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Thanks!

Thank you all for your invaluable input - does anyone know of literature referencing a mL/Kg formula looking at safety in transfusing incompatible plasma?

If you are in a Massive Transfusion situation and the patient is bleeding so profusely that you run out of available (aka thawed or liquid) ABO compatible plasma - the only available plasma is Group O. You have a specimen and the patient is Group A. What would you do?

We have Helmer D8s and recently installed 2 Sahara III - Sahara has little to no maintenance, easy to use - but VERY SLOW (24-35 minutes for 2 units) compared to thawing 8 units in Helmer (16 -20 minutes for E2555 products). Great if you are thawing a couple of units for routine transfusion - not useful in hemorrhage/trauma situations.

Has there been any questions regarding the manufacturer's QC instructions for polyspecific gel cards if you are only testing with IgG coated red cells? I thought I understood from the Ortho instructions for QC that a positive and negative control were required and C3 coated cells must be used to verify anti-C3 reactivity. I'm not saying that is what we are doing but the question has come up in our BB leader meetings about QC for the poly DAT gel cards on the Vision.

Could someone re-post the link to the NYCBC poster? It looks like the link on these posts is no longer valid.

When do you perform an elution? (e.g. all positive DATs, all positive DATS within 3 months of transfusion, IgG positive only) - Positive DAT with anti-IgG if elution has not been done within previous 30 days or performing a transfusion reaction investigation What method is utilized for the elution? Elukit What method is utilized for testing the eluate? Gel How is the eluate tested? (e.g. screening cells, full panel, specially selected cells) Panel Feel free to mention any special notes/criteria for which I may not have though to ask. If the plasma antibody is very strong (particularly with cord blood eluates), I am very careful to change tubes between washes and test Last Wash before proceeding further with adding the acid to red cells. Once eluate is prepared, at least two centrifugations in clean test tubes to make sure that any stroma is removed as it will cause major headaches when performing gel testing.

Update: This was not cited by TJC but inspector really wanted to. We prevailed when we asked to read the requirement.

FMH Lot Confirmation.xlsx

Would anyone be willing to share their process for transfusion review? Specifically criteria and how review is documented (forms?).

Please! Epic with Softbank since 2016.

We are Level 1 Trauma Center with approximately 15 Massive Transfusion activations per month. We keep 6 O POS and 6 O NEG in our ER refrigerator with 4 Group A Liquid Plasma. We started stocking O POS units last summer when our blood supplier was struggling to keep up with our O NEG need. The majority of our traumas are male and about 80% Rh positive. It has made a tremendous impact on our O NEG usage. The biggest concern was the possibility of a mistake and grabbing O POS for female patient but (knock on wood) that has not happened yet. We have segregated the units by placing O POS in a Blue plastic bin and O NEG in a Pink plastic bin - and on a separate shelf. O POS units are wrapped in a paper stating "FOR MALES ONLY".

We just implemented testing Fetal Screens old lot to new lot. I don't think Safe-T-Vue would need Lot -to Lot verification under this standard since it is not a reagent. However, to meet other requirements, it would need to be inspected to verify that it meets supply qualifications

We do a complete type - both forward and reverse

We are a level 1 Trauma center that routinely gives Emergency Released blood products with approximately 15 MTP activations per month. We have difficulty obtaining MD signature on our Emergency Release forms after the patient moves to OR or if the bleed initiates in the OR. Does anyone utilize an electronic order and use the electronic signature for emergency release/MTP activation? Have you been CAP/AABB/FDA inspected using electronic signatures? If so, were there any problems with the inspection? I am in discussions with Trauma service about obtaining a physical signature and they are begging us to make it "easier" hoping to obtain better compliance with transfusion documentation in Epic. I know that transfusion documentation and physician signature are separate issues but they have presented questions linking the two topics.