JulieSt

And us - I've only used irradiated platelets for years. Less wastage as you can use them for most patients

I agree with the others - we discard any unit which is returned spiked! I then send the transfusion practitioner to find out why they spiked it and didn't use it!

I'd also want to check that it wasn't a transfusion reaction because as others have said you want to make sure its not a 'real' event. 1 observation for you - in the UK all our products are leuco-reduced and have been since 1998 ( I think!). Previously we experienced this type of report frequently (all of which we'd do some investigation on but rarely found anything)- at once once or twice weekly. Since leuco reduction - we still some reports of this type of reaction but significantly less then previously ( probably get one report every 6-8 weeks now).

No problem with questions ( I'm really proud of our system so really don't mind) Inventory - we swap out of the fridge when its got 7 days life left. checking this on mondays and fridays ( so not too much work) The number of units we stock in the fridges is dependent on the usage in that area - initially I looked at what they'd used in that area in the last 6 months and the mix of groups. Then aimed to stock a weeks worth of stock. This has reduced over time because we've found they use less blood if they know its there but not issued! My wastage hasn't gone up ( runs at just under 1% ) Yes the system has a printer which prints out the tag - it then asks the user to scan the unit and tag within a short time (15 s) to check they right tag is attached to the unit Yes you're right the system is bidirectionally interface to the lab system. It blocks automatically those patients not suitable for electronic issue ( so antibodies, samples not completely reported etc etc) for Emergency stock (uncrossmatched blood) - it has a button to get emergency stock ( you can choose to just let them have O neg for this or give them the choice of O pos as well) I give them access to both ( as we've spent years training that if you know the patient is Rh pos then give O pos emergency stock) - this works well and reduces the use of O neg in these situations. We've only ever 1 person take O pos when they should have given O neg ( but that was when a trained nurse lent their access badge to an untrained unqualified support worker!) Hope that helps

Hi Liz, In answer to your questions - I've given access to all the staff in the blood bank to allow for restocking. This includes our support staff. We check stock levels visually (by checking on the inventory on the manager PC) twice a day ( probably restock 1 fridge or other everyday but not each fridge daily) On mondays and fridays - we swap out the stock which has less then 7 days life left so we can ensure we use it and it doesn't get wasted. This is i usually the less used groups ( especially B neg and ABs) The system has an alarm level (which is settable by the lab leads) which means if the level of any group drops below that level - the system alarms in the lab prompting us to restock. This works well - most of the theatre staff are also happy to scan in the stock if we send it down to them when someone is bleeding. The system is totally controlled by IT - we've a bi directional interface with our LIS which means patients for who you don't want to issue remotely ( like those with antibodies and those who have recently had a transplant) can simply be blocked. It also means we can select who gets access ( they use a barcode on their staff ID badge to log on) and what they have access to. We have been known to redraw access if someone keeps doing things wrong ( or hasn't used the system for 6 months so they have to have retraining) regarding bedside transfusion - we also have It there too. We have PDAs at the bedside which are used to scan the patient ID wristband (which has a barcode on it) and the blood products (again we put barcodes on them too). If the blood isn't issued to that patient is alarms (loudly!) and so prevents them transfusing. We transfuse 28,000 units of red cells in a year - and this is used for all but a handful each year ( the handful which aren't done correctly are chased to fine out why - usually things like the PDA wasn't charged or the HIS wouldn't print out a wristband) You probably think by now that we have loads of IT - well we do! Hope that helps Julie

The UK BSCH transfusion guidelines for pre-compatibility testing have just been republished. They are recommending 2 draws unless you use a fully electronic PPID process.

Hi Everyone I'm the Julie who Malcolm has asked to join in this conversation. I'll admit I didn't know this was here - you will probably seeing a lot more of me! I'll comment on the thread: We moved over from full AHG crossmatches about 12 years ago and went straight for electronic issue. Like others we experienced some resistance from the lab staff. They were mostly worried about - is it safe? and what would happen if something went wrong. We did a lot of 'information sessions' for the staff - I went through why we wanted to do it, what evidence was out there for doing it, etc etc. I also got the consultant to come along and answer questions and re-assure them that as long as they followed the laboratory SOP then they were covered for anything going wrong. The 2 were doubtful staff (even after this) I involved in week of duplicate running. This meant they could see upfront just what was involved etc. They ended up being 'champions' of EI! Regarding vending machines - I was involved in the development of the first vending machine system in the UK back in 2004-5. We have been using the system ( with multiple fridges) since early 2006 and really wouldn't go back. We've gone for putting them in theatre (OR) and have them in all our main theatres. I said at the beginning that I was concerned about portering staff doing the issuing ( and I still stand by that today) - so the staff we have doing the issuing are mainly ODP (Operating department practititioners) and theatre nurses. I did initially train all the anaesthetic consultants ( because they insisted they'd use it) but I wouldn't do that again. I've only ever had 1 Anaesthetist issue blood and he only did it to see how easy it was! Hope this helps - happy to answer questions on this.... We did publish our initial work on remote issue/vending machines. If its appropriate to I'll see if I can attach a copy!