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DOGLOVER

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Everything posted by DOGLOVER

  1. Hi, I haven't been on this forum since I retired about 10 years ago.My 40+ years took me from bench tech in hematology and Blood Bank to supervisory positions in both to just Blood Bank. The last13 years were in Florida, retired and came back up north to Maine. Got my EMR license and work with our small volunteer fire dept. The lab background was extremely helpful in the EMR classes. Also helpful because I know how to write policies and QA isn't a foreign language to me.
  2. We do the same as Donna, because we do give type compatible to kids under 12. A lot of our platelet users are heme-onc kids so we may not be able to provide adults with their own type. The only hemolytic reaction I have seen to plts was in another time and place and it was a 5 year old.
  3. You are fortunate in that you can use a department based review. We use the high/med/low (first time 2013) but had to use one made for all clinical areas. That of course leaned heavily towards nursing, but did have the ability to add comments. It is definitely a live and learn process.
  4. we use a stick on label that we wrap around the "tail" of the bag. That way it is sticky side to sticky side and not to plastic. Can't fall off.
  5. I remember a long time ago having a male med tech student (never transfused) with anti-E. Of course, have also seen other probably naturally occuring anti-E's over the years but this one we knew for certain. Not uncommon as mentioned above. Fortunately the baby in your case will be E neg.
  6. After I brought up the idea of hyperhemolysis, our medical director got with the hem-onc doc and they decidedd that is what it has to be. He is being treated with plasma exchange and I don't know what else. I hope he doesn't have another sickle crisis anytime soon. Thanks for all your input. Merry Christmas everyone.
  7. Any thoughts: Have a patient who had a 10 unit red cell exchange 3 days ago without incident. He is now hemolyzing with a hemoglobin drop of 5-6 grams/dl. LDH has jumped to over 3000. Platelets are low. Antibody screen is negative in gel, negative in PEG using polyspecific Cooms.(also neg at room temp). Dat is neg both pre and post using tube and gel testing.enzyme screen is also neg. Any ideas as to what is going on? Thanks everyone.
  8. We had VSS 5835and got a few strong pos reactions on cell 3 which were negative with every panel cell. Ortho replaced it.
  9. Dr Pepper, I know its cold, I grew up in Farmington, NH. My Mom had a rule that said if it was below 0 she would give us a ride to school otherwise we walked. When I worked in Boston I parked over a half mile from work and would wear ski pants over scrubs on really cold days. The good part about retiring is that I won't have to shovel snow at 4 in the morning so I can go to work, it just can wait until daylight. By the way I have enjoyed bicycling thru Alfred. Pretty area. In the north you get cold and in the south you get too hot. There must be a perfect place somewhere.
  10. I think I will get away from the venting,(although venting can be very important to ones sanity at times) because although we have a few issues (generally minor, like not checking pending logs when they are supposed to and acting on them) for the most part my techs are very responsible and really take their jobs to heart. They all really care and I am so thankful to have worked with this group for the last 12+ years. I will be retiring Jan 3 and its been a great group to work with. I will still PRN a few shifts here and there but not as manager. I will still check in on BB Talk. Will have time to visit and spoil my little grandbaby. Hopefully get to move back to New England (New Hampshire or Maine), depends on the housing market. Anyway, Merry Christmas and Happy New Year to all of you. Thanks so much for this website, it is a great thing.
  11. Similar to above. The nurse (or courier) has to bring an issue slip with the product checked off. If we have the product reserved or crossmatched we issue it. It is up to the transfusionist to check the orders to make sure there is a "transfuse blood component" order. The issue slip must be signed by a nurse or physician extender or we won't accept it.
  12. We too, use bleach for monthly maintenance on the cell washers. But for the drains we got the plumbing guys to put little drain sinks in the counter for each cell washer. Works great. I
  13. we have done it annually up to now, but from now on it will be every 2 years.
  14. Since one cannot say that something will "never" happen or that it will "always" happen I think it is a good idea to verify donor units even if the donor system uses a computerized labeling process. We verify the ABO with A,B antisera for group O's and use A and B for the rest. We only confirm the Rh on Rh negative units.
  15. Good Morning fellow Blood Bankers, Just wondering how often do you review procedures and policies? Thanks for the input.
  16. I know a pathologist who got her own blood back post-op because "it was her own" and she was a "little low". She said she was never so sick in her life. Nasty febrile reaction to the cytokines from non-leukoreduced blood, even though it was her own. Needless to say, she is not a proponent of autologous blood being given back when not really needed, or could have been prevented.
  17. i agree, the PA's behavior needs to be reported. Years ago, I knew a surgeon like that, it was amazing the change in behavior once the chief of surgery had a little talk with him about his behavior. You will be protecting some new technologist from this woman in the future if she is stopped now.
  18. We are just starting the process of upgrading Cerner Classic to Milennium. Seeing as Classic will sinset in 2015 your facility will have to do something soon. The upgrade willl improve the blood administration part immensely. Nurses currently have to type in the whole ISBT number. Not good. Our facility has hired a Blood Bank consultant (not Cerner) to work with us and Cerner to make sure we get what the BB needs in this project; barcode scanning of specimens, products,and anything else. I think this will really help us, otherwise we tend to be ignored.
  19. We do some of this within our system. As long as it is within system I know of no issues. We can go ahead and result what we get because it is a shared computer system. We are also CAP inspected as a system . The 2 facilities that are AABB inspected are done as a system and the other 2 will get AABB next year and then will be part of that system inpsecton in the future.
  20. I have 2 PRN's who work a set schedule of Sat or Sun every week. They are also offered any additional hours that pop up. There are 3 others who don't have regular shifts. I send out e-mails to everyone and first come first served as far as getting the shifts. Hospital policy says they have to work at least one shift every 90 days or they are let go. After the PRN's extra hours are offered to my part time person and then to full time techs as OT. Last resort, I work it and take comp time off (I am on salary).
  21. We do not repeat special antigen typings. We only have a choice of currently serologically tested units or units that have been historically neg for an antigen. However, these historically neg units are not labeled as antigen neg so we not accept them. The only exception is when there is no typing sera available for a particular antigen but there are historically neg units available.
  22. We call the pre-op area and make collect the sample, not the actual surgical team unless it is an emergency situation. They have learned we mean what we say and they do it. Most of the time when the patient comes in for pre-op testing, if it too far ahead of time for the type and cross to be drawn the nurses order and draw an ABORH confirmation. If we don't need it (history already on file) we can cancel it. Then the TXG will be drawn in the pre-op area. If the sample was drawn ahead of time for the TXG the pre-op area will draw the confirmation. In the Children's Hospital the 2nd sample, whether confirmation or TXG, will actually be drawn in the OR because they want to wait until the child is asleep before sticking them again if it is a young kid. It take education, education and more education and a willingness to get yelled at for a while. You absolutely must your Medical Director on board and willing to back you up. You know of course, that every time you request a sample it is going to be a difficult patient from whom they can't possibly obtain another sample.
  23. We result directly into Cerner. Our Rh typing sera (Bio_rad) do not call for an IS, only for the 5 min reading so that is not an issue. We are still using Cerner Classic. Had the first meeting (of many) this morning with the consultant do the build for Cerner Milennium. Any advice for those of using Milennium on things to watch out for?
  24. Yes, we allow line draws. Many samples from the Children's hospital are line draws to save these kids from extra sticks. Our samples are drawn by nursing, so it does require some education, but we have not had issues. Its a bigger problem when doing actual venous draws and they draw to close to an IV line and then we get a contaminated sample.
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