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epfeiffer

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Everything posted by epfeiffer

  1. We do perform both activities. Since we had already validated the system for transport of all other products, we validated syringes by ensuring that when they were sent they wouldn't leak or break. We also add a little additional padding to the tubes with syringes to guarantee they are held in place.
  2. I apologize if this topic has already been asked, I searched and couldn't find it! I have a trauma helicopter that wants to start carrying red cells (United States). I am concerned about the possible regulatory issues surrounding this process. We discussed most of my concerns. However, when I asked about a patient specimen for crossmatching I was informed that no there hospitals that provides this service has ever requested a sample. I was always under the impression we had to perform crossmatches on blood we release in emergency situations, I consulted my medical director and he was on the same page. There is always the possibility that I am reading too much into the FDA CFR/AABB Standards and perhaps there is a more flexible interpretation. Would someone please let me know if you see this differently?
  3. Is there any FDA approved disinfectants for cleaning the bags? I have an ID doc who said if I have the IFU for the product I should be able to see any approved disinfectants. The only issue is, they are not my bags and I don't necessarily have the manufacturer's information. Any thoughts?
  4. My sister hospital also uses API for their surveys and has had the same problems with their Anti-Ds. The new Policy is to replace the reagents after two weeks. They have also instituted a policy to test all new D negative patients/samples on the bench. They are using the exact same reagents on the bench and getting the expected reactivity, while on the Echo it was negative...weird
  5. Albaugh, we have Cerner Milenium, and you may be right it may be just as easy, I just took over and haven't had a chance to investigate.
  6. The only way I was able to determine which units left the blood bank for the MTP and trauma pack was by looking at the segments which were appropriately labeled. The nursing record correctly identified all transfused components. None of my records correctly identified the three units in question. The blood is not labeled with a patient name because we often won't have a patient name until after we deliver the blood.
  7. The paperwork with the units was not correct, it was a carbon to what we issued. We use Cerner
  8. Hi, I am having a slight disagreement with my manager. We recently had a trauma that required an MTP. Initially we complete all the issuing of blood products on paper as our computer system makes releasing uncrossmatched blood very cumbersome in an emergency, especially when we may not necessarily have a name right away. When I went to review the paper work I found that one unit had been recorded twice (it was not a split), one unit had then been omitted, and two donation numbers were incorrectly recorded. The units were all released to nursing staff, one unit was transfused and the other two were returned. I feel this is a reportable error. He feels that because this is administrative that it shouldn't be reportable. I am frustrated.
  9. I see you are switching to the Echo. I have noticed that dosage is the norm on this platform. I have changed my rule out policy to be 2 homozygous cells to rule out C,c,E,e,Fya, Fyb, Jka, Jkb,M,N,S, and s. We have almost missed a couple of kidds by only ruling out with 1 homozygous cell.
  10. We just had this debate at my facility. There is another thread here which contained a survey as to how other people are handling this exact issue. I believe a majority of people polled were calling any positive reaction D positive. Then there were a few people who were calling it negative with a comment. That thread had more to do with Rhogam I believe.
  11. I know I'm a little late responding to this thread, but I didn't see the answer I would've provided, so I thought it worth mentioning. When we would EGA treat a neonate red cell to rule out weak D we would run a drop of EGA treated red cell with an in house 6% albumin as our negative control. The control served the purpose of verifying positive reactions were truly due to the presence of the antigen and not the result of an incompletely removed maternal IgG. We did do an extensive validation prior to using the EGA kit however, verifying which antigens were denatured, so we had complete confidence the D antigen was left intact. (Immucor was correct by the way, and the validation was completely unnecessary.)
  12. Why are you doing a CRP in the first place? If the answer to that is because some disease or disease process is being investigate which would result in a deferral, than that patient should be deferred. In my experience that test is ordered for a specific reason, not as a screening test.
  13. Does this take into account the fact that our plasma is not necessarily leukocyte reduced? Or does this even matter?
  14. We currently do not label FFP collected from CMV sero-negative donors as CMV negative, the working theory (I assume) is that the low temperatures required for the freezing and storage of FFP kill or inactivate the virus. Recently we've had two customers question this decision. I cannot find any literature discussing this specific issue, does anyone have any information regarding CMV and FFP?
  15. At my old hospital all the technical staff (MTs and MLTs) on the second and third shifts were required to be competent in Blood Banking, that way when the Blood Bank tech wanted to take a break they were able to do so uninterrupted. We rotated through every department each week to maintain competancy.
  16. We only do an autocontrol on Antibody IDs and DATs only on positive Autocontrols, unless requested. We will do an elution on Patients with a positive DAT that have been transfused in the last 21 days. If a patient has a known warm autoantibody we will do an elution if the strenght of the auto control or DAT increases, or every six months. (We only deal with adult patients) We will also do elutions if requested specifically by a physician.
  17. If you're using Ortho anti-sera please note the the Rh-hr control is not recommended for a control for D typing, we use reagent red cells for each antigen we are testing for and a 6% albumin for a negative control.
  18. The Ortho 0.8% panel has a modified Antibody Screen specifically for Rhogam patients, the cells in the screen are all Rh negative and all clinically significant antigens are represented. It is a four cell panel denoted with @ sign. We used that to cut back on antibody identifications for these patients when they were not necessary.
  19. We have minimum labeling requirements for all testing, however the order in which we place our tubes for testing is totally up to us.
  20. At the hospital I used to work at we did have a TEG. The graphs were interpreted by the Anesthesiologist and the Perfusionist and actually our point of care had little to do with this intrument. In addition I feel the aforementioned interpreters had little to do with it as well, as they never refered to results from this analyzer when ordering blood products. The seemed to feel that surgery required no justification for transfusion and just ordered products whenever they felt like it, without any clinical indications that transfusions were actually neccessary.
  21. Where I work we will draw people up to 14 days before surgery. When we draw them we have them fill out a questionaire regarding their transfusion history and pregnancy history. We also place a blood bank arm band at the time of draw and insist that the arm band stay on their arm until after surgery is over. I like to scare the patient by informing them that blood is a very specific drug that will kill you if administered to the wrong patient, that usually helps inspire them to leave the arm band on.
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