[CT ratio]

Hi all,

 

I need to know what other indicators other than CT ratio be used to monitor blood utilization when a Blood bank of a 40 bedded acute care hospital procures blood from a central Blood bank and issues it to its patients.

 

In other words, What indicators may be chosen to monitor blood banking services in a hospital of this sort?

 

Can you share your thoughts.

 

Dr. Kumar

[Who is authorized to do donor physical/clinical examination]

Dear all,

 

Is it mandatory that a physician make the clinical examination for determining eligibility of a donor?

Some centres recommend that it can be done by a Blood bank technologist or by a RN.

 

Who is really responsible for this? FDA mentions that a physician or a staff trained by him provided the physician is in the premises when examination is done. If the staff trained is doing it the center should have the SOP for donor examination approved by the FDA authority.

 

Where in the AABB standards is this referred to? what is the AABB recommendation for the same

 

thanks

[Donor examination responsibility]

Dear all,

 

Is it mandatory that a physician make the clinical examination for determining eligibility of a donor?

Some centres recommend that it can be done by a Blood bank technologist or by a RN.

 

Who is really responsible for this?

 

Where in the AABB standards is this referred to?

 

thanks

[benchmarks]

Hi

Can someone provide the international bench marks for

1. PRBC wastage rates

2. expired PRBC rates

Our expired PRBC rates are around 7% and we'd like to improve.

thanks

[can FFP be stored at -70 deg C]

Can FFP be stored at - 70 deg C and if so does the shelf life increase.

What time does it take to thaw FFP stored at - 70 deg C?

thanks

[frequency of vitals monitoring during transfusion]

What are the AABB guidelines on frequency of vital signs monitoring during transfusion?

Many hospitals are following the protocol of monitoring every 5 minutes for the first 15 minutes, and thereafter hourly once till end of transfusion (3-4 hours)

Is this acceptable? what are the views of the AABB and FDA on this issue? What is being practised by most north american hospitals?

thanks

[SOP for ABL 800 blood gas instrument]

Hi,

Can somebody provide me the SOP for ABL800 blood gas analyzer. I need to prepare a SOP for our POCT blood gas analyzer and hence the need.

thanks

[Malaria testing]

Hi,

We have been screening blood donors for malaria by the conventional microscopy of stained peripheral blood smear.

Riyadh is not endemic for Malaria. Most of our Donors are Saudi nationals from Riyadh.

Now we have decided to replace this by Malaria antibody screening (ELISA, Biorad). The kit cataloque mentions that it is approved for screening blood donors.

We thought of a protocol of testing all donors for malaria Ab by ELISA and then making smears for microscopy for the Antibody reactive donor samples.

1. Is this acceptable?

2. What are the AABB regulations on Malaria testing for Blood donors?

3. What kits are FDA approved for malaria testing for Donors?

thanks

[specimen identification problems]

thanks Liz. I should have asked (rather I meant) how do you classify specimen ID errors based on the nature of the error (minor, major etc). For minor errors, can correction be allowed and so on.

[specimen identification problems]

Hi,

Our hospital does not have a HIS and LIS and documentation is all by manual method, in registers.

Our policy on acceptability of specimen for blood bank is as follows:

1. The 2 unique patient identifiers (Name and hospital number) should be matched on the request and specimen label.

2. The name should be complete 3 names (first name, middle name, last name)

Many times when there are minor errors in part of the name, the blood bank staff ask the nurse who brings the specimen to do the necessary correction and sign for that. Is this acceptable.

We have been telling them to be strictly reject specimen with specimen ID errors for the transfusion services.

The staff should retain the specimen and request and fill up the rejection form and send it back to the ward and to ask for a new sample and request. Is this correct?

How do you classify specimen identification errors and what action need be taken for each type of error? please answer this with respect to transfusion services.

thanks

[discarding urine and stool specimen]

Hi,

What are the acceptable procedure for discarding urine and stool specimen after processing.

Though biohazard waste management guidelines recommend pouring down the sink and flushing with copious water, it is practically difficult.

The next question is who will do that? The technologist or the housekeping staff?

We are looking for alternate safe procedures. Can someone help?

thanks

[bed side blood group verification]

hi,

when i initially posted this discussion thread on bedside blood group verification I had also a Query on a bed side blood group testing kit that's advertised/manufactured from Germany(Serafol" manufactured by SIFIN labs, gmbH)

Does anyone have information on that?

thanks

[crash cart and donation room]

thanks. Our staff are CPR certified (BLS). Thank God! all donor adverse reactions we had have so far been vasovagal syncope, which our staff could manage. In the event of a call for code blue and when the code blue team comes to the donation room wont this crash cart come handy? I need more clarifications to continue my discussions with our medical services director. thanks

[crash cart and donation room]

thanks david.

does AABB or FDA have some guidelines for this?

