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lalamb

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lalamb last won the day on May 18

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About lalamb

  • Birthday 01/01/1960

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    California
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    CLS

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  1. This is from our policy. We currently don't do "c" so we've noted "not applicable":
  2. We require another sample of a different collection event, prior to transfusion. Believe this is in the new AABB standards. The computer automatically orders a no charge forward and reverse retype, if the pt has "No Hx". We actually found a mislabeled BB specimen, once. Discovered when tech did the rpt on a diff sample and got a diff aborh.....
  3. 2.2.1 Pathogen Reduced Platelets and Cold Storage Platelets are not to be accepted and must be returned to the supplier. Why do you not accept Pathogen reduced plts? We are switching over to Psoralen treated plts, but have never transfused plt to any baby.
  4. Related question: How long do u keep the anagrams of deceased persons?
  5. our clinics that have the Abbott ID Now use a splash guard, just like main lab. Our main lab cepheid and Biofire are set up under the hood. Our serology strep kit is still done on the bench.
  6. We require a banded sample and an aborh for yellow products. The typenex band works w/nursing bb trxn software, Bridge. We use Cerner.
  7. On our "UA w/culture if" orders, we reflex to culture if: Dip is Esterase +, and/or Nitrate+ Slide is >5 wbc and/or >1+ bacteria If specimen is a cath specimen, any bacteria will trigger a culture.
  8. Encounter or every 3 days. This is also so a valid BB band will work with nursing transfusion software.
  9. ED nursing staff draws rainbows labs on all patients, so once labs are drawn a bb spec is included. Most of the docs are good about lab notification and samples, being a priority. They know we only have so much blood in stock. If we' get a call asking for a 2nd pair of o negs ( 3rd and 4th unit), before hanging up the phone we remind them we need a sample. Sometimes we don't get one as some pt's are shipped out quick.
  10. Thanks. Well, the latest from our microbiology department is a book referencing Ames media as a transport media. So, still looking for a reference source that sites Saline ( even though it's been used for ages and I'm sure is fine )
  11. Hi all - How do you prepare your wet mount specimens? Have seen adding 1-2 drops saline to the swab (ancient policies and the Dr's UpToDate ref source)- reason being you don't want to dilute the sample? and 0.5 -1 ml of saline ( other hosp's in our organization) - reason being you don't want the cotton tip to dry out. I also think that if you add more liquid, you get more uniform distribution of your sample. Have asked our micro dept, but have heard nothing yet.
  12. We used to have Mysis/Sunquest...Cerner is SOOOO much better. Our build was a disaster. We hade a good BB'er on the project but as it went live on all hosp sites, continual amendments were made. Here's a few suggestions....if you haven't covered them already Under ABORh typing: the "HX" drop down box. It means if there is a hx for the patient... not if a hx check was done. Name the choices "Hx yes" and "Hx no". Make the choice "Hx no" reflex to an ABORh recheck orderable.If an ABORh is ordered, the result will show up in the patients demographics box on the top. If an ABO and a separate Rh is ordered, it will NOT show up in the patients demographic box...something to consider "fixing" If ER orders an Rh only...make it an ABORh so you can collect a full type for your hx file..? . If patients are transferred to a sister hospital, the ABORh will NOT be visible to any of your sister hospitals (if you share patients and their records) but the Ab / Ag and BB comments info will.?????? We are part of a lg chain w/4 hospitals in the same general are. It's not uncommon for pts to transfer to a sister hosp. Our issue is in the "patient reconciliation" process(Some Rn on the build decided ABORh is so impt new facilities should repeat it every time ...like some tech is really going to issue based on historical type...)Make sure the types are viewable in the demographics box...can be used as a hx reference.If you can't do this, manually copy the abo recheck in the Blood Bank tab...info in the Blood Bank, Comments and Notes tabs follows the patientCord Bloods We just got a Mother -Baby...pt relationship link which is a small icon in the upper R corner of the pt demographic box. I think it's part of the new OB administration program.. Makes it a little easier to see who's baby is linked to whom. If the Fetal Screen is pos, have it reflex to a KB. Weak D testing Reflex If a baby is D neg ( and the mom is D neg) -" Perform" the Baby's results (NOT " Verify"), exit the program, reopen BB results, rescan in the Acc # and the Weak D test will be added to the acc #. If you could make that a reflex, WOW, but I don't think the system can search and interpret the babys and the mom's data. Pos ABSC. If an ABSC is resulted and Verified as Pos, it will reflex to an AB ID. Make the AB ID column less wide. All results are small in width. The process for adding multiple Ab's (and Ag's) is cumbersome. When you verify 1 the computer will ask you if you're done. You can say NO and rescan in the acc # and reenter another Ab, or you can use the "Insert Line" icon on the top. This is a little cumbersome. You click on an empty row below your last entry,then click the "Insert Line" icon on the top Left and then choose to add a Line or a Cell (I don't understand the diff between the 2). It adds another line under the orderable and you place your 2nd result there. You can insert as many lines as you want....This is handy when entering a full phenotype results from the ref lab. Ag typing results The orderable for this is Ag typing or Ag Hx (no charge dropped..if the ref lab does the typing and you are entering the results) Ref lab billing is separate. There are many reaction columns to record results done at ie IN, RT, AHG, CC. Suggest the result column at the far R is much smaller. Makes it easier to double check your entry. the brain is overwhelmed...more to come
  13. We are writing a new cryo SOP ....our facility hasn't stock it in the past. thought I had it nice and simple, included the "Suggested Adult Flow Rates" from AABB,then a question popped up... Dr wanted to know how to calculate how many units to give? Pt in question is vWD, (unsure if they'r Type 1,2 or 3), slow abd bleeding We rec pooled units from our supplier ( 1 pooled unit = 5 single untis) The tech did a good job of researching it but the math looks cumbersume, and there are multiple formula. What do others do....if anything? Our local university said: give 2 pooled units for an adult, and a 3rd if they need it. A provider on line organization said: same as above AABB : dose(untis) = (Desired fibrinogen increment in mg.dl) X plasma volume (dL) / 250 mg /unit Circular of information (2009) : for fibrinogen: # of bags = 0.2 X body weight in kgfor Factor VIII: # of bags = desired increase in F8 level in % X 40 X body weight in kg/average units of F8 per bag. Circular of Information (2013) : for fibrinogen: # 1 bag per 7-10 kb body wt t raise plasma fibringon by apporx 50-75 mg/dLfor Factor VIII: # of bags = desired increase in F8 level in % X 40 X body weight in kg/average units of F8 per bag. ????????????? hope I transcribed the formula correctly
  14. Our ER routinely draws a rainbow whenever they start an IV. They are dropped off at the lab and spun. Vast majority of those get orders. We periodically call ER with "where's my orders?" if the tubes sit w/no orders appearing. During AM draws, phlebs will draw an extra grn if only a CBC is ordered, and visa versa. Has saved the pt a stick on more than 1 occasion. Doc's can order a Band 'n Hold. Same principle as others...no charges are dropped, we spin it, report it as "Received", and write the name on the board as a quickie reference. Get them mostly from OB and ER. We did a $$$ survey once..and were told not to draw extra tubes. Don't know if they considered phleb time /cost in having to redraw tho...
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