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Everything posted by pbaker
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Our policies are sent to staff every year for a refresher. Whether they really read them or just sign off is another story
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Can your computer system do that? Ours cannot.
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I agree with this if we are transfusing. We would use O= anyway. I'm talking about just the basic blood type of the baby.
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But the final interpretation of Rh would be positive or negative?????
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If you have an D=, Weak D+ neonate, do you call them Rh+ or Rh=?
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We keep them for the month. All documentation is in the computer.
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We are a 400ish bed hospital, but our NICU usually sends the really sick babies to nearby Children's Mercy. We do not irradiate on site. We would have to get them irradiated at the blood center and the docs usually don't want to wait. I'm just trying to get information to adjust my policies since we ALWAYS have to get it out when a request comes through. Do you aliquot the unit to a syringe or send the entire unit to the NICU?
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For those of you that perform neonatal transfusions, what special products do you give your babies? Irradiated, CMV seronegative, Hgb S negative, any others? We give about 1 neonatal transfusion per year and our policy is really old. Just want to make sure we are giving the correct most up to date product.
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We had that problem with lot 134046. I contacted Technical Support and shortly after that we got a Technical Communication that we were not the only ones with the issue. It worked if we incubated at RT for a while. We stuck it out because we knew our new shipment was due in a couple of days. We got the SAME lot number!! Immucor suggested confirmation of A1 reactivity by other methods and consulting your quality department and/or medical director. We just continue to incubate at RT. When it's colder in the lab, it works better
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Thank you for the responses. Let me add an additional question. About 30-40% of the patients with type and screens are discharged home from the ED. Since there is really no diagnostic value to a TS, is this overuse? Some of those come to us as "trauma" and end up not being as bad as expected, so I get those. That still leaves about 25% being discharged to home. The others have an registration diagnosis of things like: altered mental status, abd pain, shaky/dizzy, shoulder pain, ETOH, N/V/D, etc..
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Does anybody have any data regarding how many of the type and screens ordered by the ED actually get blood products? Those products could be given in the ED or on the floor after admission. One of my ED docs is trying to determine if they are requesting type and screens appropriately. I did a 3 month retrospective review of data and only 28% of the type and screens ordered by ED actually got transfused from that specimen. Doc wants to know if that is good or if they are ordering too many type and screens. Thanks,
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Patient is caucasian with cirrhosis, sepsis, ARF, among other things. Not a healthy person. The patient hgb was stable in the 7s until a big drop to the 5s. Even with transfusion, the hgb was having a hard time getting up to the 7 again. So the doc ordered a DAT. I really don't believe the Anti-P1 has anything to do with his hemoglobin issues. We use the Elu-Kit to for the elution and perform tube testing with no additive. Malcolm, thank you for the powerpoint, but I can't seem to open it.
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Has anyone ever seen Anti-P1 eluted from RBCs? We have a patient with a negative antibody screen. The physician ordered a DAT because the hemoglobin has been dropping even with transfusion. The DAT was positive due to IgG only. Since the patient was recently transfused, an elution was performed. When the eluate was tested, the pattern fits Anti-P1, with all other clinically significant antibodies ruled out. Can it be???
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There is no regulation that I know of. I had a tech ask the question. I know, back in the dark ages, when we labeled blood products by hand, we documented the temp when we took the batch out of the walk-in and the temp when we put it back in. And we actually labeled whole blood IN the walk-in.
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How does everyone ensure that red cell units stay within temp while receiving them into the BB inventory? Do you designate a time allowed from removal from the shipping box to placement in the refrigerator? Do you take temps somehow? Do you document anything anywhere?
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Circular of Information states "Transfusion should be started before component expiration and completed within 4 hours." Doesn't really specify within 4 hours of what??? I'm guessing us blood bankers interpret this to be 4 hours of issue, since it is no longer "maintained in a controlled environment".
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This is how our tubes are viewed for micro reactions. Issitt seems to be OK with this method.
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How does everyone record reactions that are only detected microscopically? Here are the versions I have seen in my various jobs and from my various techs. I am trying to get it more consistent. +/= wk+ mic+ 0m+
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We call that "RTFL"
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We used the carryover validation exercise provided by Immucor when we received our instrument. No problems with CAP.
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We have not had the greatest experience with Aeroscout. It frequently fails to send readings even though it is still reading the temp. I don't know that I would trust it to monitor a cooler.
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Yes
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We require a ABO/Rh specimen for the current admission.
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We are currently building the Bridge system for transfusion documentation. I know AABB and CAP standards require "amount transfused" to be in the patient record. Does anyone know if this is by individual unit transfused or a cumulative amount?
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A true trauma stat (not a drama trauma) is 60 minutes for ABSC and 35 minutes for ABO, from receipt in lab. All other stats are 65 minutes for both. We batch our cord bloods and do them every 4 hours. The nursery has it in their brain that it must be completed by then in order to treat the baby accordingly. Of course, when they don't send it down for 3 hours and miss our run time, they get mad at us.
