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mollyredone

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Everything posted by mollyredone

  1. After reading a little more on here from reference labs who said not all DARA patients have positive screens right away, we will run a gel screen first, then a LISS screen if the gel is positive and then send it off to the reference lab if the LISS screen is positive. We only have one patient so far and we got a screen before he started treatment and I was able to type him here for most antigens. If the screen treated with DTT at the reference lab is negative, we will use electronic crossmatch to issue blood.
  2. http://capatholo.gy/RHIG Here you go!
  3. This is ours. It's not that fancy. Wish we could give out a medic alert necklace or bracelet! antibody ID card.pdf
  4. I agree that your ARC experience depends on the region. I'm in southern Oregon and we used to use ARC in Portland, three hours north. If I called for PRBCs at 6 AM, they wouldn't arrive until 5 PM, because they would have missed the Greyhound bus. ARL was not available overnight. And they were more expensive. We went with a community blood center affiliated with a larger group, Bloodworks NW, which is in Seattle. We're an hour from our blood center and when we send up a reference specimen, it is flown up to Seattle from Eugene and sometimes I have preliminary results the next day because they work 24/7 for no extra charge. Plus we are supplied a historical database on units, which has been a godsend. To me, the difference is the customer service level the community blood bank is willing to give us. And they are cheaper!
  5. How many of you who treat with DTT do comprehensive phenotyping including Kpa, Kpb, Jsa and Jsb? When I talked to our reference lab they indicated that would be a good idea. If we send our specimens out to the reference lab and get a negative antibody screen in return, how many of you would feel comfortable with electronic crossmatching? If the patient's antibody screen has always been negative, it should be eligible. Because otherwise we wouldn't get a compatible crossmatch, since we don't use DTT here. We just got our first patient and I did a screen and antigen type for K. Also, what is your experience with how frequently patients on DARA need transfusions? Weekly, every other week? I'm concerned because we have to Fedex ours to the reference lab, but they usually can fax us results within 36 hours.
  6. How many of you who treat with DTT do comprehensive phenotyping including Kpa, Kpb, Jsa and Jsb? When I talked to our reference lab they indicated that would be a good idea. If we send our specimens out to the reference lab and get a negative antibody screen in return, how many of you would feel comfortable with electronic crossmatching? If the patient's antibody screen has always been negative, it should be eligible. Because otherwise we wouldn't get a compatible crossmatch, since we don't use DTT here. We just got our first patient and I did a screen and antigen type for K.
  7. Here is what I wrote for our purpose: Compatibility testing is all pre-transfusion testing performed on a potential transfusion recipient and the appropriate donor blood, in an attempt to ensure that the product will survive in the recipient and induce improvement in the patient’s clinical condition; the electronic crossmatch is performed with the ABO compatibility truth tables built in a computer system. The electronic verification of donor/recipient compatibility has many advantages. In addition to the major benefits of increased patient safety and decreased unnecessary work, the electronic crossmatch has advantages that include time savings, job simplification, increased throughput, decreased turnaround time, reduced patient sample requirements, and reduced handling of potentially hazardous samples, as well a avoidance of false-positive and false negative reactions associated with serological crossmatches.
  8. Yes, I believe I got the idea from you! So to make sure your positive reaction was not due to IgG in the buffered card, you added saline instead of anti-complement? We very rarely have a positive DAT HEM.
  9. Do these labels go on the back of the unit? We still have dot matrix unit labels and "unit ready" slips. We send the unit ready slip when the unit is crossmatched and the nurses tube it back when they are ready for the unit to be sent by tube. Everyone but ER and OR use TAR. ER and OR are still paper holdouts!
  10. But since you have learned about novel antigens, maybe in your spare time you could write a (wait for it!) NOVEL!
  11. I saw the poly card from Ortho (IgG and complement) for DAT since we used to do DAT with poly first, but if it was positive you would have to do the IgG and complement separate so we just went to IgG cards, which we already used and buffered gel cards for complement.
  12. Yes, our reference lab also provides an itemized list with CPT codes. I review all antibody workups the next day I work and charge for things like antigen typing and DATs if autocontrol is positive, since we don't do any elutions or other fancy stuff!
  13. I also manually bill for these charges. The reference lab sent me the CPT codes and I charge everything as a "Bill only" charge. If we do an antibody ID in house, it's billed as ABID. When it is done at the reference lab it is BO ABID ADD for additional, since we do charge for ABID even if we can't come up with an answer. So there is BO ELUTION, BO PHENOTYPE, etc. We built our charges for these to be a little more than the reference lab charges to cover shipping, etc.
  14. Terri, I realized my confusion right after I posted it. I have the FDA guidance as well as the AABB one. We are getting closer to going live!
  15. Ours is called a draw and hold and there is no charge. We save them as valid BB specimens if needed. We have two racks in our fridge-actual BB specimens (Type and Cross, Type and Screen and Type); the second rack holds cord bloods, prenatal type and screens, FMH, DAT HEM, and Draw and Hold specimens.
  16. We challenged that checklist item when we were told we had to have positives and negatives, because it also says that you don't have to if you are following manufacturer's instructions, and Immucor says you don't have to for Anti-A, Anti-B or Anti-A,B. Just Anti-D. We weren't cited.
  17. We test our manual gel with A2 cells diluted to 0.8% in MTS Diluent for the negative (and are thus testing the MTS Diluent as well) and check cells diluted in MTS Diluent for our positive. control for our IgG cards. For our buffered gel cards, which we use for complement DAT, we run controls each time with Complement check cells for positive and A2 cells for negative. Running the controls with each run ensures that Anti C3b-C3d was added, as techs are more used to the IgG cards.
  18. I agree, it's not like the patient's sample or the product turn into pumpkins at midnight! All of the evening shift techs have 3 years or less experience as techs, so sometimes you have to spell it out for them, hence flowcharts and printed directions on processes in Meditech. Saves me a lot of calls!
  19. Is that written in any AABB publication or inspection checklist, or is it just common sense?
  20. I know that it is the law in Washington and Oregon to have the physician obtain informed consent. I don't know about other states. I also know that it is rarely done here by physicians, even though all other treatments or procedures are explained by the physician. I don't know why transfusion is being treated differently, but we have a new QI person and TJC will be inspecting soon, so hopefully they will decide to follow the law! Plus, it is very rarely fully completed here and I have beaten my head against the wall many times trying to get compliance. I just might make a comment when TJC comes in to talk to blood bank, even though the lab is inspected by CAP.
  21. I had this question asked by my staff and I wanted to get some other opinions. An inpatient had a blood bank sample drawn. A unit of PRBC was issued on this patient before the patient sample expired, but the transfusion was not completed until 12 minutes after the sample expired. The patient had received three previous units of PRBCs, starting 5 days prior. When they wanted another unit we got a new sample. My feeling is that if the unit was started before the sample expired, it was still okay to issue it. What is your policy/process for this situation? Thanks!
  22. I think I was getting that confused with the general idea of having two separate types on a patient, but needing just one on O types. I tried it in test for EXM and it definitely won't let you override that! Thanks Dansket!
  23. I thought I had read on the forum somewhere that patients that type O with the first type don't need a second type for electronic crossmatch. Is this true? I don't know if I can override that in Meditech. Or do you need to do an IS XM? I know that if you don't have a 2nd type on other blood types, you can do an IS XM and give O blood. I want to make sure I am getting everything set up for going live with EXM. We have the EXM attached to the IS XM in Meditech. Thanks in advance.
  24. It was a download, but there were no tools to copy and paste, no print buttons. Very frustating, but...problem solved!
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