Crash cart is NOT essential, but . . . donors have died during the process. It is your Medical Director's decision on what/how you are going to care for donor reactions. There does need to be emergency medical treatment available.

[crash cart and donation room]

Is it mandatory to have a crash cart in the Blood donation center. What are the mandatory first aid equipment and medication that need be in the donation room to ensure donor safety in the event of an adverse reaction that happens to the donor?

thanks

[hemolytic transfusion reactions - near misses and sentinel events]

Can you give me an idea of the number of near misses (due to wrong blood group) and sentinel events (hemolytic transfusion reactions) occured in secondary care and teritiary care centers in the USA due to incompatible blood or blood products? How many of them resulted in fatalities or sequelae?

thanx

[pipette acceptable standards]

thanks david

You need to see what your pipet applications are. If you use the same ones all the time I would make my goal to comply with the most stringent. It depends on what the pkg insert calls for as far as pipet precision goes. For me, the applications called for 5% and 2% so I set my limit as 2% precision.

[pipette acceptable standards]

Hi,

Are we supposed to follow thwe ISO 8655 stds for inaccuracy and precision of pipettes. When we look at guidelines from different labs upto 5% inaccuracy and 5% CV is acceptable for pipettes < 50 ul and 3% inaccuracy and imprecision is acceptable for pipettes > 50 ul.

What are the references that site these levels? can someone provide me a good reference for piptette cali standards?

thanx

[pipette acceptable standards]

hi david,

thanks. are these limits applicable to all volumes?

the FDA looks at what precision your testing requires. I set my limits to the test wihcih has the strictest requirements (+/- 2% in my lab). You need to look at your test's pkg insert to see what precision is required . . . that is the standard.

[pipette acceptable standards]

Hi,

Are we supposed to follow thwe ISO 8655 stds for inaccuracy and precision of pipettes. When we look at guidelines from different labs upto 5% inaccuracy and 5% CV is acceptable for pipettes < 50 ul and 3% inaccuracy and imprecision is acceptable for pipettes > 50 ul.

What are the references that site these levels? can someone provide me a good reference for piptette cali standards?

thanx

[bed side blood group verification]

Thanks for that information. Are these blood bank assistants, trained nurses or trained blood bank technicians? Do you have them in all the shifts?

We perform a bedside confirmatory type with each "start" of a transfusion at my facility. We have special Blood Bank staff called "Blood Bank Assistants" that take the blood to the floor and start the transfusion with the patient's nurse. We do not use a special kit. We merely take a small tray of supplies and perform a slide type on either a fingerstick specimen or a specimen drawn from the patient's line. This is performed BEFORE the start of the blood or blood product. We perform this bedside type each transfusion unless there is product hanging with which we can compare blood types and patient information. As a result, we do not have ABO hemolytic transfusion reactions. This bedside type is even performed in surgery using a small amount of blood from the line tip. This is acceptable with all regulating agencies, including FDA as we are FDA inspected). The last AABB inspection we had was so impressed that I was told that they would try to make it a recommendation.

[bed side blood group verification]

I heard of a bedside blood grouping kit meant for checking the reciepients blood group just prior to starting transfusion. The name of the product is "Serafol" manufactured by SIFIN labs, gmbH. Is this an FDA approved kit. Can it be used for this purpose. Does AABB standards recommend this?

Thanx

[pipette acceptable standards]

Hi,

Are we supposed to follow thwe ISO 8655 stds for inaccuracy and precision of pipettes. When we look at guidelines from different labs upto 5% inaccuracy and 5% CV is acceptable for pipettes < 50 ul and 3% inaccuracy and imprecision is acceptable for pipettes > 50 ul.

What are the references that site these levels? can someone provide me a good reference for piptette cali standards?

thanx

[Hi]

thanx guys. great to share knowledge and information!

[Hi]

Hi all,

I am a clinical microbiologist and heading the quality management in our Lab.

I am working for a 300 bedded MOH hospital in Saudi Arabia. Our lab has Chemistry, hematology, Blood bank, Microbiology And Viral serology services.

I need to know if an apt algorithm exists for troubleshooting discordant results of External quality assurance.

Could somebody guide?

Also if there are excel templates for free download for LJ chart plotting