BrianD

we allow tube transport in our facility to only specific areas: 1) Emergency Department, 2) CVR (post cardiothoracic surgery recovery unit), and 3) critical care units. A tube transport request is submitted with all the appropriate identifiers and a copy of the physician's order indicating the unit is to be given immediately. the request and a copy of the physician's order are kept in the BB and we haven't decided how long we'll keep them yet. the tube transport request also includes an area indicating the name of the nurse initiating the request, who shipped it, and there is documentation of a phone call confirming receipt of the unit and by whom. confirmation should be made within 5' of transport. only packed RBCs and plasma products can be sent via tube transport since the vacuum and somewhat physically violent passage in the pneumatics activates the platelets in our experience. no significant hemolysis was detected during validation for the PRBCs. we were actually surprised, the blood bank staff was actually expecting the pneumatics would rupture the blood bags or hemolyze them.

hi Donna, you've repeated the argument i made but i don't make the policy. fortunately, the issue resolved with later lots and now we are immediately going to the ID panel after a positive ab screen using the ECHO. whatever it was that Immucor "fixed" has us back to a high degree of confidence with the Ab Screen. if it is positive, we almost certain to find something on the ID panels (we do Ready-ID and Extend I and Extend II as needed).

hi Donna. i know she completed an MLT program and has been credentialed. the program she's from isn't known for academic rigor (the students don't have to compete for placement) and as best as i've been able to determine they have no training in ethics. i hear rumours of the BOR withdrawing accreditation for the program because the percentage success rates for passing registry are pretty dismal.

hi Brenda! normally, we do our best to antigen match as closely as possible for our sicklers. this patient, ultimately, was able to resolve crisis without transfusion. she did become a "frequent flyer" with us for about 3 years before succumbing to CAP.

at our facility, we ran the ECHO DAT with an ID panel but the cost in time and materials was a bit too high so now, a manual (tube) ab screen is performed through the AHG phase with an auto-control to confirm positive ab screens from the ECHO. we went to this protocol after having an unusual number of positive screens due to "non-specific adhering factors" that couldn't be reproduced via tube testing with PEG.....this problem has not been an issue with later lots of Capture-R and we will soon stop confirming the positive Capture-R by tube testing and simply perform a manual DAT while we wait for the panel(s) to complete on the ECHO.

This falls under "scariest things i have heard:" i had a new graduate assigned to my team and she was posted to the blood bank. we had a young woman in sickle crisis admitted to the critical care unit with orders for only a type and screen. the antibody screen was positive and the antibody was identified as anti-E. our policy is to find and cross match 2 units negative for the offensive antigen regardless of there being a physician's order or not. i came into the blood bank to review the work up and found no units had been screened. when i asked, "why haven't you completed this patient's work up?" her reply chilled me: "Oh, she's going to die anyway." i never expected to EVER write up someone for depraved indifference and disregard for human life. she runs a centrifuge in our separations department and will be leaving soon to attend "beauty college." for some reason, i don't think i'd want her to touch the hair of anyone i cared about....