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SMILLER last won the day on April 15

SMILLER had the most liked content!



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    Has been around for a while
  • Birthday 08/10/1958

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    Medical Laboratory Scientist
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    Saginaw, MI, USA
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    Generalist, mid-sized level 2 trauma center

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  1. If documentation of proper blood handling for transfusion is not appropriate, I am pretty sure that the inspectors will not care whether it's happening in the Blood Bank in the Lab or in OR. This is healthcare, after all, and this is my hospital. I do think it is worthwhile to try to correct deficiencies. It make seem like a sisyphean task at times, but one cannot just give up on this stuff just because we "are at the mercy of human beings". (We should all be used to that by now!) I do think that efforts should be concentrated on making things as simple as possible, not only for ourselves, but for those other humans in all the other departments that we work with everyday. I do think its worth the effort. Scott
  2. Generally during the same patient stay. Scott
  3. We do not have units in a fridge in OR (or anywhere else for that matter besides the BB). Our BB is just down the hall from OR, so our OR units are kept in the BB until needed for a specific patient Then they are issued in a cooler. Presumably the correct ID and read-back is done in the OR for each unit. Scott
  4. Hmmm. Here in Michigan, we are indeed doing negative controls for reverse cells (we just use albumin). We are FDA and JCAHO inspected. Scott
  5. That caveat is used for inpatients who have a continuous stay. We cannot take the patient's word for it if they have been away from our facility. However, we have an exception for pre-admit testing, which we will allow up to 10 days before the procedure IF the patient gives us info regarding pregnancy, transfusions and other hospital stays. Also, in a similar vein, we generally will not repeat an eluate on a positive DAT if it has been worked up recently and the strength has not changed. Scott


    On June 15, 2018, following an investigation by the U.S. Attorney's Office in San Francisco that lasted more than two years, a federal grand jury indicted Holmes and former Theranos chief operating officer and president Ramesh "Sunny" Balwani on nine counts of wire fraud and two counts of conspiracy to commit wire fraud. Prosecutors allege that Holmes and Balwani engaged in two criminal schemes, one to defraud investors, the other to defraud doctors and patients.[7][56] After the indictment was issued, Holmes stepped down as CEO of Theranos but remained chairperson of the board.[8] The case is proceeding in the U.S. District Court in San Jose. Holmes and Balwani have pleaded not guilty.[57] They face up to 20 years in prison.[58]
  7. I don't think you can do much "assuming" like this in the BB, much less healthcare in general. A unexpected positive reverse cell is most likely due to something innocuous, but it could be, at the least, a sign of an ABO subgroup or whatever. In any case, you would want it all documented for the next time you see that patient. Scott
  8. I just answered this question. My Score FAIL  
  9. If the patient has been transfused or pregnant in the last 3 mos, one has to r/i r/o significant atypical antibodies every three days. This going to involve more than a screen. Scott
  10. In general, here the anesthesiologist is responsible for transfusions during major surgeries. A tech or nurse would do the documentation in OR. When all areas used transfusion forms that were attached to the units, regardless of where they were transfused, copies of those tags were sent back to the BB. We reviewed them for completeness and anythin g else that may have been missed, such as a raise in temp, and then sent the reports back to the managers in charge of those associates for comments and corrections. I believe the deficiency statistics were reported to the transfusion committee. Now the transfusion vitals, etc. are put right on the electronic chart. Deficiencies are almost non-existent as the system alerts the person entering data when something is amiss. Scott
  11. LOL! We would send it to our reference lab! We have other things to do here... Scott
  12. For the simular case we had, all we did extra was a 30 min, 37 C settle test (unspun) to resolve the positive reverse A cells (A patient). We did not see a point in doing anything else--the gel screen was negative. Scott
  13. One reference I read puts the prevalence of EDTA-clump-able platelets at less than 0.2% in hospitalized patients and only 0.1% in the general population. It's a purely in vitro phenomenon so I would guess that donation processing does not include screening for it, as it would have no in vivo significance. Interesting question though. Scott https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538042/
  14. Trouble with the reverse A cells? We had a similar case recently. Scott
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