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mollyredone

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Everything posted by mollyredone

  1. mollyredone
    Brenda, we are a 150 bed hospital in southern Oregon. We get our products from ARC, three hours north. Our maximum ON stock is 6 units, ABP and ABN 2 units, OP (including 4 OP IRR) and AP 45 units, AN 12, including 4 AN IRR, BP 6 and BN 4. We get one PPH delivered three times a week. I don't know why, but we rarely waste any units of blood. We try to give sure transfusions the short dates, and all pre-ops long dates. Our shortest date OP is 4/10 and our longest date is 4/17. We send our PPH to a neighboring hospital (90 minutes south-they keep 5-8 on hand at all times) the day before they expire. We do try to have one PPH on hand all the time. I know you probably know all this, but this has worked well for us. If we urgently need a unit, we can have the highway patrol speed one up or down the highway to us.
  2. mollyredone
    Our form is like Magnum's, a tear off with all the info about the patient and unit on it. If they don't have one, they can bring a printed demographic label with the patient's blood bank band number hand written on it. We don't get to see the dr's orders-wish we did! Dr's also don't have to justify why they are transfusing, as I've noticed some of the hospitals require. That, too, would be nice!
  3. mollyredone
    At our hospital, people other than RNs are allowed to "check out" blood products. That would seem to be the same as letting lab assistants do it on the lab side. Proper training is the key!!
  4. mollyredone
    Thanks for the input, Mabel. I think I will try for automatically giving OP to male traumas and massive transfusion. In a typical massive transfusion, we would be out of ON in 1 hour! Something's gotta give! Mari
  5. mollyredone
    Smiller, I agree you don't want to create antibodies, but the rate of anti-D formation in trauma patients, or any patient under stress, is much less than previously thought. What about the other antibodies the patient may have that you are stimulating when you give a unit of blood to an unknown patient? If the patient is desperate for blood, they need to have blood. Our maximum inventory of ON is currently hovering about 6 and we are three hours from our supplier! If that patient with anti-D comes in under any other situation, we would give Rh neg.
  6. mollyredone
    We only test cords of Rh neg moms or group O moms, or if mom has an antibody capable of HDN. Kate, do you have a reference for just testing Rh neg moms or group O moms? I'd like to just do those samples, but can't find anything in the technical manual. Also, do you charge a type on the mom if you don't have one before you perform the DAT and type on the cord blood? Thanks, Mari
  7. mollyredone
    Liz, that's why we want to write this procedure, so it is accepted as our standard. The pathologist will inform the medical staff that this is what we have to do to conserve our O Negatives for our numerous real ON patients.
  8. mollyredone
    Thanks Elin, Our pathologist would like a standard policy so he doesn't have to be notified every time. I think our ER docs are on board with it, since we seem to be in a permanent shortage mode with ON. I'm not sure if we want to state "2 ON upon arrival, then switch to OP for males until we get a specimen" or what. Does that make sense? Our max inventory is supposedly now 6 for ON and we are 3 hours from ARC, or 1-1/2 hours from another town if it's delivered by highway patrol. And you can go through those six units pretty fast!! Mari
  9. mollyredone
    Anyone??
  10. mollyredone
    I would love to have a little help writing a procedure for switching from ON to OP in a trauma when you haven't received a BB specimen yet. I'm thinking two ON uncrossmatched, then switch to OP for males and females over 55(?) until a specimen is received. I know some people automatically give OP to all males, but we may stay a little conservative here. Does anyone have an SOP to share? Post it here or send me a message! Thanks, Mari
  11. mollyredone
    I just checked the AABB manual, 17th edition, and it says alarm activation quarterly, which means physically raising and lowering the sensor probe temps. We do a battery backup activation check daily. I didn't know we had to check the high and low electronic alarms daily. Is that a CAP requirement?
  12. mollyredone
    Wow, this is an old thread, but I've found it very interesting:)
  13. mollyredone
    We don't see any inpatient orders. The nursing staff just orders through the computer. Many times the doctor has ordered two units xm'd and when he puts in the order to transfuse, the floor orders another unit instead of coming down to get one of the ones that is xm'd!! Now we know to call before we add on any units and say, "did you know this patient already has units xm'd??"
  14. mollyredone
    Most of our NB samples come in a glass 10 ml clot tube. They don't want to switch to plastic because they want to sterilze the tubes with the surgical tray. Although we have been getting a few EDTA plastic tubes. I'll have to check and see if I can find a sterile kit that they could order.
  15. mollyredone
    I don't recall getting notification either.
  16. mollyredone
    Mabel, I think I had strange reactions on cell 9 on two patients. But of course I can't remember their names now! Mari
  17. mollyredone
    Srtech, that's what our BB policy states as well, and the AABB manual says each facility should define and validate policies for the detection of additional antibodies. But this discussion has certainly brought up some "food for thought" and I may be looking at changing our policy. I do think the idea of not re-identifying the original antibody is valid, and cells should be selected to reflect that thought.
  18. mollyredone
    I only did it because I had time on my hands. It definitely isn't somehting we do on a normal basis. Can I help it if I thought it was fun??!
  19. mollyredone
    We pull two segments from each unit as we process it, and attach a label from the back of the bag. We put these in a biohazard bag until full, write start and stop dates on the bag and refrigerate. We keep three bags at a time, so we throw out the oldest bag when a new one is full. I have gone digging through the bags when a patient developed a new antibody and was able to find the segments she got 2 months earlier and they were positive for the antigen that she developed an antibody to!
  20. mollyredone
    I agree with James. I keep the tubes and segments in order until the whole batch is done. Haven't had a mismatch yet!
  21. mollyredone
    I see what you mean. In the course of identifying patient antibodies, you will run across weak antibodies naturally.
  22. mollyredone
    Where do you get your pre-calibrated digital thermometers? Actually most of our refrigerators and BB equipment has Isensix monitors so I don't have to worry about them. But there are still a couple left. And no one knows when our $3000(!) NIST thermometer was last calibrated!
  23. mollyredone
    Wow, that's amazing! We just had this same issue come up!
  24. mollyredone
    My husband's Army tags state he is O+ when he is actually B+!!
  25. mollyredone
    Wow! I'm sorry I don't have any advice, but I wanted to say that is awful! Seems DONs can get away with a lot. We had one that stated that her nurses were too busy to take critical value results over the phone!
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