[PIPETTE CALIBRATION]

Can you please share what validation was done for your Artel?

[Biorad Reagents and Clay Adams Serofuge]

Was your optimal spin time 15 or 20 seconds?

[Biorad Reagents and Clay Adams Serofuge]

Is anybody using both Biorad Reagents and Clay Adams 2002 Serofuge? My Blood Bank is considering ordering Biorad Reagents instead of Ortho and Immucor. Biorads reagents inserts states to spin @ 800-1000 RCF or g. Clay Adams set to 3400 RPM. The conversion calculators I got needs a radius for the rotor. I measured the rotor and got app. 6cm. This works to 817 RCF. I had someone else calculate and he got 7.5 radius and >1000g. Any comments or views will be greatly appreciated. Thanks

[Surgery Schedules]

Thanks everyone for your responses. Unfortunately, using the surgery schedule is a must for us. Hospital Admin mandated that we use them. Prior to that we had sooooooo many issues with surgery because they either:

1. Forget to order blood/blood products

2. Put in the wrong order

3. The other placed had the wrong attributes

4. Put in the orders,(dispatch status) but forgot to send a specimen. etc..etc...

The surgery schedule has greatly reduced friction between the OR and BB. It's feels so good not to have anaestheologist screaming at us that we " are killing their patients"!!!!!!!!!!!!!!!

[Transfusing Patients With Warm Autos]

The blood center we deal with uses adsorbed plasma to find compatible xm'd units. Is this that so much safer than using "least incompatible units"?

[Calculating Expiry Dates]

You could print out the calender from otho's website.

[Routine turnaround time]

Our Blood Bank Policy allows an 8 hour turnaround time for routine, but experience has taught me that quite a few TS ordered routine becomes a stat orders. Thus we try to get all our routine TS done in a 2 hours. Stats - 1 hour.

[Terumo "Trucise" System Users - alittle help please!]

Presently we use Cerner Millennium which has the Label Verify option. However what we did prior to this(infact we still do it to eliminate errors) we had an MT, other than the one who prepared the product, to perform a second check then dispense. If a Tech crossmatch, aliquot, thaw, irradiate or otherwise modifies a product, he has to get another Tech to do a double check and dispense the product.

[30 minutes for return blood and blood products]

We do not check temperatures if RBC/Plasma are returned within 30 minutes. We send all our RBCs and Plasma on ice and they are kept on ice if there is no blood bank refrigerator in that department. They are also returned to on ice. We perform yearly tube system validation where we document temperatures on several products sent to and returned from different locations/hospitals, within 30 minutes.

[Do you require a second specimen from a different draw when you have no history for a pre-transfusion candidate?]

To prevent sticking the patient twice: You can have 2 people identifying the patient and signing to that effect prior to the draw.

I must comment that tubes sent to the rest of the lab should be well labelled just like the BB tubes and that the second ABO test (if you have 2 draws) is just as serious as the first!! come on of course it is, and if you get a discrepancy you need to get a thrid one. This is serious business! Lives are at stake, and depend on our accuracy.

We presently have a policy where two people need to be present for a draw. You'd be amazed at how ingenious nurses can be...recently we received two specimens supposedly from the same patient with double verification(two initials); each specimen had a different name!!!! When I called the nurse..she told me nursing's take on double verification....."Each nurse goes to do their draws and brings it back to the nursing station to be double verified by a second nurse...

[Surgery Schedules]

Thanks

[Surgery Schedules]

Thanks for your response Deny!

Do you keep your surgery schedule for a specified period of time, in case there are issues later?

[Surgery Schedules]

Does any one else do this?

About a year ago we began asking our Operating rooms to send us their surgery schedule the night before surgery. Our third shift staff will then check the schedule and compare it with orders in our computer system(dispatched, collected). If anything looks amiss, they will contact the floor(for inpatients) and preop(outpatient) to rectify the issue. Also one of our a Blood Bank Staff attends a 6.30am meeting to compare what products the Blood Bank has ready for each patient. They various doctors will then notify us of any changes then. Since it"s inception, we"ve had fewer isuues with the ORs, even if it's additional work for our BB staff.

