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ColleenA

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About ColleenA

  • Birthday 04/24/1964

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  • Location
    Chicago
  • Occupation
    Director of Transfusion Services,

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  1. We only have gel testing available in the US for the vision instruments.
  2. To determine the volume of an RBC unit we use an empty bag, usually a transfer bag and place this on the scale and then tare it to 0. We remove the empty bag from the scale and then place the RBC unit on the scale to determine the weight. We generally feel that for transfusion purposes this is close enough to the real volume to let things go with the weight on a small label. When measuring the volume actually transfused we rely on the infusion pump to see how much was truly infused. For quality control purposes, there are conversions for weight to volume. These are in the AABB technical manual. For RBCs from WB with no additive solution the specific gravity is 1.063, for additive RBCs it is 1.060. Just divide the wieght by the specific gravity to determine the volume in mL. Hope that helps, Colleen
  3. I looked at rates and we are at about 9 per 1000 RBC transfusions of course we get reactions reported for more than just RBC transfusions. Our reaction work up is also in 2 phases like others listed above and although we enter the reaction results in the computer system, our MDs who review the investigation like to see the manual worksheet. Just FYI we used to have the MDs sign the worksheet but often this was not completed. Last revision we took them off of it as the final consult from the MD is in the computer system which is stamped with signature and date. Did not want to get cited on another inspection for incomplete documentation.
  4. The issue that I ran into was not from the maufacturers of the heat block but the reagent manufacturers limit. When I looked at the product insert for the LISS and PEG that we use for tube testing they required a 37 +/- 1. The heat block allowed +/- 2.
  5. When I was previously over the QC lab at a blood center, we used the cutoff of 2.7 as it was within 10% of the 3.0 cutoff. This was something that our medical director came up with so nothing writen in stone. We tracked data for low counts to look at equipment trends and tried to make sure that it was not instrument or tech related. We did find a couple of instrument problems this way but often this can be donor related as well. Some donors just are stingy with their plts and you have to adjust the target level up for these individuals.
  6. I had a question from the Micro lab manager about how do people handle cultures when there is nothing left in the bag? The transfusion reaction either occurred after the unit was already transfused or they gave the rest of the unit anyway. She said that they have added saline that is supposedly sterile but when the culture is positive it is hard to say with certainty that it was really the unit and not the way that the culture was performed. Thanks, Colleen
  7. I just wondered if you did nay typing on the patient with anti-A,B? Does your blood center perform titers of anti-A,B on their PLT donors? Could there have been a high titer anti-A,B in the PLT donor that recognized the A antigen on the patients weakly positive cells? It seems I only have questions and no answers.
  8. The expiration for the frozen pool is 1 year from the earliest collection date for the individual units in the pool. IF one unit is collected 8/10/11 and the other 4 units are collected 8/12/11 the expiration on the frozen pool is 8/10/12. Once the cryo is thawed it is good for 6 hours with a closed (sterile connection) system. We applied for licensure without the sterile connection and FDA would not approve it unless we used the sterile connecting device.
  9. I left the blood center a couple of years ago but was there when we implemented the pooling process. You can get the pool bags from Charter Med that have 5 or 6 or 10 leads to sterile connect on the single cryo units. We pooled in groups of 5. We made the first stage and waited till testing was complete and actually labeled the units so that we could pool the same ABO units together. It would have been a pain if one of the units tested positive after it had gone into a pool. A very expensive lost pool. We thawed the units in a cold water bath and spun the units down like we were making single cryo. We left slightly more plasma on the units (20-25cc) so that we did not have to add saline and track that additional information. Then we sterile connected the 5 units and massage the cryo into suspension. Hung the units to drain into the pool bag and put them on dry ice to freeze quickly. We had a 1 hour limit from the time we took out units out of the water bath until we put the units on the dry ice. It was tough but we processed in batches of 12 so we usually had 2 pools and 2 singles but had a couple extra if one of the bags broke in the water bath. Hospitals love these and now that I am on the hospital side we do not order anything else.
  10. Precounts are helpful and the higher the count the more likely a unit is to split but it depends on what type of apheresis machine you are using. You may want to talk to the vendor to see if they have any guidance as to what pre-count is likely to split on that particular machine. Most of the newer machines have you program in the height and weight of the donor to calculate the total blood volume and then incorporate the pre-count to figure out what type of collection they are eligible for. The other variable is time. The longer a donor sits on the machine the more plts you collect and the more likely you will have split units. It depends on how nice your donors are and if they have extra time to stay on the machine. Good luck.
  11. The filters that we use are distributed by Fenwall but are called Sepacell filters. The 5 days that I was referring to are that you have up to 5 days to perform the sterile connection and filter the unit. This is listed in the manufacturers package insert.
  12. Most of the time when you filter after the collection it is just the RBC that you are filtering. The usual processing of the WB into the RBC and FFP are completed on day one and then after the units have been tested and found to be acceptable you can sterile dock on a LR filter to the RBC. The ones that we use are good for 5 days after the collection. This is still considered pre-storage LR. It is easier to get a WB to go through a LR filter but if you have additive RBCs you should not have too many issues. The only other problems we have had are with donors that are hemoglobin S positive. These units are known to cause filter failures as well as QC failures when counting WBCs to show LR. Good luck.
  13. We had the exact same issue and went back to the product insert and found the centrifuge time to be from 15 to 45 seconds. Of course staff automatically spun at 15 seconds as that is what most other tube testing requires. We moved it up to the 45 seconds and I have not heard any issues for the last month.
  14. When I was at a blood center we switched from the Charter Med syringe set to the Caridian sample set. We had issues with the Charter med set leaking where the syringe connected to the tubing. It needed to be checked manually to make sure it was tight before you started and ocassionally it had a crack that could not be detected. We wrote an abstract for AABB (I think 2007) on the cost savings we had when we switched because of the units that did not have to be discarded due to contamination. The cost was about the same for both devices. Hope this helps.
  15. Not sure where you are and who you are inspected by but if AABB or FDA come and visit you may need a validation plan that has been approved and signed off prior to actually putting the equipment into use. This should include IQ (Installation Qualification) appropriate plug, room for ventilation, door that has room to open, OQ (Operational Qualification) make sure that the temperature is set correctly and that the alarms are working as expected and PQ (Performance Qualification) make sure that it runs for specified period of time and is monitored (we check ours every 4 hours for 24 hours) usually checked empty and then filled.
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