tubeshaker

Hi Donna, Good points, and I would concede on every one. I think the point I was trying to make was, at least at this facility, we were unprepared for the amount of work that would be going in to the project (and I can't say whether or not a salesperson was at least partly to blame for that) and didn't have the IT support we needed. I'm not trashing Mediware, our Implementation Specialist was fantastic and very patient with us, and like I said, the software looks great when you're seeing the finished product, just somewhere along the line (further up the purchasing chain?) someone was either misinformed or blissfully ignorant of the resources and personnel required to get it up and running. My part of the project was getting it interfaced with our Galileo, which took a couple weeks (while working on the side off the bench) came off without a hitch. Incidentally, I just talked with a former co-worker, and the first of 6 or 7 (can't remember) facilities within the organization sharing the software just went live this week, 2 years and 5 months after starting and I'm sure an embarrassingly huge sum over budget. Most people I've spoken to that have experience with HCLL didn't take nearly as long to implement, 3-6 months has been the average. JD

Hi Mearley, The best LIS I ever used was DBSS, the Defense Blood Standard System. Unfortunately, if you're not a U.S. military facility, it's not available to you. I do have one I would caution against, however. My previous facility had (is still having) extreme difficulty getting Mediware HCLL up and running. Everything is user defined, so unless you have a highly competent and invested IT department (we didn't), it can be very difficult to implement. It looks like a great package once you get it up, but their Mediware implementation project was started around February 2008 and they still haven't gotten to the final validation stage. It could have been limitations of the people involved in the project and other members may have had different experiences, but I would recommend being aware of the investment involved if you're considering this LIS. Cheers, J

Hi Goodchild, Here are some references: W.J. Judd and L. Dake. PEG adsorption of autoantibodies causes loss of concomitant alloantibody. Immunohematology, vol. 17, number 3, 2001. 82-85. Cid, et. al. Use of polyethylene glycol for performing autologous adsorptions. Transfusion, vol. 45, May 2005. 694-697. C.L. Barron and M.B. Brown. The use of polyethylene glycol (PEG) to anhance the adsorption of autoantibodies. Immunohematology, vol. 13, number 4, 1997. 119-122. R.M. Leger and G. Garratty. Evaluation of methods for detecting alloantibodies underlying warm autoantibodies. Transfusion, vol. 39, January 1999. 11-16. And an interesting one from 2003: Chiaroni, et. al. Adsorption of autoantibodies in the presence of LISS to detect alloantibodies underlying warm autoantibodies. Transfusion, vol. 41, January 2001. 651-655. If there's one you want but don't have access to let me know and I'll try to get you a copy. Cheers, J

I would take offense to being considered "only" a C, H, BB, etc. (and admit I'm a completely biased BB(ASCP)). A tech with a categorical certification is a Technologist, and I'll wager the blood bank-related questions on my BB exam were much more difficult than the blood bank questions on the MT exam. There are additional work experience requirements one has to fulfill to obtain a BB certification beyond that required for an MT (now MLS) certification (see http://www.ascp.org/FunctionalNavigation/certification/GetCertified/TechnologistCertification.aspx), so I don't understand any justification for paying someone with a BB less. It's a lot more work to get one, so if anything they should be paid a premium. A tech with a categorical certification has demonstrated specialized knowledge in a subject area, while a generalist MT has demonstrated generalist knowledge. A tech with a categorical certification should be expected to function at a higher level in their area of specialty than a generalist MT, that's the intent of categorical certifications. I don't think the regulators at the ASCP thought them up so that mentally deficient techs that can only remain competent in one area have a chance to work, too (I don't mean that with the mean spirited tone it's carrying, I just can't think of a more effective way to phrase it). Anyway, bottom line is, your HR department is wrong, the BB certification is not an "add-on" and it's not equivalent to a Technician certification, and if they don't value the specialized knowledge you've demonstrated you have then there are plenty of organizations that will. I see adverts all the time for blood bank techs preferring the BB certification over the MT. Many supervisor positions now advertise "SBB or BB preferred." Incidentally, you're a Technologist now, so you should drop the MLT from your credentials. You're a BB(ASCP)^CM, say it loud and say it proud. Peace, JD

Love it! It still amazes me that so many people use AHG containing anti-IgG and anti-C3d, when they are using EDTA plasma! Doh! :):)

Hi John, No, there was a perception that it could potentially cause harm to a D-positive recipient. Many of the policies in the institution were there not based on any rationale other than "that's the way it's always been." The practice was probably a holdover from the days when they were transfusing whole blood and no one ever thought to update the SOP. I look back nostalgically on pretending to read antibody screens from EDTA samples for hemolysis when it was time for internal competency evaluation. One of the downsides to low turnover, I suppose. Cheers, JD

