[Weak D testing]

We only perform weak D on new patients who have no historical type.

[walking donor]

We have a list of walking donors who can be called the day they are needed to donate. But we do not cut corners with testing. Their blood/platelet products go through the same rigorous testing that "Joe the Plumber" has. You just can take chances.

[Blood Specimen for Plasma/Platelet transfusion]

We perform a ABORh for the first platelet or FFP order on a new specimen.

[Can't find expiration dates anywhere!]

We expire samples at 72 hours no matter the history. The exception is neonates in which we keep the sample until they are 4 months old or are discharged to outpatient.

[Specimen Labeling]

The medical record number is required by CAP. All of our sample labels are computer generated so the patient name, medical record number, and a accession number is always on the label.

[Specimen Labeling]

We use preprinted, computer generated, labels. The patient also has a blood bank ID bracelet which one of the numbers MUST be attached to the specimen. We also use electronic PPID which helps prevent mislabels. The nurse will scan the patient's armband, then the medical record number on the label. If there is a mismatch then the user gets an error message. We also require sample labeling at bedside.

[D positive apheresis platelets to D negative recipient.]

We only infuse platelets based on patient blood type, Rh does not matter. For example, O patient can receive any type platelet products. A patients receive A or we volume reduce other types and so on. The only type of platelets we transfuse are plateletpheresis.

[Just For Fun]

I worked with two medical students named Hurt and Butcher.

[Quiet!]

Our Blood Bank is segregated from the rest of the lab (behind a wall) so the noise is what we generate in the room. The only rule we have about interruptions is when we dispense a product. If we are interrupted in the middle of a dispense, we have to start over. So if anyone of us is dispensing, and someone goes to talk with us, we usually hold up a finger (index) and give the "1 minute please." The joke then becomes, "I have to wait, I just got the finger." If a radio is too loud, then we politely ask them to turn it down.

[Can we issue blood products for porters or nurses ?]

We ship the majority of our blood products through a pneumatic tube station. Blood Bank and the OR have the highest priority meaning if we hit the Send button, the system stops any other tubes from entering the system until the Blood Bank tube is delivered. For products that have to be hand delivered (syringe, saline resuspended, washed) the RN, LPN, or health unit coordinator can pick up blood. The paperwork, that goes with the unit, is two part so we can see who picked up the product and time and who hung the product and time.

[Validation HELP]

I am in the process of validating our Hematology analyzers to perform platelet counts on platelet rich plasma from our plateletphersis. Has anyone ever done this? If so, can you share what you did to validate, the statistical methods you used, and your acceptable criteria? The analyzer does not matter. I don't want to reinvent the wheel if I don't have to. Thanks!

[Transfusion reaction workups]

We use a Iris urinalysis analyzer. If the dipstick is positive for blood then the sample is aspirated by another part of the instrument, passed through a flow cell and digital pictures taken for the tech to review. Beats spinning them.

[Computer downtimes and Digi-trax]

Our HemaTrax is set up on our hospital network but can only be accessed by Blood Bank personnel. We have one dedicated computer, that is set up on a different hospital server, for downtime of the network. We use a general username and password, so that everyone can log in, and we have not had any problems thus far.

[Neonatal Transfusion Practice]

We reserve one unit per patient to reduce donor exposure. If the unit is close to expiring, and we can use the unit for another patient, we will release the product from the neonate and set the unit up for another patient so that we do not loose the unit.

[Confirmation of ABO/Rh Type]

We use a second ABORh typing rack with a different manufacturer of typing reagent. A second tech performs the type recheck using the different reagents. If only one tech is in Blood Bank (mostly midnight shift) then the same tech can retype the sample since a different set of reagent is used.

[Blood Ordering Policy]

Our physicians order the volume they want and if the patient needs volume reduction of platelets due to volume issues. All of our products are irradiated, leukoreduced, and tested for CMV status due to our patients being oncology patients. The Blood Bank determines the patient type and CMV requirements based on testing, diagnosis, and cytogenetic data. With our sickle cell patients, the orders for RBCs are for C, E, K and Sickle negative. We perform phenotyping on these patients at admission and then give products based on the information. The Blood Bank makes the decision as to whether a patient will get CMV negative products or not.

[Tubes of blood bank]

We switched from red top glass to plastic K2EDTA pink tops with no problems. The great part is not having to wait on the sample to clot.

[Hematology Analyzer for Donor Center]

For those of you who have validated a hematology analyzer for platelet counts on plateletphersis products, can you provide me with information on what you did to validate the instrument? I am working on validating a Beckman-Coulter LH 750 and DxH and need a reference point. My fax number is 901.595.4135 or you can email me at crystal.melloh@stjude.org. Than you in advance!

[Just For Fun]

We give volume reduced (plasma reduced) plateletpheresis for incompatible platelets. We have a patient that was transplanted and requires AB plasma products. I took a call last week from the doctor stating he did not order volume reduced but he did not want the patient to have a reaction or form an antibody (duh! neither do we). I explained that because of her plasma type requirement, and the fact we rarly have AB platelets, all of her platelets would be volume reduced. He ended the conversation with "are you sure she won't have a reaction?"

Crystal

[Platelet Counts on Platelet Rich Plasma samples]

We allow our products to "rest" for one hour after collection and the rock for another hour before sample collection. By allowing the platelet to relax, does this cause any microaggregates to dissolve causing an increase in the platelet count? If so, would vortexing the sample give the same result or would it activate the platelets making the counts even lower?

[Platelet Counts on Platelet Rich Plasma samples]

I am getting ready to start validation a LH 750 and DxH, both Beckman-Coulter, for platetet counts on platelet rich plasma. I have a few questions. Is there a certain amount of time that should elapse between the PRP sample being collected and the sample analyzed? How often should linearity for PRP be performed? We remove 3mL of PRP from our plateletpheresis product, place the sample in EDTA, and refrigerate. Is this the best storage option or should the samples be kept at room temp? Thanks!

[Hello from Memphis]

Hi everyone! I am new to the forum and am really excited about having someone to talk "shop" with outside of my employer. I work at St. Jude Children's Research Hospital as the Evening Shift Supervisor. I look forward to talking with you.