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Thanks for the input thus far. I did email AABB for a definition so if I get a response from them I will share on this thread as well.
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For AABB standard 6.2.4 I am seeking guidance on what is meant by Records shall be created and maintained to include: 5) Method(s) used (when more than one method is in use). How does AABB define methods. I work for a hospital system and we are currently merging many of our practices. Some facilities consider methods to be instrument v. manual. Some facilities believe manual tests such as manual gel and manual tube testing would be different methods. I am just trying to get a feel for how organizations define and practice this. Thanks for your help in advance.
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I know there are some conversations about this topic already out there, but I haven't been able to find the answer to my questions. My facility would like to being using Thawed plasma with the 5 day outdate. I am currently not registered by the FDA and need to know if this would require me to register? Any advice is greatly appreciated.
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Does anyone have policies, processes, procedures to share regarding how you deal with gram stain discrepencies between technologists and when you would perform a corrected report. Also if you have any references regarding how and why you use this criteria that would be helpful also. Thanks.
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Thank you for all of your input. Our 1 hour rule is just something we've "always" done and predates me so I do not know the origin. The current package insert for the K-B stain states, "maternal blood sample should be collected in a syringe with a sterile needle or by evacuated technique, as soon after delivery as possible." The new maternity director at my hospital is questioning our policy for the 1 hr requirement, which is really the only reason I need to find some data or evidence for or against our policy. I'll keep digging but if anyone else finds out more info in the meantime. . .keep me posted. Thank you.
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Our current policy regarding postpartum RhIG workups is that the mother be drawn within 1 hour of delivery to ensure accurate dosing with the Kleihauer-Betke test. Does anyone else have a time frame and if so do you have a reference for where your time frame came from?
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Members of my nursing staff recently asked me if FFP and platelets needed to be infused with 0.9% NaCl. I am really unclear about what to tell them as I know that 0.9% NaCl is the only acceptable IV solution to be administered with blood or blood component, but I do not know the specifics of running 0.9% NaCl with platelets or FFP. When I reviewed the Technical Manual and the Lippincott Nursing procedures there is a lot of verbage suggesting the use of 0.9% with blood OR blood components - but there just isn't that black and white answer. Does anyone have any suggestions?
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My institution currently performs Therapeutic Phlebotomies, however we waste a lot of bags because we buy the case and once the foil seal is open the expiration is only 30 days. We need a bag that would collect up to 500mls. We always immediately dispose of blood collected for therapeutic phlebotomies. Any suggestions? We are also going to begin performing ANH procedures at our facility. Again I am running into bags that would need to be bought by the case, however we will not be performing this procedure very often. I am looking for collection suggestions for this protocol. Thanks in advance for any advice.
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I am currently in the process of purchasing a new centrifuge for our EDTA specimens. This is the first time I have had to validate this type of equipment and am unsure of where to start. Any tips? Thanks.
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For items requiring annual review, does anyone know if AABB has a definition of what "annual" means? For instance, OSHA and TJC define annual as 12 months + 30 days.
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I am just posting this questions as it has come up by our pathology group. Are your pathologists allowed to order a Transfusion Reaction Workup or RhIG for an Rh negative patient who has received Rh pos platelets? I ask this just because we have had instances where a patient's physician has not ordered at times when they probably should have. We then consult our pathologists and some will order and some refuse. Thank you in advance for sharing your practice with me.
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I am looking for some help. . . Does anyone have a good reference/resource addressing quality metrics when dealing with blood and blood component wastage. My hospital quality department wants me to reduce our wastage - which we can work on, but it would be nice to know how other organizations stack up to us and what goals we should set. Thanks, Sara
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I am working to create a protocol regarding patients that were typed as Rh negative by the tube method, but are now Rh positive in Gel. We have found this problem a handful of times recently from our own history and also due to prenatal testing that is being performed at another facility in town. Our current procedure states to give RhIg to individuals if their reaction with anti-D is <2+. I am not sold on this and we are seeing these patients are sometimes >2+ with anti-D anyway. Physicians still want RhIg because patients have had it in the past. . . I am looking for advice from anyone who has encountered this problem or anyone who has insight. Thank you.
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My hospital would like to eliminate all glass tubes. Currently OB is sending cord bloods in a 10mL Red Top Clot tube. I was wondering what everyone else out there was doing? Thank you.
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I am a little unsure of all the FDA regulations. Below is a situation I have encountered. A patient being transfused did not have an armband on at the time of transfusion. Is this an FDA reportable event?
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Thanks for posting. Sometimes it helps to know what others are doing.
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I am looking for some input regarding CAP regulations and the volume of blood collected from patients. CAP wants labs to reduce the amount of blood drawn from patients. My laboratory is doing away with collecting "just in case" or "extra" tubes of blood drawn. We are only collecting what is ordered. We are also reducing the tube size in a lot of cases. For those of you using Ortho Gel Technology, what specimen(s) do you have drawn when a type and crossmatch is done?
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The diagnosis on the patient is elevated INR that was originally found at another facility and they were then sent to the ER. We have our blood supplier involved too, they will be reviewing the case and hopefully help determine if the plasma was a causitive factor in this or if it is the patient.
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I am in need of some help to determine the cause of a patient's sudden decreased plt. count. A patient presented to ER shortly after midnight with an elevated INR, relatively normal chemistries, and a normal CBC (WBC 9.9, RBC 4.0, Hgb 13.0, Plt 182). 2 units of plasma were given to the patient between 2am and 6am. When the patient's labs were rechecked at 11:00am, the platelet count had droped to 5 (rest of hemogram looked similar to original). Since this time (it has not been about 36 hours) the patients plt count has remained around 5, WBC count has dropped down to 6.6 and Hgb 11. The patient had no typical adverse reactions from the plasma transfusion, however the pathologist ordered a culture on the plasma and a transfusion reaction work-up. Does anyone have any advice on what this may be caused by?
