LABLAD42

Neonates first sample is usually O negative that does not require a second sample( exemption) ABORH on second testing you have a history on first draw . So what is the complication?. At 4 months there is antibody production that requires TS . But first sample drawn or second on heal stick. We have a secondary Policy PWS Phlebotomy Witness Statement that requires two signatures upon witnessing the sampling or drawing of the blood at Bedside Requires two person ID on drawn just as giving besides ABOrecheck policy and corrective action upon any deviation with computerized tracking of any deviation.

I think more than anything the inspectors are looking at notification documentation and preliminary notification. I include a form in each Tx rx workup and they never have given me a hard time. My former boss drafted the form after a citation that was corrected . I use it since and had only compliments since.

August 19, 1994 MEASURING HEMOGLOBIN CONCENTRATION AFTER TRANSFUSION. AS Brett reviewing Wiesen AR et al. Ann Intern Med 1994 Aug 15. At what point after blood transfusion is it possible to get a reliable measure of the increase in hemoglobin concentration? These researchers tackled this question by measuring hemoglobin concentrations in 39 patients 15 minutes, 1 hour, 2 hours, and 24 hours after the patients received two units of packed red cells. None of the patients had active or recent bleeding. The mean baseline hemoglobin level was 7.4 g/dl. Fifteen minutes after the transfusion, the mean hemoglobin concentration was 9.4 g/dl, and remained at this level throughout the first 24 hours. Various clinical variables such as body size, recent diuretic use, or duration of transfusion did not influence these results. AS Brett Comment Determination of hemoglobin concentration 15 minutes after transfusion of packed cells accurately reflects the steady-state concentration for the next 24 hours. When a measure of the effect of a transfusion is needed, a single hemoglobin determination shortly afterward is sufficient. Citation(s): Wiesen AR et al. Equilibration of hemoglobin concentration after transfusion in medical inpatients not actively bleeding. Ann Intern Med 1994 Aug 15 121 278 280 PubMed abstract (Free)Web of Science - See more at: http://www.jwatch.org/jw199408190000005/1994/08/19/measuring-hemoglobin-concentration-after#sthash.YLIdWCz2.dpuf

All products Pharmacy we just release by sending approval after testing Rhig

ECHO Immucor 8 year user excellent ! great service and price have used Gel Ortho also good results both I prefer Immucor for automation but Ortho is a great backup

If your DAT is negative or auto control is negative and positive ECHO is inconclusive then change methods to Peg or if MTIDS ORTHO gel. if negative then Non-specific Solid Phase Dependent Antibody ( sometimes related to Liver disease or TPN alimentation ,cross reactions or (may be IgM to -IgG phase development see above) after 2 negative encounter post NSPDA change to negative screen delete history cross due to cross reaction.

I have a log with Saline lot# ,Lot# of PBS,date opened(in use) ,expiratiraon(30days),visualcheck ,PH in range,High and low of Control buffer,Tech Intials,

I don't want to call them negative if the are just weakly positive There is a difference between just weakly positive and Du positive. If the patient gets tested at another hospital,I don't want him to say the he tested negative previously unless,it's just Du pos. If you are interested .write me at lablad42@aol.com and I will fwd the pics I took of a case I had.

I agree that pre-printed labels can introduce error, specially for employee`s that do not understand the importance of bedside labeling. The hand written labels can also introduce spelling and numerical errors. The solution how ever is very strict no-tolerance requirements from deviation policy,alot of documented education.Followup to making sure it is everyones is doing the same thing the same way. I have found that the bar code indentification system is not only a real tool for transfusion identication but also pharmacy, So talking about safety, it is priceless as our lives.

I worked for a Emergency Trauma Center and giving O negatives are always viewed as a last resort, When a John Doe or Jane Done enters the ED, it is given a T number, or a trauma number in case they are many following unidentied patient. It is a unique identifier besides the BBID # , temporary medical record number. Also barcodes are the new recommended standard that is being adopted. The patient should have a blood sample immediatedly drawn before any Type is given so that blood supply is not wasted. And a virgin,reference sample is availlable, and further transfusions can then be swithed to the correct group. Some hospitals are giving O Pos for Non-childbearing age patients to help the shortage of Oneg. When time is important, pre-planning can mean the difference between correct action and saving a life .

When we started testing with the Echo we encountered that a few weak D would test as negatives since the Echo use both series 4D and 5D for testing and found communication from Immunor that required further manual testing of the Rh negatives,manualy,Previously we did`nt have such problems with the Monoclonal D Blend done manualy. However by using the alternative D(more expensive) on the negatives, and or incubating with Monoclonals Blend at 37. We are able to confirm the weak D previously missed. Physican education should be an important ongoing processs. Unfortunately admistrative priorities seems to be in the direction of profit vs qualiy these day...