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slsmith last won the day on February 5

slsmith had the most liked content!

About slsmith

  • Rank
    Junior Member
  • Birthday 08/09/1955

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  • Location
    Portland, Oregon
  • Occupation
    Medical Technologist
    (Lead Blood Bank)
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  1. slsmith

    Tips for 1st job as a Blood Banker?

    I would read the book, "Modern Blood Banking and Transfusion Practices" by Harmening. It is pretty easy read unlike the Technical manual. Plus it has short quizzes at the end of the chapter. As far as workflow you probably need to wait to see how your BB does things. Only thing I tell Techs that I train on the simple things such as loading the centrifuge or setting up their tubes for testing is to be consistent in how you do that task, don't flip back and forth.
  2. slsmith

    Blood products for OR

    The OR runner or nurse brings a "patient label" which has the full name, MR #, Acct# and DOB. If blood is needed emergently and there is no Type an Screen the doctor places the order "prepare emergent blood" for how many units they want. The way the order was built includes a electronic signature so no high risk form needs to be sent
  3. slsmith

    Rh Pos or Rh Neg?

    Cliff I feel your pain about this issue. We have often had to explain this issue with much difficulty to physicians whose patient have a historic RH positive from another facility but we call it negative. And sometimes it is truly negative not calling it negative because the reaction is 1+(that is Legacy's cutoff). I agree with the other panel member(sorry can't remember your name) if we call antibody screens + that are 1+ why don't we call a patient Rh positive if their D is 1+. Anyway what we have done is explain that RH D testing can change based on the reagent or testing mechanism and that is safer to go with the RHIG injection than not go with the injection but it is ultimately up to them ( of course I don't say this but the pathologist does). We have also (once) sent a sample to the reference lab to see if the D was partial or weak and were able to get the results back within the 72 hours. I don't see us doing this all the time though
  4. slsmith

    Hours worked

    I do not know of any requirement such as this and none of the accreditation agencies that have come through including ISO have ever commented on this. It could be a previous "rule" from an incident that occurred? At one time people who did doubles were not allowed to work in the BB for both shifts, because the common factor(excuse) for errors made while doing a double in the BB was "fatigue".
  5. slsmith

    Cryoprecipitated AHF storage

    I have never thought of putting cryo in the Platelet incubator but I don't see any hard in doing so. That being said we just leave the cryo sitting on the counter
  6. slsmith

    Eluate Blind Samples

    Sometimes I use the Coombs Control. Other times I have antigen type an expired unit for E, C or K and if positive for one of those put a couple of mls in a tube add the corresponding anti-sera, incubate for 30 minutes. I found the another anti-seras don't work so well.
  7. We don't re-spin the card , we re-spin the sample. If this doesn't work here is our process >Perform a full gel panel with auto control >If not pattern, no antibody identified(some cells pos/some negative) >not all clinically significant antibodies r/o consult tech specialist or technical lead >all csa ruled out report as an "no significant antibody" and use gel xm
  8. The Blood Center we used does not label with historic antigen types, only confirmed. They do however put them in a spread sheet which gets sent to us. If we need a particular antigen we scan the spread sheet, find the unit/s we need and antigen type them ourselves
  9. slsmith

    inconclusive antibody ID

    Forever ):
  10. slsmith

    FDA reportable?

    Since the unit was dispensed and transfused ,yes it is.
  11. slsmith

    Direct antiglobulin test

    Yes unfortunately we look at negative reactions under the microscope. I really want to stop doing this and thank you for the reference to support my plan. It is correct reading microscopically causes more trouble then it is worth. Answers to the other questions" > Yep we get a CAP survey >And as far as I know reading under the microscope isn't a CAP or AABB requirement. Note: I am the most senior Blood Banker here now (30 years) and this process has been in place when I started ( I think). Anyway I will be seeing one of the retired Supervisors today and will ask why we started doing that
  12. slsmith

    Training new employees

    This is an awful situation, if he doesn't follow processes when he is training what is he going to do if and when the training is complete? I would just document the heck out of everything in writing and perhaps asked for a meeting with the higher ups and include the person that is training. If you have a BB Medical Director you feel like you can confide in talk to them about your concerns. Good luck.
  13. slsmith

    TAT for STATs

    >350 bed level 1 trauma center plus 165 bed children's hospital >60 minutes with the exception of traumas which is 45 minutes >RN's, Phlebotomist's, MLT's, and anesthesiologist >Time starts when the specimen is in the lab >Just moved the automation to another hospital in the system but we only performed Outpatient Prenatal type and screens.
  14. If the weld stays intact the parent unit keeps the original out date. Then it depends if the product is a red cell or a plateletpheresis for the out dates: > red cell aliquoted to a component bag is the original out date. > red cell aliquoted to a syringe 24 hours. > platelet 4 hours no matter if to a component bag or to a syringe.
  15. slsmith

    Group A plasma for traumas

    We give low titer liquid plasma to the traumas and hasn't been an issue. But right now it is only for the emergency pack that is sent to the ED waiting for the patient to arrive. And the first round of the MTP if we don't have a blood type. >emergency pack: 6 O+ or O= red cells, 4 liquid plasma and a pphl >mtp: 4 red cells, 4 fp and 1 pphl ( could change depending on the PT, fibrinogen, hct or platelet count

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