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mollyredone

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Everything posted by mollyredone

  1. mollyredone
    Well, I have never used it, so I guess I'll throw the formula away! I guess if the positive control doesn't work, we would send the test out for fetal hemoglobin F.
  2. mollyredone
    This was an emergency release situation, so there was not time to complete an "empirical" 40 minute crossmatch or the antibody screen. The doctor declared it an emergency, not the blood bank. As I said she had comorbidities, but we still had to write it up as being against protocol, issuing units that had not been screened for Fya.
  3. mollyredone
    I found the formula in the technical manual: 1 drop of 2-5% Rh positive control cells and 15 drops of 2-5% washed Rh negative control cells. Add 1 drop of this suspension to 9 drops of 2-5% washed Rh negative control cells. I'm going to mark it in case I ever need it.
  4. mollyredone
    We did have a patient who came into the ER and we knew she had anti E and anti Fya. We had pre-screened units for E, but not Fya. The doctor insisted so she got two units. She had a lot of comorbidities and was transferred to a bigger hospital and died two days later. One of the units was Fya positive....
  5. mollyredone
    I agree with Terri. Our techs work alone in BB and only work with one type at a time. Results are put in the computer immediately. The computer system has a verification if the reactions that are entered do not match the type entered by the tech. We require a "type check" for a patient without a previous type.
  6. mollyredone
    We use the same form for emergency release and high risk transfusion. Most emergency release are issued before the antibody screen is done and they get O Neg or type specific if the type is done. We require the form be signed but not before the units are issued. If we know the patient has a previous antibody or the screen is positive, I insist that the form be returned to me signed before I will release the blood. I don't want anyone saying "I didn't know there was a problem" after the fact.
  7. mollyredone
    I have also noticed that the positive control is a lot weaker than the last lot. "Did anyone have the opposite from within the last few months? Where fetal screens came up positive but the KB was negative?" Goodchild, do you check mothers for Du when you have a positive FMH before sending it out? That happened to us a couple of times before we implemented testing for weak D into the procedure if the result is positive. If the Du is positive, we report the test is invalid and send it out for Fetal Hgb F.
  8. mollyredone
    So a tech is manually entering the interpretation as positive? It's not a computer glitch? When we enter our history comment, we enter "KNOWN ANTIBODY" if there is a previous antibody, even if the current screen is negative. Our computer (Meditech) has a pop-up that alerts us to a history of antibodies or special needs (IRR or CMV-) and we order gel crossmatches and antigen negative units.
  9. mollyredone
    Very cute!
  10. mollyredone
    Most of our OB docs are doing OP T&S on early prenatal visits. This is a big help. We get Draw and Hold on normal deliveries and T&S on C-sections.
  11. mollyredone
    We do the same as Jaymeh and Tbostock, testing the new kit reagents with the current positive and negative controls.
  12. mollyredone
    I was worried about this as well for CAP, especially since the rest of the hospital is JC inspected. But I worked with a nursing educator and pointed out the annual testing requirement and we put together a LEARN module on the computer that nurses must do annually. They have to answer a certain number of questions, and if they do not pass 100% they have to go through the powerpoint presentation and retake the quiz.
  13. mollyredone
    We have about a 61% completeness compliance right now, with the majority of blanks for volume transfused, although enough have vital info missing that it's being strongly addressed with nursing now. Our forms are scanned into Meditech, but not until after the patient is discharged. We will be implementing TAR soon, so I hope our audits can be more "real time."
  14. mollyredone
    I have discovered that too with the @ cells on the Ortho panel. Sometimes it does rule everything out with a homozygous cell, but not all the time. Here's another question. We have a special antibody for Rhogam recipients, D residual Rhogam, which is resulted out only if we have a definite date for Rhogam. With a real anti-D, we would always do a gel crossmatch. We are doing that with Rhogam as well, even though the panel is negative. Is it safe to discontinue gel crossmatches if we have negative antibody screens after that? We had a patient who was last in with Rhogam in 2005, but has had three negative screens this year. I feel it is safe to revert to an immediate spin and delete the antibody. Thanks! Mari
  15. mollyredone
    Understood! Amazing how a "pond" can change the meaning of terms!
  16. mollyredone
    I would think you should use in date antisera to QC red cells from expired panels. We always use a negative and a positive cell that is heterozygous for QC. But maybe if you QC'd expired antisera with in date red cells at the same time that would qualify. We typically just use expired red cells as additional rule out cells.
  17. mollyredone
    "The OP isn't talking about IS XM though, but regrouping every time. I still do IS crossmatch, even though it is no longer a requirement with electronic crossmatch. I just like to double check myself immediately, rather than waiting 40 minutes for the XM to finish before finding the wrong group has been selected." I don't understand. If you are doing electronic crossmatches, why is it taking 40 minutes for the XM to finish? In the US, an electronic XM means no serological work is done. If you are talking about an IgG XM it might make sense to do an IS IM before setting up the IgG XM. In fact, an IS XM is required with an IgG XM if our computer system is down.
  18. mollyredone
    We do as Brenda does.
  19. mollyredone
    I would have temp monitors on the units while they are out of your sight. They could let them sit out for 2 hours and put them in the fridge for an hour and you would never know. The lab where I worked previously would send someone up to the OR each morning to document temps and alarms as well as checking and changing the chart monitor. But I don't think it has to be a lab person. I calibrate coolers once a year. I'm sure someone else will have other good suggestions.
  20. mollyredone
    We send most of our units by tube system. We do highlight the antibody on the unit tag and also highlight that the unit is antigen negative on the tag. When a unit is checked out in blood bank with a nurse many of them read "no antibodies identified" or the antibody listed and do look at the unit for the sticker. I don't think it is that difficult for them. They understand that if there is an antibody the unit needs to be negative for that antigen (without explaining the underlying theory of course)We don't do many bedside audits, so I don't know if they skip that on verification or not. But all our tags do state PATIENT ANTIBODIES: None identified, so many of them read that out loud. Edited to clarify: Our tags do state "PATIENT ANTIBODIES: None identified" if that is the case.
  21. mollyredone
    At our hospital they can just line out the consent for blood products on the general consent and initial it. Otherwise they can fill out a refusal of blood products form.
  22. mollyredone
    My medical director is not involved in antibody IDs. She does review all MTPs and transfusion reactions.
  23. mollyredone
    Terri, I'm interested in that as well. Our "consent is just two lines on the general consent form that patients fill out at admitting. I don't think that cuts it!
  24. mollyredone
    Thanks, jmm! I had all the others but the first one you posted. That will be great for training new techs and students.
  25. mollyredone
    In Meditech, PRBCs and PPH are ordered specifically: either PRBC or PRBC IRR or PRBC IRR CMV. If the patient requires such, then they are charged. If we just order it as PRBC and give an IRR unit, they are only charged for a PRBC. Usually we have more trouble the other way around-people forget to charge the right product so we get reimbursed correctly.
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