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mollyredone

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Everything posted by mollyredone

  1. mollyredone
    I know this is an older topic, but here is a copy of our high risk/emergency release form. When it is emergency release for the ED, we are not as picky about getting it back, usually give it a day. When we know there is a problem with a warm autoantibody or non antigen typed units for an antibody patient we require the form be signed before issuing any units. HIGH RISK TRANSFUSION & EMERGENCY RELEASE FORM.doc
  2. mollyredone
    We do have a committee, but it hasn't met in a year or so...I do audits monthly-PRBCs one month, PPH the next, FFP the next, so each is done quarterly. I check lab values, diagnosis, whether the documentation by nursing is complete (start time, 15 VS check, done < 4 hours and consent signed. Then I do a wastage/usage check for all, including how many patients got PRBCs, how many products expired, transferred, destroyed, etc. I also do a report quarterly for units of PRBCs crossmatched vs transfused. We are very proactive with transfusions and will call the floor or doctor if we feel it is inappropriate, i.e., platelet count >20<50 we will ask, what kind of procedure is the patient having. Our computer pops up with appropriate labs (if PRBC ordered, H&H) 1) when product is ordered, 2)when workup is done and 3)when product is issued, so we wouldn't issue a PRBC for a Hgb of 10.
  3. mollyredone
    We have Meditech 5.67. When products are ordered from the floor or in the lab, they are either PPH, PRBC, or FFP with appropriate CMV or IRR properties if needed. In our product menu we have apheresis platelets of PPH, PPH 2 or PPH3, red cells are PRBC, ARBC or ARBC 2, FFPT, AFPT and liquid plasma fall under FFP. Does that make sense? ETA: in our external reports the products are only reported out as the first three items.
  4. mollyredone
    We keep 4 A liquid plasma in rotation. We got that approved with the Trauma Committee for emergency release as well as Massive Transfusion Protocol, citing several studies. It's easier to keep on hand than AB liquid plasma. Doctors can't order it, we just substitute it as necessary. When the expiration date is close, we will use it on in or out patients as compatible units.
  5. mollyredone
    Yes, Magic has BBK history files. But I don't know about BBK History desktop. Our BBK history is a separate entry under BB in Meditech. I did find a place where you can change crossmatch type for a particular patient, but we don't have any options built in there right now. We'll try to get Meditech to build in the three XM types so I can select XM GEL. Is C/S more like a Windows setup or is it still DOS looking?
  6. mollyredone
    Is that for 5.67 Magic? That's what we have. My IT guy isn't familiar with the BBK History desktop. Appreciate any help.
  7. mollyredone
    Does anyone know if you can modify Meditech 5.67 to automatically order gel crossmatches on a patient with a history of an antibody? Right now, we have to remember to TNP the IS crossmatch and order XM GEL.
  8. mollyredone
    Here is our QC sheet. We have an "extra" QC sheet for each month to document lot changes during the day, or 3% screen QC. We document it in the computer. Daily QC Template Master.xlsx Hope that helps.
  9. mollyredone
    Our Hematrax is not connected to Meditech.
  10. mollyredone
    We are not AABB inspected. We got approval from the trauma committee to use type A liquid plasma as the first two units in an emergency release or MTP. If the patient has a documented historical blood type, we have to issue them in Meditech as emergency release, otherwise the computer won't accept the incompatible type of product. We can also issue it using paper forms. What does standard 5.15.4 say? I'm not finding it in my book.
  11. mollyredone
    We are fine with the Mobilab labels, but do print Meditech labels because Moblilab doesn't have the small separating tags which we use to label our gel cards for the antibody screen.
  12. mollyredone
    We used to use preprinted labels and hand write the ex date and time before ISBT. Our labels for FFP were from Shamrock.
  13. mollyredone
    I figured out that you can't upload files in IE. So here is my paper transfusion form. HIGH RISK TRANSFUSION & EMERGENCY RELEASE FORM.doc
  14. mollyredone
    We have 5.67 and we use the account number, since that changes with each visit. The nurses scan the wristband first and then the four (or five) barcodes on the unit. We have a hematrax to print lower half labels when we thaw plasma or cryo. We do have to remember to input volunteer donation, as well as the expiration time being the same as the component was made in Meditech, not 2359 as we did previous to TAR, otherwise it won't match Meditech when they scan it.
  15. mollyredone
    Maybe it just doesn't work in IE. I am in Chrome now. So here's our form: QUARTERLY BB ALARM WORKSHEET.xlsxQUARTERLY BB ALARM WORKSHEET.xlsx
  16. mollyredone
    I tried to upload my form, but it says there is an error with the upload. This happened the last time I tried it as well. Has anyone else had any problems with uploading?
  17. mollyredone
    Dr. Pepper, we have had to order antigen negative units on a nightmare patient-16 recently-with anti-S, anti-K and anti-C. Her phenotyping says she is negative for Fyb, so we are throwing that one in as well. She also has an HTLA antibody, so half the units we were getting were incompatible by gel. I discussed the situation with the reference lab and we decided to do a full crossmatch in tube instead of gel, since our compatible rate was only 50% in gel!
  18. mollyredone
    We are not going to use them because you have to test them if you use them after the 5th day. Our blood supplier is very good about swapping out our platelets.
  19. mollyredone
    We do as Underwood does. We've been burned too many times. We had a patient come into the ED with a hgb of 1.9, not actively bleeding. An MTP was called. They only used 1 PRBC and 1 FFP and then transferred him to the floor. Surprisingly he survived, although he was ultimately transfused with 7 PRBCs, 3 PPH and 2 FFP, discharged after 10 days.
  20. mollyredone
    I do two pos, one neg for screen and one pos, one neg for DAT twice a year.
  21. mollyredone
    When we print our new ISBT label with current product (thawed) and expiration time it also states that it should be stored at room temp.
  22. mollyredone
    I'll ask the IT guys. We use a bi-fold tractor feed card that prints a unit tag and a unit ready slip and it is programed to print the cards automatically once the unit is issued through emergency release. We have to manually print the transfusion forms since ED and OR are the only departments that will not use TAR (they're special) for transfusion data.
  23. mollyredone
    I'm in Oregon. We use a local blood bank in Eugene, but they have just affiliated with Bloodworks NW in Seattle. I think Mabel was saying that Red Cross was now doing something like that as well. In turn, if we have to antigen type a bunch of units we will fax our typing worksheet to Eugene so they have more historical data to input! I just found out that our blood supplier is sending units to Puerto Rico due to the Zika virus.
  24. mollyredone
    We are lucky because our blood supplier sends us a historical antigen database with each shipment. Of course not all units are on there, but I can quickly sequester Jka- units with a tag that says historically negative. I print out the database each week, separating units by antigen, so you can look down the list for the right type and antigen and then check to see if it is negative for any additional ones you might need. Our supplier will also send us historically negative units if we ask for them for no extra charge. We have to type them in house and tag and charge for them. We also put a copy of the antigen typing worksheet in the patient's antibody folder.
  25. mollyredone
    We also have Meditech. We do pretag 2 ON units and 2 OP units with our downtime forms, unit info and temperature indicators and save 2 segments in a cup. We also prelabel our emergency release form with the unit stickers and information, along with a copy in case the first one gets lost before it is signed. We also keep a box with ice ready on every shift, which is replaced if taken. And we rotate the units when necessary. However I encourage techs to issue units in the computer if we have a patient name. It's better documentation that way. The unit tags print right after the units are issued, so we tag them and box them, then print paper transfusion forms, since the ED doesn't document in the computer. I would say it takes 5 minutes to do it that way if the tech isn't totally rattled.
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