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bowerj1

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About bowerj1

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  • Birthday 02/08/1973

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    Oregon

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  1. Hello. We have been looking at our policy regarding when the nursery orders Cord Blood Workups (Type and DAT) on babies. Currently we do all babies of Rh Neg moms (of course), as well as of O moms. I have read that many blood banks have dropped performing these on babies of O moms, and only do them as part of the RhoGam workup. In talking to a few of our pediatricians, none of them seem to care much when we call them to inform them of the positive DATs and they shared that they do not treat differently based on the result. This article states that testing babies of O moms is not required (American Academy of Pediatrics): https://pediatrics.aappublications.org/content/pediatrics/114/1/297.full.pdf What are your thoughts? What do you do at your facility? We are discussing this currently at ours and appreciate your feedback.
  2. Question. If the patient is registered, why can't you use the SoftBank emergency issue function prior to the Type and Screen being completed?
  3. Yes, Epic/SCC. I'd love to join the emails - please! (We also decided not to pay for SNUG this year so I no longer get the SNUG group emails, would love to be included.) Thanks!
  4. We don't require blood bank bands for inpatients or outpatients. All outpatients getting blood have their Name, DOB and MRN confirmed when they arrive for a blood transfusion. Then the Epic band is placed on the patient and the barcode is used for administering blood products etc. We do have a two ABO policy as well where all patients require two separate types (not same draw). Honestly when we first started this change (we stopped using bb specific bands about 7 years ago) I was a bit nervous. But it really has been a non-issue. Our Infusion nurses are very careful and know their patients well. Us
  5. I apologize if this has been discussed previously. I'm sure it has but I had a hard time finding it. In the situation where you have anti-E (but no other antibodies) in a patient that is c antigen negative, and they want to transfuse...in what situations do you give c negative units? Is the rationale that they were likely exposed to c (I understand this part - because of the antigen frequencies) and so they will likely make it if they are exposed again? Is it simply trying to avoid future anti-c creation? I assume if there is an emergency that you'd have to bypass this step and just give E antigen negative blood? What are your policies/practices regarding this?
  6. Thank you Malcolm! You are in England right? Where did those IRA bombings occur? Wow.
  7. At your hospital, who do you call when you need additional employees in the blood bank during a Massive Transfusion event? Just looking to see what other facilities are doing. We are only an 80 bed hospital, so we don't get a lot of these. But I'd like to hear what larger facilities and trauma centers do as well. Thanks!
  8. We got rid of them 5 years ago when we implemented our new BBLIS and started requiring a confirmatory ABO and using electronic crossmatching. We prefer the confirmatory ABO to blood bank bands. We require the phlebotomists ID to be written on all pre-transfusion specimens. We are happy with our system and its working well.
  9. We require that every pretransfusion tube be signed by the phlebotomist. Our strong preference is the employee number/tech code. But we do allow initials/signatures. In these cases we can check the info in the HIS/LIS and connect the initials to the employee, if needed. But we do not have a policy that requires us to confirm this in the HIS/LIS. The main thing is that the tube must have the employee ID/initials or it's rejected. (For non pretransfusion samples, ie DATs, Cords, ABO Confirms, prenatals - we do not require an employee ID/initials. We simply depend on the HIS/LIS in these cases.) -Jesse
  10. "If there is a question about passive vs. active Anti-D, a Rhogam is given (to err on the side of caution). " That is sort of what I was getting at. At our facility we do not require a new ABO\Rh test result each time RhIg is issued. We will issue with an historical Type (we do this for yellow products as well). Our current policy says that we "should" perform an antibody screen prior to issuing RhIg, for example to an ED patient. This is where I am seeking to clarify the SOP. I know that RhIg should not be administered to a patient that has been alloimmunized to D. But practically how do you determine active vs passive D, especially when you have a patient miscarrying in the ED and time is limited. Since it seems prudent to err on the side of caution and give RhIg regardless, I'm having a hard time seeing the value of the antibody screen test, since it seems RhIg would be issued regardless of the result.
  11. Thank you. I see what you mean about a current type. Myoriginal question was do you require an antibody screen prior to issuing RhoGam? Thanks, Jesse
  12. Hello, What are your policies for requiring an antibody screen prior to issuing RhIg? Is the policy different for ED patients vs clinic patients? If you have a blood type on file already, do any of you not require a sample for a screen in an ED situation where an Rh Neg mother gets an order for RhIg? It seems that in almost all cases you will issue RhIg regardless of what the antibody screen result is? Is the point of the screen to have a "clean" pre RhIg sample in case there is a need to titer? Thanks in advance, Jesse
  13. I agree with Bill - keep it simple. We also would report out only the negative tube screen result, then add internal comments that would not go on the external report, but would help guide the next blood banker working up this patient in the future. We would not report out the Echo results at all. Seems like it would be very confusing to the provider to see both a positive (or inconclusive) and negative for an antibody screen result. Solid phase is so sensitive that it's going to pick up these insigificant "capture panagglutinins" from time to time. However David's point is good - how can you be certain that you are not missing a high incidence antibody? But the likelihood of non clinically significant "junk" with solid phase is much higher than a very weak (doesn't show up in LISS or PEG) high incidence antibody.
  14. Hi rcc1974, It sounds like you have your settings set the way we would like them. If you don't mind, would you be willing to share your settings for: (In customer defined parameters): mismatch override (yes or no), restrict of no currenet blood type(yes or no), and (In Blood Type dictionary):allow emergency issue (yes or no and for which blood types), and did you allow all Rh Neg types to be compatible for all Rh Pos red cell types?? If anyone else has any tips, they'd be appreciated! We are having a tough time making this work the way we'd like. Thanks in advance! Jesse
  15. I can't either link to work. I'll take it if it's still available.:confused: ______ I think the link had some extra letters, I just cut and pasted this part. Click: http://www.surveymonkey.com/s/RMLMZYD
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