Deny Morlino

Another Technical Specialist (supervisor).

Awesome news!!

Welcome to Pathlabtalk!!

We have been using polystyrene for several years with good results. The main difference discovered during validation was a difference in spin times during centrifugation. If spun too long the roll-off is VERY difficult.

A vague rumor I think I heard too. Seems like they are spinning off pieces of BB at least (i.e. Rhogam).

This is the key part of your statements. Unless you have the same (or a VERY similar) group of hospitals to consider peers I think determining what is "appropriate" will be almost impossible. If you are interested in using this metric, consider collapsing the data to a quarterly number (to help adjust for those "strange" months) and look at your own trend over time. If you notice an increasing trend, drill down into the transfusions to determine if their is a particular physician or segment of care causing the shift. Whereas this will not allow a comparison to others, it will still allow you to see any developing trends and examine the transfusion practices affecting the metric. Hope this made sense.

Yes, that is the jist of what I remember. Sounds like the verdict is still out until further research is completed. I guess the final decision comes down to an individual one at each hospital based upon whatever works best for the stock available, medical director's comfort level, etc. I believe everyone is in agreement that there should be plasma infused whenever large amounts of packed cells are necessary. The ratio is up to the facility's discretion until better data is available.

I cannot remember where I read the information, but the military recommendations were determined not to be the best practice when examined in the civilian realm.

Welcome back!!

Have been using Rhophylac for several years now without issue. Shipping times are great from order to receipt.

Congratulations!!

D-dimer here

Scott, I review all transfusion records myself. When there is an outlier for any reason (rise or drop in BP, temp spike, heartrate increase, etc.) I route a copy of the record to the nursing part of the equation that delves into these aspects described by the "solid numbers". Upon chart review the documentation either explains the reason or not. Either way the information is reviewed at transfusion committee and any followup with nursing regarding the outliers is addressed as well. Inspectors seem to be fine with it (and they have dug into it on several occassions). As with everything inspection wise it is subject to inspector interpretation to some degree.

This is where we give a solid number, but nursing is instructed to use their professional judgement for determining if the situation is actually a reaction or not. Documentation in the nursing notes describing their thoughts covers the situation.

72 here

Congratulations Melissa and good luck Emily!!

Bev, We provide irradiated red cells/platelets upon physician request. If the patient is one we have historically administered these products to, we will double check with the ordering physician if irradiation has NOT been ordered. Our usual use of these products is in transplant patients, but we occasionally see orders for use in other patient diagnoses. We charge for the irradiated units only when administered per physician order. Hope this helps.

We give formal notification via a copy of the reference lab report (always after the fact for the final report) and the physician signs for incompatible units prior to transfusion. When they are required to sign for incompatible units they usually become much more conservative with transfusion and look for any other method possible to avoid it.

As did I Mabel. Looking forward to the next "entertainment". Thanks for all the work Cliff.

Another thing to consider about Helmer is that they are located in Indiana and build their units at this location. Parts should be very readily available and service should be easy to communicate with.

I have a Helmer on order now, so that is my vote.

Sometimes a med tech school is in need of such information. Often they are operating on a very tight budget and are thrilled to have them as a reference for the students even if an older version.

Awesome idea!! Will consider bringing that to OB's attention.

SBB project perhaps?

For many years we have done the same (ab screen before RhIg). Recently one of our OB satellite facilities wanted to stock RhIg for issue. It would not be possible to complete the ab screen prior to administration in this scenario. We went to a policy of performing a records check in our blood bank to determine whether the patient had history from the current pregnancy of a negative antibody screen as performed in our blood bank. If so, the checks are all documented and charted in the OB office and in blood bank and the patient is drawn for testing. The patient then proceeds to have the RhIg administered by the OB office. If the patient has not had the testing performed in our blood bank, the specimen is drawn and the patient scheduled to return to the OB's office the following day to allow the blood bank time to assure a negative ab screen. This is working well for us. We may pursue changing all antenatal RhIg administration to this process to better serve our patient's needs.