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About apfelblosm

  • Birthday 06/28/1980

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  1. We use 50 years for our child bearing age/potential. We only do weak D on moms with a positive rosette test. Otherwise, we do it on only cord bloods who are initially D neg. We have a policy that if a woman is less than or equal to 50 years of age and she has one of the following: History of being weak D positive Questionable IS result for D typing Anti-D series 4 and anti-D series 5 are discrepant on the NEO or Echo Then the sample gets sent for genotyping for weak D.
  2. Hello, My hospital just expanded and opened another hospital. The laboratories are separate, however we are all in the same lab system. The system recognizes the 2 different sites, but everyone has access to both sites results. My question is, does anyone else have this? I feel like there is a HIPAA issue here. I have worked at two other organizations that had multiple entities and I have never had access to the other labs' results, unless I had access to an EMR and then I could see the results there, but never in my lab system. I can only enter things into the other sites if I move the specimen and receive it into the other site, but just having access when many of us don'r work over there seems like a problem to me. Also, because we are linked, the system doesn't recognize that a type and screen done at the other site doesn't apply to my site. Thoughts? Experiences? Thanks!
  3. So I just took over at a 350 bed hospital. We have a Neo and an Echo. We run routines on both and will do panels on both if screen is positive. Their current procedure is that if they can't rule out everything in the panels on the automation, then they can just run the few cells they need to rule out in PEG-IgG and be done. Then, they only XM in tube with PEG. This has concerned me since I got here. My inclination is to either makes them rule out everything in PEG in order to XM in PEG, or to get crossmatching on the NEO and ECHO. Thoughts? Jen, MT(ASCP)SBB
  4. Hey all! For those that perform the KB stain using the Sure-Tech Kit, I have a few questions for you. We do a ton (10-20) of these a month. We are having problems with our controls staining appropriately. It is hard to determine the positives. Here are the variables we have already examined: 1. Happens to variety of techs including seasoned and new techs 2. We only use the stain for 5 tests and then we discard it. 3. We run high, low and neg controls every time we do the stain. 4. We use the same area of the lab every time to try to control temperature. Is anyone else having or has had a problem with this? Thanks! Jen
  5. Thank you all for your comments. I was in agreement with everyone, but I didn't want to just change that if there was a reason that I was unaware of. Thanks all!
  6. I just moved to the position of supervisor at this blood bank and I found that they freeze their in date antisera that they don't use very often, i.e. anti-Fya, anti-S, etc. Anyone else do this? Is there a reason behind this? The techs told me that they do this as a throw back from a long gone supervisor. My inclination is that since this is not in the package insert, this is violating the package insert and shouldn't be done prior to use for in date antisera. Side note: they run QC once a day, but this equates to almost everytime they use this antisera because they use it so often. Comments? Thanks! Jen
  7. You are in compliance if you only have the cooler calibration. You don't have to use the temperature stickers, but I like to use them for peace of mind. The thing to watch is your manual documentation vs. your LIS documentation of issue and return times. I have found that these can differ greatly and send up red flags to inspectors. Also, you didn't mention it, but make sure to replace the tag with the "good until" date and time on the cooler when you re-ice. We have a 10 hour limit on our coolers, so we don't have to re-ice. I also have a policy to keep track of the time the cooler has been out and call the OR when it gets to 9 1/2 hours if they haven't returned it, but we are a 350 bed hospital so this is possible here, but may not be feasible everywhere else. I have also worked at a 1250 bed hospital where the boxes were good for 8 hours and they didn't use the temp stickers and didn't check on the boxes. They had a lot of wastage. Good luck!
  8. I have a question for you all and I would like some insight if anyone knows of any regulations here in the US that speak directly to this or not. I previously worked for ARC in their reference lab. When we did antigen negative labeling, it was a manual method, meaning a tie tag with written WBN and antigens. When we completed the tagging, another tech had to review the tag to the testing and that the tag was attached to the right unit with the right testing and document that review. I now work for a large hospital where it is still all a manual process, however the only thing that is reviewed is that the testing is put into the LIS correctly before the unit is issued. The testing itself is not reviewed until a supervisor or specialist reviews it which could be after the unit is issued and there is no step in the procedure that speaks to reviewing that the correct testing was recorded on the tag and that the correct tag was attached to the correct unit. In my mind, this is just like any other labeling, ie ABO, and I believe that there is a regulation that states that ABO/Rh manual labeling has to be reviewed by a second person, but this could just be an ARC thing. Anyone know? Thanks, Jen
  9. FYI- we recently had an anti-K that did show dosage and did only react with the homozygous cells. We have a reference laboratory here. We recently just changed our procedures to include ruling out on two heterozygous or one homozygous cell. We are a 1250 bed, tertiary level 1 trauma center. Thanks! Jen, MT(ASCP)SBB
  10. Currently we have a very manual process for our Emergency Release and MTP processes. We are a 1250 bed, level 1 trauma center. We currently tag each unit ahead of time with a Emergency release tag with the attestation that requires the MD signature. The MD, currently, has to sign each tag which is labeled with the unit number, PC, type and patient information. There is no electronic charting for this until after the event. We are looking to have the MDs sign off in the computer on an order. The order wouldn't contain the product numbers or how many products were given until after the event was over. The point is to eliminate the tags on every unit and having the doctor sign each of these tags which can be 30 tags in a single case. (We still have a "Uncrossmatched Blood" sticker on all the units even if this tag is removed) The question is, if we are not able to build this in the computer and we have to continue doing a manual process, do we have to present the MD signing with the product numbers when he signs? The director would like to present the MD after the fact with a list of all the units that were transfused and then get their signature. IMO, the doctor knows that he transfused units and a ballpark figure of how many units. The actually WBNs will be recorded in the blood bank for lookback, but the MD doesn't know, nor does he care, what the unit numbers are. If he really wanted to know, we could produce that information. My peer believes that the standard 5.25.5 says that the doctor needs to know what units he is signing for. Ideas? What is your all's interpretation? What do you do? Thanks, Jen
  11. Hello all, I know someone on here knows what I am talking about. At AABB this year there was a presentation about a study that was done (in think in Canada) about a patient with anti-Ku who needed blood and the study was looking at masking the antigen on blood using PEG in order to not stimulate the immune system. Does anyone know if the slides for that presentation or a similar one are somewhere online? Or if they know who did it that I might be able to get a hold of the slides? I found it absolutely facinating and I wanted to share it with my staff, but I couldn't find it. Thank you in advance, Jen
  12. I also work in a very busy Level 1 trauma center. We allow 48 hours for them to sign and return, but I have to admit they are not very good about it. We are also a teaching hospital so that adds to the headaches in this area. If they don't sign, then we create an addenduem with the patient information and the units and have the ordering physician sign that at a later time, but we log a "problem" in our area so that these are tracked for trending purposes.
  13. It also states in the 28th edition that the expiration is 6 hours if pooled using a sterile connection device in the same table you are referring to. ARC uses sterile doc, so we also use 6 hours for our pools from ARC
  14. We require a second sample in a tube that is not available on the floor, that the BB controls. We also do electronic XM. Barnes-Jewish Hospital, St. Louis MO
  15. Hello, I have a tech who insists that it is bad practice to rule out big C on R1R1 cells that are Cw+. I find this ridiculous, but is there anyone else that has this practice and is there any literature to back this up, or visa versa? I would appreciate any and all ideas. Thank you, apfelblosm
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