Is any or everybody else doing this? How long do you keep the surgery schedules? Please share your method of keeping surgery HAPPY .

Thanks

[Frequency of Antibody Identification]

"confuses me, how can you tell if there has not been another antibody developed unless you do a panel to ID what is there"

Per my Blood Banks Policy· When the current antibody screen is positive and an antibody identification has been performed within the last 30 days and there is no increase in strength of antibody reactivity or appearance that there is a different antibody present than what was previously identified, antigen negative units must be crossmatched without further antibody identification work. (Exception: When the patient has demonstrated a warm autoantibody and the screen is positive antibody identification must be performed every 7 days if patient was transfused after the last workup).

.

[Frequency of Antibody Identification]

Forgive me if this has been adressed before...

At the hospital where I work we repeat Antibody Id's as follows:

1. Pregnant Patients : Every three days.

2. Warm Autoantibodies : If patients have been transfused after last ABID- every 7 days.

3. All other patients : every 30 days if there is no increase in strength of antibody reactivity or appearance that

there is a different antibody present than what was previously identified.

My search of the AABB Technical manual did not result in any time frame that I could find.

How often do you do the above?

Thanks for your anticipated responses!

[Red Ink]

Thanks everybody. We are being inspected by CAP this week and my boss was going up the wall because I had signed off some QC with red ink. Anyway we ended up with one reccommendation...and it had nothing to do with my QC!!!

[Red Ink]

Is there a CAP or AABB checklist that says no red ink used in Blood Bank or the Lab.

[Anti-D or Passive D]

300 ug of RhIG was given. We always perform saline titers. We have never used enhancement

for any of our titers. (well I haven't and hopefully the MT who performed the titer did not since we

do not have a SOP for this ) :disbelief

[Anti-D or Passive D]

Thanks you David and John for your responses.Titer was done in Tube.

I did reccommend that the patient be given postpartum RhIG and

I will also reccommend that a TS be repeated in the future (3-6 months).

Thanks a million!

[Anti-D or Passive D]

Patient had a Type and Screen(TS) done in June 2011 by A Reference Lab. ABSC was negative, ABORH=AB negative. Patient given RhIG on 8/10 by Doctor's office. TS done on by us on 8/26 gave 4+ reactions in gel for both screen cells. Titer was 1:32, Fetal Screen was negative on 8/28. Per AABB Technical manual 17th edition "Administration of RhIG during pregnancy may produce a positive antibody screen in the mother, but the titer is rarely greater than 4."

Is this Anti-D or Passively Acquired D?

Thanks for your anticipated response!

[staffing issues and workload, etc.]

1. We use the pneumatic tube for all products dispensed; however if the tube stations are not working or for Massive Transfusions, the OR sends a retriever to collect the blood/products.

2. Nurses do inpatient draws and phlebotomists do outpatient draws. If nurses are unable to do the draws, phlebotomists will do them.

3. All draws, whether by a phlebotomist or nurse are witnessed. Each specimen has two initials.

4. Nurses draw nursery specimens.

5. We perform Type and screen. If patient is immunized, we do ABID and xmatch 2 units on downtime form and request that a new specimen be collected on surgery day. We do TS on new specimen and xmatch the same two units with new specimen.

[Rh control]

RH Controls when performing weak D testing; is Saline or 6% albumin acceptable?

Is it necessary to QC the 6% albumin daily? Would you use chech cells as a possitive control?

Also for AB pos patient; which is acceptable? 6% albumin or an autocontrol?

I've searched several of the previous threads and inserts and am still not sure

which is correct.

Thanks for your much anticipated answer!

[Controls for expired rare panel cells]

This came up at my LAB's last CAP inspection. We run a negative and positve panel cell for the antibody being identified. We run these with the patient's plasma as part of our workup. Our CAP inspections agreed that that was fine; we just needed to add it to our policy.

[emergency dispense in Cerner Millenium]

You can adjust the column size; then you can see everything on your screen.

[Awesome site]

I sure will Liz..thanks.