Hi lalamb, The current issue of Transfusion has a relevant article: Katerina Pavenski, Theodore E. Warkentin, Hua Shen, Yang Liu, Nancy M. Heddle Posttransfusion platelet count increments after ABO-compatible versus ABO-incompatible platelet transfusions in noncancer patients: an observational study (p 1552-1560). Volume 50 Issue 7 (July 2010). Link (for those with online access to Transfusion): http://www3.interscience.wiley.com/cgi-bin/fulltext/123304739/HTMLSTART There is also an abstract available on PubMed ahead of print for another paper that should make Transfusion soon for a screening technique: Quillen K, Sheldon SL, Daniel-Johnson JA, Lee-Stroka AH, Flegel WA. A practical strategy to reduce the risk of passive hemolysis by screening plateletpheresis donors for high-titer ABO antibodies. Transfusion. 2010 Jun 23. [Epub ahead of print]. Link: http://www.ncbi.nlm.nih.gov/pubmed/20576015 Excuse the formatting variations, I'm cutting and pasting the citations from the web. The facility I worked in previously screened group O platelets for isoagglutinin titers less than 1:200, greater than this the product would be labeled "High titer anti-A/B" and given to a group O recipient only (with the previously mentioned caveats for RhD). I wasn't sure where this cutoff came from at the time, but I do note it's the midpoint of evaluated dilutions in the Quillen article. Cheers, JD

The facility in which I worked previously would transfuse units from donors with antibodies randomly for all but anti-D (excepting peds), and these we would only transfuse to D-negative recipients. In addition to the uses for the plasma proposed by Adiescast, I had an agreement with our community blood center to send me the antibody-positive units to use for antigen screening on the Galileo using the IgGXM assay. I built up quite a library before I left, and they really came in handy when you had to screen for multiple antigens (or even for 1 when the antisera was expensive). I could screen a couple hundred units for 3 or 4 antigens in 3 hours or so (using expired Capture-R Select plates). A lot cheaper than using up the commercial reagent (I'd only use it to confirm negative screening results) and we didn't have to rely on our reference lab all the time, which was about 2 1/2 hours away. Cheers, JD

Hello everyone. I'm J.D. from Lakewood, CA (for the time being). I'm currently an SBB student in the American Red Cross Southern California Region program. I was introduced to the blood bank as a military lab tech 11 years ago. After schooling, I didn't care what section of the lab I went to as long as it wasn't blood bank or a donor center. I was summarily assigned to a post where I would rotate between the blood bank and donor center. Luckily the operation was run by a fantastic pathologist with a passion for teaching who promptly changed my tune, and at this point I'd never go to any other section of the lab. I made sure of it by obtaining BB(ASCP) certification rather than a generalist license (although that didn't stop a former employer from rotating me through the STAT Lab regularly). I have looked back on occasion - I spent a little over a year working toward a PhD in biochemistry, but the prospect of working 16 hour days for the next 10 years as a graduate student and post-doc, as well as a completely dismal funding environment (I went through 3 advisors due to grant-maintenance issues before quitting) led me to change my mind about what I want to do when I grow up. I also tried a short stint in a University veterinary microbiology lab, but it wasn't for me, either. I missed the blood bank too much, so I went back. So, I've now hit the point in my career that it's time to take the next step and go for the SBB, and here I am. You can probably tell from this post that I tend to be long winded, and for that I'll apologize in advance for all my (hopefully) future posts. This is a really great forum and I hope to learn a lot from participating. Cheers, JD

Thanks for the replies and welcomes. All good points to consider, I'll share your advice with my classmate. I've noticed your observation about the trend in applicant pools, adiescast. My wife is a generalist MT and has been applying for jobs in the area but more than once has hit a brick wall when the hospital's online application process is not compatible with Apple's Safari web browser. Usually if Safari doesn't work then Firefox will, so it's more a minor inconvenience than anything. Anyway, off the point, which was going to be that yes, I think just about every hospital she has applied to has required applicants to go through an online application process. Thanks again, JD

Greetings everyone, I'm a new member, this is my first post, you guys have a really great forum here. I'm a student in an SBB program, and yesterday my counterpart and I were discussing when we should start looking and/or applying for jobs. This forum seems like the perfect place to solicit advice, so what do the folks on here think? We'll be graduating in late December, and I at least plan on registering for the exam as far in advance as possible so that I will be able to apply with SBB credentials right out of the program, but I'd like to get as much of a jump as possible. I'm not tied down to any geographical location and I've seen several positions posted online that look like great potential fits, but how long would a prospective employer be willing to wait for me (us) between submitting a resume and graduating? Thanks for any advice. J.D.