Kathy3171

You should also be able to ask your Meditech consultant.

We currently use the Blood Loc system, It works great. We require that the nursing floors and surgery return the blood loc bags with the Blood loc back to the Blood Bank. When this does not happen there is an immediate call to the floor requesting it. Our blood is released to surgery in temp monitored coolers so there is no need to remove them.

We do all our unit confirmations on the Provue labeled with their unit number, we also do the IGG crossmatches on the Provue as well. The Provue does read the ISBT labels and the CODABAR labels as well, there only has to be a slight view adjustment to read the whole ISBT number. Your technical service person should be able to help you

We are currently validating EXM for our hospital for Meditech 6.0. My questions are, when you are typing the same sample for the second time can you do an abbreviated front type or a full type--my thoughts are a full type. My second question is how do you label units as to compatibility?

Generally this occures due to the type of reagent being used and which D clones are present in them. We currently use the Ortho Provue and do have this issue occasionally but they have an interpretation guide for IGG cards on what to do if the reaction is less than 2+

What does your policy say if consent for blood/blood products cannot be obtained in an emergency.

I am looking for literature on the amount of time a post partum specimen should be drawn for and accurate calculation on a Rho Gam dose. Anybody have any ideas???

For our negative DAT QC we use blood bank saline.

We've

We referenced the same article by Dr Judd. As far as cord bloods that type <2+ by gel and/or are weak D positive, we have a canned comment that states the mother is a candidate for Rh prophylaxis but the infant is considered Rh negative for transfusions.

We use the cutoff of gel D <2+. These are reported as Rh negative and candidates for Rhogam. Until we have molecular testing for D, I don't think there is a way to truly determine weak/partial D's as some of these are capable of 3-4+ reactions.

We've been using the Provue since 2003. You can add testing once you have started a run. It will finish what it is currently pipetting, then start on the stat that was just loaded. We went with automation when our workload increased to the point we needed help but not quite a full FTE. By having automation, we can now stay with our current staffing. We chose gel back in 1998 because when we did comparison testing, we found too many false positives with the solid phase. I'm sure there have been many improvements in both methods over the years, but our staff is comfortable with the gel system and the Provue helps us manage our workload.

We use a 24 hour outdate, probably based on going from a closed to an open system.

Nurses perform the majority of the draws for our hospital so they are the ones responsible for labeling the armband with the bloodloc code. We have very strong administrative support that backs us up if the nurses don't comply with the entire process. Any occurrence reported to Risk due to bloodloc errors is referred to the Nurse Manager of the floor involved and appropriate disciplinary action is taken, usually reeducation for the first offense. One floor now requires 2 RNs to verify the bloodloc at the time of draw because of one nurse's failure to follow protocol. It seems cumbersome, but at the same time, the nurses do really like the added safety feature. Also, the contracted dialysis tech that tore the bag has been asked not to return to our facility. As far as the SOP, I followed the manufacturer's guidelines, then added our own requirements such as, if it the specimen is missing any of the main identifiers (name, date of birth and Bloodloc code) the specimen will be redrawn, no exceptions. If they can't wait, then it will have to be issued uncrossmatched.

I have just been asked by one of the nurses how often does the transfusion tubing need to be changed and if it is the same for red blood cells, FFP and apheresed platelets. I looked on the box of the transfusion set and I can't find anything as far as the number of units. One of the component infusion set boxes states to discard after 24 hours. We currently have a policy that says to use a blood infusion set for no more than 2 units but does that apply to other components as well? Any help would be appreciated.

To get to the meditech tutorial (which is minimal, at best): http://ww.meditech.com/prlab/Presentations/BBKbbTPisbt/ISBTPrint.htm I actually found it by wandering around in the Meditech website and just happened to stumble across it. Good luck!

We are a transfusion service and do not intend to make any labels as we only thaw FFP and cryo (our supplier has prepooled frozen cryo). I have been trying to get started with Meditech ISBT implementation and have printed the tutorial on their website. What I need now are all the product labels to test. I've printed off what I can find on the ICCBBA website, but they don't include all the different barcodes, AS-5, AS-3, irradiated, leukopoor, etc. (at least I can't find them). Any help would be greatly appreiciated.

We have a unit of fresh O negative, CMV neg, Adsol unit with pedipaks attached delivered from our blood supplier every other week. Our neonatologist does not require irradiated blood. So we use our 'fresh' unit whenever a transfusion for an infant is requested. (not that often). We do not use cord blood but require a heel stick for type and hopefully enough for a screen. If not, we use the mother's specimen and if there is an antibody, then we would honor it by giving antigen negative blood. The baby's that we transfuse do not usually require more than 2 aliquots and if they are that sick, they are transported to a childrens hospital with a higher level of care.

Our patient care areas can order irradiated but have to add the CMV neg comment. The first time this happens, we enter a comment,a maker as well as call the CMV an antibody so the computer alerts us to the product requirements. I wrote a letter to all our oncologists telling them that once these products are ordered, we will continue to honor this request until we are told by the original ordering doctor to discontinue. This alleviates the possibility of the doctor on call not knowing the patient transfusion requirements. I also included in the letter, that once the patient tests CMV positive, we will discontinue the requirement for CMV neg products. We have it set up in our system that the patients most recent lab results (H&H, PLTC, PT, CMV, etc) show up at the time we access the patient information. That helps alot.

I've always been interested in barcoded armbands, but waiting for administration to agree to the spending of the funds was taking too long. We are finally starting to barcode the patient armband and they are currently using it for bedside glucose ID but that's about all. They will need to research PDA's or some other method of RN bedside ID that works for multiple departments (Laboratory, Pharmacy, POC, etc.) before we will switch completely. Hopefully, I will be retired by then.....I'm about validated out!!

The bloodloc code is put onto the patient's inpatient ID band at the first draw for blood bank. For massive transfusions, we will issue several units in several bags with one lock (the bags can be piggybacked so more than one fits onto a loc). Surgery has a procedure for recording the bloodloc before the patient is under sterile drapes. We've just had our third torn bag. This was by a contracted dialysis tech that was unfamiliar with our system. Again, this has been referred to our Risk department for follow-up.

In the five years that we have had the Bloodloc system, the bag has only been torn open twice. Once when we first started and once when the surgery department read the code incorrectly. We have not had any mistransfusions and the barrier system works for us. It's an extra level of safety that the nurses are willing to take in order to be assured the patient is getting the correct blood. They probably have a system where someone is opeing the bag as they walk it from the tube, so there are always ways around it. I just hope they walk into the right room and do the correct bedside checks.

The only time we do not use the bloodloc system is when we are giving O negative, uncrossmatched blood for emergencies. It is used at all other times. We require that the loc and the bag be returned to the Blood Bank. If they are not returned or are returned torn or cut, it is reported to the hospital risk department. They follow up with the offending department and occasionally, the Medical Director of the Blood Bank has a few kind words with the head of the department.

The company that makes the Bloodloc is Novatek Medical. Their phone in 1-800-3585023. We have been using their product for several years and find that it works very well. There was a little resistance at first because of the extra time but it has been demonstrated to them that it has prevented transfusion errors on more than one occasion. No more complaints....

Just one more question to all those that go straight to 'thawed plasma'....We have a mixture of plasma products from our supplier, many of which are apheresed. According to the AABB technical manual the expiration of apheresed plasma is 24 hours after thawing. Do you treat this product differently?