Jump to content
April 2024 Challenge

DOGLOVER

Members
 View Profile  See their activity

  • Posts

    155

  • Joined

  • Last visited

  • Days Won

    2

  • Country

    United States

 Content Type 

Everything posted by DOGLOVER

  1. DOGLOVER
    All our cord blood orders have an order for a DAT with them, so it is just as easy to wash tubes for the ABORH at the same time. Works well and prevents problems even though it probably isn't reeally necessary.
  2. DOGLOVER
    We are just starting the planning process for upgrading from Cerner Classic. Our EMR is Cerner so it should work well. Our health system has hired an outside expert to help set up the system to do what we want it to do. He has extensively worked with Cerner and seems to know what he is doing. I think the biggest issue for GilT is the lack of corporate support. It is absolutely necessary that the BB be fully involved, otherwise no matter what system you have it is not going to work. Cerner may not be the absolute top of the line, but it does work well and definitely can be configured to your needs.
  3. DOGLOVER
    Our local donor center will come in and do the occassional therapeutic phleb when needed. That way it is under their medical director and we avoid any issues that way.
  4. DOGLOVER
    At the time of logging in the units, we remove 2 segments; one for confirming the unit type and the other is saved until 10 days after the unit outddate in case of delayed reaction. We store them in plastic bags with the date of receipt, the date of outdate and the pitch date. These are kept in order in a couple of boxes in the bottom of one of the fridges. Each night the night tech pitches whatever bag or bags are ready to go.
  5. DOGLOVER
    All of our neonates receive group O irradiated, leuko-reduced red cells. They receive AB platelets and plasma. Have never had a problem. Also many times sickle cell patients get group O, if necessary to match their phenotype (if they have an antibody). Also if there are short dated O's on the shelf anyone can get them.. I think your medical director needs to have a discussion with the physician who refuses to take what the Blood Bank gives and explain that the Blood Bank makes decisions based on availability and inventory control. What would this doc do in an emergent situation where you are issuing uncrossmatched O units?
  6. DOGLOVER
    We check by name and match birthdates (where are multiple names the same). Pick up an aamazing number of duplicate MRN's. Once we have a name and birthdate match, we match the SSN. We have to do this,e ven beyond the duplicate MRN issue, because we are a 5 hospital system with 2 of them using different MRN's. I don't think the duplicate problem is going to go away anytime soon, esp since pts give differing info many times. Sometimes they give a middle name, sometimes use maiden name as middle initial and who knows what else. Good luck, we all just do the best we can.
  7. DOGLOVER
    I have seen a couple over the years. The first one was a long, long time ago and was on a dialysis patient. In times past anti-N was not uncommon in dialysis patients. The other as I recall was IgM and prewarmed away . Looks like you've got one of the antibodies that make life interesting in the Blood Bank
  8. DOGLOVER
    We have dedicated Blood Bankers (no generalists) and all can override if needed.
  9. DOGLOVER
    I can't think of any transfusion service which allow them to not draw a specimen. At my facility we give them O neg uncrossmatched units, then heckle them if we don't get a sample in a reasonable amount of time. They are usually pretty good about it.
  10. DOGLOVER
    If you are doing electronic crossmataches, could you not stock a small Blood Bank refrigerator in the L-D area with 2 or 3 O neg units and do an electronic xm if needed. Have a printer next to the fridge which would print out the label/tag for the unit. Of course, the L-D personnel would have to be well trained in taking the correct unit and labeling it. (that's why I say only O negs). You would need to have someone monitor temps.
  11. DOGLOVER
    Are you referring to the use of leuko-redeuction filters or the use of regular blood filters which is of course required even if the units are leuko-reduced. Our entire supply is pre-storage leuko-reduced, by our supplier, which is the most effective way of doing it.
  12. DOGLOVER
    Thats basically what I would have done. Do you only have one panel? Do you save outdatedd panels for selected cells, so that you could find more than one "rule-out" cell. That is a great help, as long as you run appropriate QC.
  13. DOGLOVER
    check with your vendor. You may be able to buy label stock that the bottom right corner is perforated and stays behind when you peel the label off its backing. I have some, got them by accident and we are using them up. I am not in a Red Cross serviced area so haven't had to deal with this.
  14. DOGLOVER
    We issue products in paper bags, but that is only for esthetics.and patient privacy. I don't know of any standard, although I have never actually been inspected by Joint Commission (except as part of a tracer) because we are CAP and AABB accredited.
  15. DOGLOVER
    It sounds like you folks need to speak with your lab director about this. How are you answering the CAP standardTRM.40300 if you don't have a historical record?
  16. DOGLOVER
    We have an emergency issue form that we send with the first units. It will have the unit#s on it. The physician signs (either then or later) and returns the form to us. We just add more unit numbers to it as needed.The doc doesn't care what the numbers are. That is really for us. The form also has a line on it that says ABC_______________for XYZ_______________MD.for use when the physician is unable to sign but has verbally told the nurse to get emergency blood. That is rarely used. We also attach transfusion tags to these units that can be scanned into the EMR later, because otherwise when there is a big emergency it probably won't get into the EMR properly. (In our system the unit numbers have to be manually entered because the EMR doesn't "talk" to Cerner Classic except for orders and resutls to cross.
  17. DOGLOVER
    Having worked in Boston , I had no doubts but that the hospitals would be able to rise to this sad occassion. My daughter is a physician at MIT. She was actually in NY at the airport when the bombings happened. When the shootout happened she said it was unreal, continuous sirens and helicopters overhead. She got a text from MIT that night,saying don't come to work. Pretty scary. Hope and pray that this is truly over. Also pray for the folks in West Texas.
  18. DOGLOVER
    We do type and screens on all Moms when admitted to L-D. If pos due to RHIG we do a mini-panel.(We use gel).That way if something goes wrong and an emergent C-section is needed or there is a lot of bleeding we are "good to go" We do have a high risk obstetrical practice.
  19. DOGLOVER
    Very helpful. Thanks very much
  20. DOGLOVER
    Does anyone have a photograph of tube reactions graded weak to 4+ that they would be willing to share? It would be helpful to students. I had a nice one in the manual in the Massachusetts hospital I worked in a long time ago. I'm hoping someone has one. Thanks in advance for any help.
  21. DOGLOVER
    We use all irradiated apheresis platelet products. We did this for better inventory control and to eliminate risk of someone grabbing a non-irradiated unit inappropriately. We charge the cost for the irradiated products. We got medical staff approval so that all platelets are considered to be ordered as irradiated. Red cells; we keep 2 separate inventories. I would like to have all irradiated, but financially I can't get it done.
  22. DOGLOVER
    We send WAAs to our blood center reference lab. Usually we are provided blood that is compatible after absorption.Once in a while just phenotype matched if the situation is more urgent. Either way, the physician has to sign an incompatible release form.We will fax it to them and they can fax back, or give a copy to the nurse so the doc can sign when making rounds. Several of the hem/onc docs are proactive and come and sign the form before we even have the blood, just so they don't have to do it later. One release works for the entire admission. If they leave and come back we require a new release be signed. A pathologist can approve letting the physician sign the form after the fact if they have personally discuseed the situation with the MD.
  23. DOGLOVER
    Well, the guy said it is not unusual for them to get 50 or 60 calls about something, so I guess it has to be more than that to really get their attention.
  24. DOGLOVER
    You are right, I was basically told by them last week when I called about the Mi(a+) screening cell that they don't do anything unless they get a lot of calls.
  25. DOGLOVER
    I give them to our Medical Library every year and they are delighted to get them.
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.