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About ksmith

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  1. We are updating our Massive Transfusion Protocol. We are a 400 bed non-trauma facility that does not keep FFP thawed. We would probably have 2-4 MTPs per year. How are other similar sized facilities handling these? Do you include only blood products in the initial phases? At what point do you add other labs or meds to the protocol? Who do you designate to contact the BB of the initiation & to stop the MTP? If anyone has a flowsheet or process map that they are willing to share, it would be much appreciated. Also interested if anyone has designed a review form to evaluate each MTP after the event to look for ways to improve the process. Thanks.
  2. We just purchased a new Helmer refrigerator. We need new dividers or trays to store RBC bags. Has anyone purchased trays or dividers recently? I'm interested in options from sources other than Helmer. Thanks.
  3. Does anyone have the title of the national guidelines so I can search for it? I have desperately wanted to stop investigating the positive DATs when the treatment is the same. But, I'd like to review the reference prior to stating my case. Or more likely, having the reference to use when my Medical Director notifies them we are no longer performing certain testing. This would save us lots of time when it doesn't add any value.
  4. I haven't seen anything defined in writing and was concerned that I was overlooking something. Our goal is to give them some general guidance and remind them about TACO. That's what the newer nurses are looking for.
  5. With our current multi-facility EMR, there was no rate built with the component orders. It was decided each facility would have 'recommendations' of a time frame or as the physician orders.
  6. We are revising our blood component administration policy to flow along with our RBC administration policy. I cannot find the original source for our current administration rates for FFP, platelets or cryoprecipitate. Looking for a reference/best practice for administration guidelines for blood components.
  7. For Mom, we routinely perform Type & Screens on all OB patients. For Baby, we routinely perform cord blood testing (ABO/Rh & IgG DAT) from deliveries of all Rh Negative and Group O moms. We still perform additional testing when the baby has a positive DAT (IgG testing only). When there is an ABO incompatibility or mom has a current detectable Anti-D due to Rh Immune Globulin, are any facilities still doing more testing on the cord blood? We still do even though the baby is going to be treated the same way. Our protocol is use of a bili light and for a bilirubin to be performed 12 hours after delivery. I haven't reviewed recent literature on the subject. Curious to see what other facilities are doing for positive DATs when the is not a clinically significant antibody involved.
  8. Thanks, that's good news. We purchased one. I'm getting ready to write up a validation plan.
  9. Has anyone purchased the new cell washer from Thermo Fisher, the Cell Washer 3? I'm interested in your experience with it and any advantages/disadvantages you see. Are there any extensive maintenance requirements you wish you would have known prior to purchase? I was unable to find the operators/service manual online. Our old Sorvall 2+ finally died, may it rest in peace. I've reviewed the operators manual to the new Helmer. It looks nice. Not sure how long the display will last with my staff. I also thought a negative was that they recommend running distilled H2O through it daily or after it sits for more than 4 hours. We don't use it often, so we'd be running distilled water through it prior to every use. Thanks!
  10. It is, but I use this environment throughout the year for new employee training and competency. I didn't think there were any actual regs, but wanted to make sure. The other option is to purchase another server for the upgrade environment to use until we implement the upgrade.
  11. We are about to embark on a computer upgrade. We currently have 2 environments (production & training). To save money, the question was asked if there was any regulatory reason that would not allow us to move the upgrade onto the training server. This would leave us without a place to validate/train/implement any change for about 6-9 months until we went live on the new version. Thanks.
  12. TreeMoss - Do you know if CBCs are run from placenta blood at your facility? If so, could we reach out to your facility to talk to them? Thanks.
  13. They are drawing from the baby side of the placenta from the fetal vessel. I’ve not decided if I consider this any different from the cord blood. When I said it must come directly from the patient, they said it does. I think since there is nothing written definitively stating this type of sample is not acceptable for pretransfusion, they are just looking for a way to not take blood directly from the baby. I’ve asked for info to contact other facilities with this practice, but haven’t gotten anything yet They are just beginning to look at this process, so we’ll see how it goes.
  14. No David, you’re not an old timer (or we both are). I feel the same way. We would never transfuse from a cord blood. I had never heard of such a thing before yesterday. There is a video on YouTube about it. I hoping someone has some experience with this request.
  15. Is anyone using blood collected at birth from the placenta for Neonatal Type & Screen and transfusion? Our facility is looking at doing this for initial labs and they want to include the Neonatal Type & Screen which could be used for transfusion. If you are using this, are there any special considerations you made when implementing this process?
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