richj

Hello For Pre-Op patients not transfused or pregnant we will add a comment to GS ...Reserved until (60 days from collection) . For all other patients we are will not add a Reserved until comment ..we will choose to let the specimen be invalid for testing 96 hours post collection. (Technologist has to calculate 96 hours from collection.) In the event a nurse or clerk enters the wrong history , we won't have an issue as we obtain a new sample. Question..Are there Meditech 6.16 users who do things differently? Allow some samples to be counted 96 hours from issue if history is taken and trusted. Thanks Richard

Thank You everyone for your responses. Richard

Hello What is the policy at your facility regarding repeat antibody investigation? Is it possible to introduce rules to reduce unnecessary testing and reduce costs without impacting patient safety. Take frequent flyer Cancer Clinic patients who come in once a week. Patient has Anti-E ...Same lot # screening cells, no variation in strength, regardless of transfusion ..can you eliminate the panel and perform a gel compatible crossmatch with E- units. Thanks Richard

Thanks for the replies. I thought maybe there was a new practice being adopted out there where you didn't have to rule out other antibodies, just confirm Anti-D in Moms having received Rhig. Heard rumblings in the greater Toronto area. Thanks Richard

Hello How do you rule out clinically significant antibodies when the antibody screen is positive due to RhIG? Thanks Richard

Thanks Malcom

Hello All labs incubate Cold Agglutinin titres at 37C, but there appears to be less of a consensus when it comes to 30C , 22C or even 4C . What phases should a transfusion service perform to assist clinicians and to be in line with current standards, best practice? Thanks Richard

Hello What are the pros and cons of using IgG vs AHG when performing a tube crossmatch or tube screen assuming that the tube method is a back up method to MTS gel. Is it possible to miss a complement binding IgM antibody early on by using IgG only. The standards seem to indicate that IgG only is required. Thanks. Richard

Thank you for the replies. We figured out the barcode. On a related topic though, we are told that we have to use the single unit entry when scanning in rbc inventory instead of the batch entry. Seems there are limitations like not being able to scan the phenotype barcode in batch entry. If anyone cares to comment about limitations of batch entry using 6.16. Thanks

Hello When entering inventory into Meditech 6.16 (scanning units) How do you get a barcode to test the Donor group. Does Meditech automatically create an order and label that you have to match up with a segment after the labels print. Can you use the RBC unit label? We intend to run the donor confirmation on Biorad IH 1000? Thanks Richard

I think saralm88 is saying that the Mom's plasma vs D+ cells is barely reactive. Where is the high titer Anti-D?

Hello We are changing from Horizon Blood Bank to Meditech. In HBB, based on the specimen type you assign a specimen and subsequent transfusions. the specimen expiry is automatically calculated and displayed on the at-a-glance bar. It is my understanding that in Meditech there is a default expiry of 96 hours but some institutions opt to remove the default entirely. Isn't the default of 96 hours with an override provide a measure of safety over no expiry at all and therefore a better option? Comments appreciated. Thanks Richard

Hello Can you enter ISBT product code when entering product into Meditech using batch mode. It doesn't seem right to have to change the date and time of delivery to say 0930 (when your delivery came in) between every rbc unit unit you enter unless you use the default (current ) time which is not the accurate time of receipt in the Blood Bank. Thanks Richard

Hello It is my understanding that when issuing blood in Meditech the location automatically populates . What happens when an inpatient goes to the OR and blood is issued to the OR. Does Meditech capture this? If not can you change the location or do you just make a comment somewhere. And when issuing blood in a validated cooler can you designate your cooler ID in the issuing screen which allows you to return blood >30 minutes, or do you just make a comment and then return the blood no more than 30 minutes post issue even if it was out for 4 hours. Thanks Richard

Good Morning, An AB Positive patient received a unit of A Pos platelets 12/29 evening uneventfully. The patient then received a unit of AB Positive Rbcs during the night and developed chills and a fever of greater than 1C to 39.3C from 37.8C. The pre and post transfusion workup was uneventful other than the Pre DAT was negative and the Post DAT was positive (Complement only) Does this represent the Anti-B in the platelet unit? Should an eluate be done for complement only and what is the blood and platelets of choice for this patient going forward. Note the patients HGB has dropped to 54 form 76 ..However there are no signs of hemolysis. Thoughts greatly appreciated.. Thanks, Richard

Thanks Malcolm We waited on the Oneg platelets. Delivered in 90 minutes despite minor snowstorm. R

Hello, We have an ABneg female of child bearing age with allo Anti-D and Anti-E. She requires platelets. Currently we only have group A Rh positive platelets in house and Canadian Blood Services can only provide Oneg platelets in about 2 hours. What is the best option for this patient? How does having Anti-D change normal procedure of giving Rh neg platelets as first choice followed by Rh pos platelets with Rhig as second choice? Thanks for your thoughts.. R

The cards I saw at the Erytra demonstration were the ABO/RH (2 D) cards and the 8 well IgG cards. The ABO/RH cards had A, B, AB, D, D, Ctrl, A1 and B. One of the Ds is to detect Weak D. and the 8 wells mean that you can perform 4 -2 cell screens as opposed to 3 .

Hello Saw a demonstration of the Erytra by Grifols. I believe cards are cheaper and with 8 wells you get more bang for the buck. Thought the instrument had many nice features. Just looking for any feedback regarding the instrument, cards, reagents etc if anyone has information. Thanks

Thank you to everyone for your input. Richard

Malcolm, The Horizon Blood Bank (HBB) Emergency Issue feature is simple enough to use. However rotating staff do freeze when a near hysterical nurse or transport assistant are waiting impatiently for blood because their patient is bleeding out. The issuing process including packing a validated cooler can take up to 10 minutes. I see some respondents have aimed for 5 minutes with paper to expedite and prevent the freeze factor. What do you feel is an acceptable time from pick up request at the window to issue? Jane12 Do you remove a sticker from the units and affix to your emergency release form? How do you match the 4 units for which you have photocopies to the patient for computer entry post issue. Do you have product ID Tags for the units ready to go and if so what do you call them ie Trauma ONEG or Trauma OPOS Amym1586 What information is initially in your downtime book? Do you place a sticker there as well and what time are you aiming for? Do you have product ID Tags for the units ready to go and if so what do you call them ie Trauma ONEG or Trauma OPOS Thank you for your thoughts. Richard

Hello, We use Horizon Blood Bank 'Emergency Release to a Known' patient when issuing uncrossmatched units in an emergency. Our staff find the process of using the computer and attaching the labels somewhat time consuming. Further, under stress to issue units Stat, they sometimes freeze. (despite periodic training) Is there a quicker more stress free process to issue unmatched blood using HBB or a process that involves quick release of units followed by computer entry afterwards? Even non Horizon Blood Bank. Is there a best practice consensus for speed and simplicity? Or should the approach be to have an algorithm in Emerg and OR establishing reasonable time lines for unmatched units? Thanks, Richard

Hello, We are looking at the Ortho Vision. However, it appears the Ortho QC is somewhat expensive at around $500 a month. At least here in Canada. Has anyone had success with a home made recipe? We make our own QC in house for the Provue but am told it won't work with the Vision? Appreciate your pros and cons on the instrument as well if anyone has a minute. Thanks, Richard