[Exclusion of anti-E in the presence of anti-c]

We do B

[Do you have a weak D policy when tested on the Provue?]

Same as mollyredone

[HEMOLYSIS AND AUTOCONTROLS]

Aww, thanks for the snowflakes, Cliff!

[HEMOLYSIS AND AUTOCONTROLS]

Same as David and Terri

[SoftBank for Tissues]

We are going Live with SoftBank in January '14. I had considered tissues but I think some of the lot numbers are too long than the number of characters allowed so we decided to keep it a paper process since we don't get that many. I think had I done it, it would have been as an action, not a blood product.

[frequency of vitals monitoring during transfusion]

We do pre, 15 min and completion vitals. All patients get discharge instructions- both inpatients and outpatients. Some inpatients are transfused day of discharge so we recently decided to include both groups to increase awareness of delayed TRs especially since they make up 20% of all our reactions.

[Complement Control]

We do the same as David. We only do DATs in gel.

[Transfusion slip w/ Blood Bag Label]

Same as Auntie D

[Confirming order before issue]

I should also add that if we set up units "in case" (ex. Patient has antibodies), we'd put little tags on the unit that say "Do Not Issue, Physician order needed"

[Confirming order before issue]

We do same as Terri

[Laser Paper for Transfusion Record]

Sorry for this. I realized today that I just had the paper in backwards! It prints beautifully and the carbon copy goes through when you write on the 1st page. The brand we tried is Relyco carbonless 3-part straight, Item: RE811S3.

[Laser Paper for Transfusion Record]

I am seeking help from users who currently print Transfusion Record paper on a Laser Printer, and then require a copy of the completed Transfusion Record for Blood Bank records. In our state, Blood Bank needs to be able to evaluate records for Transfusion Reactions, so we currently receive the yellow carbon-copy of the 2-part form that includes the nursing signatures and vitals (currently written on the form by nursing). We will be moving to a computerized process soon.

 

I found the multi-part paper that prints beautifully on our laser printer but I didn't realize that if you write on the first copy it does not go through to the second copy. Help!

[Mass Transfusion Protocol for Pregnant Patients]

OB organized a task force and it took about 1 year to implement. It has been very successful since.

Basically, like a MTP, if there is a protocol and everyone knows it, and it's followed, good outcomes are bound to result.

[Mass Transfusion Protocol for Pregnant Patients]

Sorry if I wasn't more clear. Based on the CA program 5dogs refered to above, the OB hemorrhage is "staged" by levels. Level 1 (least serious to level 3 (most serious). OB estimates blood loss by weighing pads, etc soaked with blood as a more accurate method then by just "eyeballing it". Once a certain level is measured, the patient is "staged", BB is notified, and based on that, we provide the appropriate products.

[Mass Transfusion Protocol for Pregnant Patients]

I hate to sound dense but hemorrhage is hemorrhage. Please explain what you mean by "the stage of the OB hemorrhage". I really am trying to understand but the old brain cells don't fire as well as the used to.

[Mass Transfusion Protocol for Pregnant Patients]

But.......is there any difference in what the blood bank/transfusion service does?

Depending on the stage of the OB hemorrhage called, we provide the appropriate products.

[Use of K-Centra in massive transfusion initiation]

We have implemented Transexamic acid for Orhopedic patients which has shown to decrease blood usage.

[Mass Transfusion Protocol for Pregnant Patients]

Our OB Hemorrhage policy/ protocol actually came out first and is based on the CA resources mentioned. It includes immediate response from lots of folks, not just Blood Bank (anesthesia, pharmacy, rapid response team) The MT policy specifically addresses blood products and labs to draw at which time frame so the two are different.

[Mass Transfusion Protocol for Pregnant Patients]

I'm curious, for those of you who have a MTP specific for OB patients, how does it differ from the MTP for all other patients? I've been through massive bleeds with OB patients as well as others and I can't think of anything I would have done different specifically for the OB patients.

[PBS and ph testing]

My thought is just that we QC all reagents used for patient testing. Saline is a reagent, so it gets QC'd. pH paper is also a reagent.

[Donor retypes]

100% agree with David and dragonlady.

[Procedure Review]

Annual (in NJ)

[Duplicate samples in Blood Transfusion]

The HIS has rule set up to automatically cancel a type and screen sample if ordered within X number of hours since the last sample was drawn. This has helped eliminate many duplicate draws at our facility.

[Survey: Massive Transfusion Protocols]

Done

[Spiked units of blood - return/reissue question]

I agree with all, and also Terri that this is a reportable incident since the error reached the patient before it was detected. Good eyes by the family member.