pbaker

We just got some from MaxQ.  They are corrugated plastic and we validated them for 12 hours.  They have a handle on both sides for easier carrying and the ORs love them.  They are bright yellow so they (hopefully) will not get left behind in the OR or discarded as trash.

We keep them for the month.  All documentation is in the computer.

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?

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?

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 

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.  

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".

This is how our tubes are viewed for micro reactions.  Issitt seems to be OK with this method.

We used the carryover validation exercise provided by Immucor when we received our instrument.  No problems with CAP.

We keep them until the monthly invoice comes and then they are discarded.  All documentation of unit receipt and final disposition is in the computer system.

We keep them until the monthly invoice comes and then they are discarded.  All documentation of unit receipt and final disposition is in the computer system.

We require a ABO/Rh specimen for the current admission.

We require a ABO/Rh specimen for the current admission.

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.

They are in an MTP cooler that has a separate RT platelet storage box. 
Although we occasionally get them back in the cold part of the cooler.  They claim it's just easier to put them in there.  SIIIIIIIIGH!!!

We use the 2nd person to identify, knowing full well that it is not very reliable.  We recently had a safety fair, prior to TJC arriving, and used an armbanded model as our patient and laid the collected specimen next to it.  The names were similar, but different, MRN were different and DOB was similar but different.  Only about 50% of the nursing staff caught the discrepancy.  We then explained to them that the specimen was labeled properly only from the wrong patient.  Since blood bank does not see the patient or the armbands (we use a BB armband), we would have accepted the specimen and resulted the testing for the wrong patient.  Some understood and were scared, some just wanted the stamp on their paper to get their CEUs.
Please don't ever put me in the hospital!!!

We have the same set up for basically the same reason - a patient was transfused with no transfusion orders.  However, blood bank only gets notification of the product order.  Also, no specimen collection label will generate if only a transfuse order is placed. 
We had a case where a transfuse order was placed on one patient and a product order was placed for a patient with a VERY similar name on the same floor.  RN came to pick up blood for the patient with the transfuse order and couldn't understand why we did not have it ready.  "Patient was bleeding!!!!!" 
Our transfuse and product orders are going back to being linked together so you can't order one without the other.

We very rarely transfuse neonates (like 3 times in the last 4 years).  Because of the rarity, we no longer stock a quad unit.  We have gotten approval to give the baby the freshest O= on the shelf until the quad unit can get here from the blood center.  Here is my question for others like us.  When you get an emergency request for blood for a neonate, do you take the time to aliquot for the nursery or do you issue the entire unit and let the nursery physicians aliquot what they need?

Nursing orders to transfuse are just that - NURSING orders.  The blood bank does the testing required for the product orders received and makes sure blood products are available and/or ready.  If the RN/courier appears at the window to pick up a product and we have a valid product order, we will issue the product.
It is very frustrating when the lab gets blamed when the nursing staff cannot follow/clarify a physician order.
 
 

Hematology tried to move it to the blood bank and our medical director vetoed that!!  She said it is a stain and stains are done in Heme!!

We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.

We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.

We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.

We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.

We always require an ABO/Rh for each admission, just in case someone else is using that patient's information.