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BldBnker

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Posts posted by BldBnker

  1. I would also like for someone to share their SOP's with me.  We are about to implement the Ortho Vision Swift instruments after 14 years of Immucor Echo instruments.  Huge change for us and the generalists that cover the Blood Bank on alternate shifts.  I appreciate any help!  Thank you!

  2. Sonya Martinez, it is an old COBE 2991 (I think they are now made by Terumo).  It is programmed to wash a whole unit, a pedi/quad unit, or do a 2-L wash for IgA deficient patients.  Our machine is probably at least 30 years old.  We just spike the unit and spike a 1 L bag of injectable saline using the wash bags that are used on the machine.  The machine takes care of it! 

     Here's the link:   https://www.terumobct.com/2991

  3. To clarify, we sterile dock a packed cell into quads and wash one quad at a time when a transfusion is needed.  We try to dedicate one packed cell to an infant (which decreases exposure) but will use a unit for more than one infant if needed. This helps prevent wastage. Our overall wastage is very low here.  Also, we don't transfuse too many infants at our facility (maybe 1 baby per month).  Really premature/sick infants are transferred to a local children's hospital for a higher level of care. 

  4. I have used Immucor Echo instruments since 2008.  I love them!  There are still some issues with cold antibodies and weakly positive DAT's causing positive screens, as with any newer methodology.  Unfortunately, we are going to be going to the Ortho Visions due to corporate decisions.  I'm trying to be optimistic but am thankful to be in the latter part of my career (3 years to go!).

  5. There have been many improvements over my career.  Now, of course, we have barcode scanners being used by our phlebotomists which have greatly decreased the number of mislabeled samples.  We also have Epic BPAM for transfusions.  However, we are all human and we still have the rare specimen error, usually in a hurried/emergent situation (when SOP's sometime go out the window, unfortunately).  A bedside ABO slide type would have saved the patient in Texas that recently passed from an ABO HTR.  :(

     

  6. We perform at bedside slide blood type for confirmation before starting blood at the hospital where I work.  A Blood Bank employee (Blood Bank Assistant/Transfusionist) takes the issued blood to the patient's bedside and participates in the starting of the transfusion with nursing personnel.  The slide type is an extra layer of patient safety.  Pre-transfusion testing is only as good as the quality of sample!  We have caught wrong-blood-in-tube (mislabeled) samples this way.  We also have computer confirmation with barcoding of units but that doesn't always catch WBIT samples.

  7. The patient's DAT is positive, right?  Has the patient received ABO incompatible platelets lately?  Or received Immunoglobulin therapy (gamma globulins)?  I have seen both of those scenarios cause incompatibilities with the patient's own type.  Could be either Anti-A or Anti-A,B from O platelets or the gamma globulin therapy.  

  8. We do the antigen testing for units ordered from our blood service.  We have found units that were supposedly negative for an antigen but actually positive.  We also are required by our computer system to enter the antigen testing results for a unit before it will allow the selection of that unit to a patient with the corresponding antibody.  

  9. We (the Blood Bank) evaluate for Rh Immune Globulin at our facility.  Since we issue, deliver the Rh Immune Globulin to the floor and do the FMH testing (we also have the KB results from our Hematology Department), we issue the appropriate amount of Rh Immune Globulin syringes to be taken to the floor (based on KB results).  

  10. Our pathologist (Blood Bank Medical Director) wants to approve each case of transfusing least incompatible units.  He will often speak with the ordering physician to discuss benefits vs. risks involved.  Once he has approved the transfusion of least incompatible for that patient, we do not need further approval unless something changes.  So far, in my career, these patients have never reacted to the transfused blood.  Usually, they were already hemolyzing their own blood and needed transfusion to correct very critically low H & H's.  

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