. Our policy is to count / split before the platelet is 24 hours old. We let the platelets rock over night to allow all the clumping to dissapate. We have a sample tube we collect the plasma / platelet in and then perform the count. This is also the sample we perform our WBC count on. At this time we also get a rough volume and estimate whether the product will be a single, double or triple. We do bacterial detection by BacTech Alert and then wsample off the 10 mls after the unit has been collected for 24 hours. Then we start to we divide up our units or dock on an additional bag if the collection qualifited for a triple. Our products are FDA licensed and I was told that the bags have to agree within 10 mls of each other.
  8. Can anyone tell me what P code they are using for pre-pooled cryo?
  9. For those who buy cryo already pooled, do you use E3591 for the thawed pooled product code?
  10. Can someone tell me what the Ortho package insert states about the age of a sample in order to perform an ABO / RH on a gel card? My manufacture, we are doing tube testing, states the sample should be less than 10 days olds. My concern is in pre-admission testing where you allow a type and screen or crossmatch to be drawn several weeks before the surgery if the patient has not been pregnant or transfused. Most of the time the tech crossmatching additional units will repeat an ABO / RH.
  11. I need help with the particulars in shipping/ issuing blood products for patients that are at one of our remote locations that is an oncology center (the center is 6 miles from our hospital). The center is part of our facility so the employees will be under our regulations but my concern is packing units to send to the center and then they sit there for several hours during the transfusion process. My concern, well actually I have a bunch, but the one right now is a patient who gets 2 red cells and 1 platelet. They typically transfuse the red cells first and finish with the platelets because they get a 1 hour platelet count before the patient is discharged. In my current setting we rotate platelets for 30-60 minutes before we issue them and if they are sitting in a transport container for 5-6 hours won't they need to be "mixed" before transfusing? Anyone's experience / comments in this type of setting will greatly be appreciated.
  12. Yes, we use Spectrum labs for our calibrations.
  13. We use Sunquest and download the files, monthly, and print a daily / weekly report, to a zip drive and on a file on a PC. If by chance we can't get to the file on a PC we can use the zip drive on another computer to view the info.
  14. We also just had a Joint Commission and inspection and there was no mention about dispensing out of blood bank. Blood is a drug and it is dispensed from blood bank. Don't you think its a patient safety issue that it is dispensed from blood bank making sure the right dose and if the patient actually qualifies? My fight is that even though the OB floor has the process for ordering; blood bank is the czar. We had 3 occasions where it was an inappropriate order: the wrong dose was ordered, patient was 16 weeks and a physician wanted to give a mini dose (we don't stock anything but the full dose), ordered on a RH positive patient, ordered on a patient that developed an anti D previously - we had been titering throughout the pregnancy. The last 2 scenerios who not have hurt the patient but there was an added expense and the last patient was already confused as to why they couldn't get their Rhogam shot - because they had gotten it at 28 weeks in the doctors office. There's so much hoop-la in all the standards (AABB,CAP and Joint Commission) about making sure patients get the right dose, we type them correctly and we identify patients who need it why would someone make us move it out of the best control?
  15. I got the same deficiency from Joint Commission that there could not be a designee so I changed my process and my medical director does review all SOP's. It's not fair that the other departments can have a designee review their SOP's.
  16. We only have to consent 16 year olds and it is part of the consent that results will be charged with the parents.
  17. Gosh, I hate to think if you didn't allow donors to donate who were on anti-depressants. Also donors on meds.......everybody takes something.
  18. Does anyone know of a requirement for performing QC on RadSure stickers? If so, could you share what you do?
  19. When we do our initial count, to see what it qualifies for we just use the sample from the parent bag. Then we pull off for the bacterial detection, we use BacTech Alert, and then split. Then at the "storage" count we do volume, PH and platelet count. When we did our validation we did the parent and then counted the splits and then counted all again at "storage".
  20. Do you have drives at: At shopping malls? Movie Theaters? Festivals or summer events? Draw your employees for competitions between departments for prizes We had a drive at a movie theater for "Twlight" T-shirts and they got free popcorn and advanced seating....
  21. Yes, I too got caught in the SBB no pay also. My facility merged during my 12 month schooling and the "rules" changed. I spent $10,000 for school and then got a whopping $20.00 a week certification pay.......I guess I missed that point during career day also.
  22. I've been "googling" reasons for a negative DAT and suspected hemolytic reactions and found the following postings. "If the post sample is collected 3-6 hours after the hemolytic event bilirubin may be present in the plasma (brown / green color) causing a bright yellow discoloration. The DAT can be paradoxically negative if the incompatible red cells have been rapidly destroyed. The DAT on the patients post transfusion sample may be negative even though a hemolytic transfusion reaction has occured - if at the time of testing most or all transfused donor red cells have been removed from circulation." Our post sample was collected almost 24 hours after the completion of transfusion. A febrile reaction would not have reported by nursing because the temperature was less than 2 degrees.
  23. The pre-transfusion specimen was a little hemolyzed due to difficulty in sticking the patient. Physician ordered another unit because the patient was hypotensive and had fevers which he considered to be from sepsis even though there were no positive cultures (blood or urine). HGB pre and post were both the same. Interestingly enough the patients HGB on pre transfusion was 9.6, their reason for transfusion was Cardio Vascular Disease.
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