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SMILLER last won the day on September 26

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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    TAT for STATs


    Rh Pos or Rh Neg?

    I suppose if you are dealing with a cold-M (with positive reactions in gel) that you later successfully warm-away with tube testing, you could consider the antibody screen negative, when technically you would have a positive gel screen to begin with. But this is not the same as reporting a "positive" screen as negative! Scott
  3. It's all electronic orders here, so the ER physician would be initially responsible; but the OR surgeon or anesthesiologist are responsible for any transfusions there, including uncrossmatched units. Scott

    Group A plasma for traumas

    We have three electronic "uncrossmatched" orders that can be used: Emergency Release, Initial Resuscitation Cooler (2 RBCs and 2 plasmas), and a MTP initiation. These orders include physician documentation for uncrossed transfusions. Scott

    Sysmex XW-100 Waived CBC Analyzer

    That FDA press release caveat seems strange. Why don't you see if you can get a customer list from Sysmex and then call and ask how they are being used at similar facilities. You will want to talk to current users in any event. Scott

    Antibody history and workup records

    Our stuff is stored for 10 years, with a set of notebooks for each year. The patient's records are stored alphabetically within each year, with the current year's set is found in the Blood Bank. We do not collate individual patient's records from year-to-year. We do not search for expired patients in order to clean our printed records. We just toss a year's worth when it is 10 years old. Scott

    Suspected Transfusion Reactions

    At the end of the quoted policy above is this caveat: "Increase in temperature alone should not always constitute justification for a transfusion reaction work up. Nursing judgment should be used in evaluating symptoms and notification of physician." Here, we occasionally have problems with workups not being done, or direction from the blood bank to stop transfusions, against hospital policy. This is because there is sometimes a tendency to excuse reactions, such as a temp increase, to something other than an acute reaction to the transfusion. Now, every facility has to go by their own policy, but I would rephrase this as: "A significant increase in temperature, that may be attributable to some other cause, shall not constitute justification for ignoring what may be a life-threatening acute transfusion reaction. Nursing judgment should be used in evaluating symptoms only after consultation with the Laboratory Blood Bank, and attending physician." Scott

    Antibody I.D. Work-ups

    In the US we have been doing what you say is going to be the new policy for many years, except we only would do a DAT if the autocontrol was positive. I think that approach is pretty common. Orthos' panel A is for the ijnitial assessment. Most of the time, you will have a pretty good idea what you are dealing with with those results. Then, going by the 3 x 3 rule, w use other panels for rule-outs / rule-ins. Also, if there is no history, we antigen-type the patient for those antibodies that are being made. Scott


    Ditto. For those of you who are still in evacuation areas, please get the hell out of there. Scott


    It sounds like your SD is set too low. Try recalculating it based on recent results. Scott

    Coag q.c. every 8 hours

    Doesn't that analyzer run QC automatically? If it does, and there is a QC failure, it should not be sending those test results for patients to your LIS until the outlier is resolved. We run our PT and APTT QC every 8 hours like this but we have 500s. As a side note, we do run our Hema QC (manually of course!) every 8 hours +/- 1 hour. Inspectors do not have a problem with this so far. Scott


    Do you then have a policy that references the References which describes where the references are referenced? Just wondering, Scott

    Electronic vs Immediate Spin Crossmatches

    For screen negative (currant and history) we do electronic crossmatches for trouble-free patients. We use blood bank specific armbands/specimen ID bracelets. When we do a repeat ABO/Rh it is done on the same specimen. Scott

    Sysmex XT2000i open vs closed comparison

    A simple standard to go by would be to use the same acceptable limits for correlation that you use for QC. You cannot expect precision to be better for patient correlations than you get for QC, and it should be at least as good. Scott
  15. TRM.30900 appears to apply to those situations that do not follow standard operating procedures and policies. However, if the hospital and blood bank HAS policies and procedures that cover release of uncrossed blood (approved by the Lab Medical Director -- just like every other P&P in the Lab), then the need for a "written authorization" would not be needed in those situations, as they are not "deviations from SOPs". Scott

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