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slsmith last won the day on April 24

slsmith had the most liked content!

About slsmith

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    Junior Member
  • Birthday 08/09/1955

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  • Location
    Portland, Oregon
  • Occupation
    Medical Technologist
    (Lead Blood Bank)
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  1. The Trauma patients are assigned MR# when they arrive and banded. Usually the request is for what we call a R-Pack(resuscitation) which includes 6 O red cells, 4 A liquid plasma and a platelet pheresis. Either a OR runner or ED Tech comes to pick up the blood product bringing a ADT label which has the patient's MR# , Doe name, and generic dob. The blood is issued in millennium documenting location, reason, transporter's employee number. The same log for issuing regular old blood products is use which has the patient's identifier, the two Techs issuing(reader and listener), the transporter's number(or full name) and the number of each product that is issued. There is also a refrigerator between the 2 trauma bays that has 4 O+ red cells and 2 liquid plasmas. The nurses have to scan their badges(employee id) and enter the Patient's MR# to get access. There is a huge computer screen in the BB that shows that the refrigerator has been opened and we can see what got removed, who removed it and who it went to. However, I don't recommend this feature it is a pain in the behind ):
  2. We don't honor phenotypically matched blood on a newborn unless the baby has a positive antibody screen due to the mother's antibody. The product that is set up for the baby is fresh ( less than 5 days old), O =/O+(depending on the babies type), irradiated (same day), leukoreduced(comes that way from supplier) and hemoglobin S negative.
  3. Until we have two blood types( original and confirm) O positive blood is issued for Men 18 yrs old or greater and females 50 yrs old or greater.
  4. We use it during a computer downtime when the transfusion is needed before the computers come back up. Then once the computers come back up the units are retroactivity computer xm/dispensed
  5. We use a electronic huddle report via the email system. The shift charge is responsible for writing it and they gather the information by going through the departments to see how the day went, inquire about any issues and asked for pertinent information to be passed on. Most everyone is good about reading this report especially since there is usually some kind of interesting bit of intel to be passed on that induces a chuckle. Also there is 1/2 hr to 1 hr overlap and Techs are good about communicating any issues. Great team work at my site..
  6. We use Ortho Anti-D and their insert says agglutination is interpreted as positive. It also states one drop of Anti-D is used. But our procedure is add 1 drop of Anti-D and if the reaction is negative we add another drop of Anti-D and if the agglutination is 1+ or less the interpretation is negative. We do not send for genomics testing unless the physician requests, which has happened in the past when the patient had a history of Rh positive from another institution. Never have we been cited from CAP or AABB which are the accreditation agencies we use. Who is HFAP anyway?
  7. It had probably been like 10 years or so since there was a "real" exchange, before that 2 times a year??? But since EH is a training hospital for both MT's and MLT's and it seems like we are always training a new employee a product for the exchange is prepared several times a year
  8. The neonatal units we have on hand are less than 5 days old with only one being irradiated ahead of time(for emergency neonatal resusit.) Once aliquoted in a bag it keeps the neonatal outdate which is 28 dates from the draw date but the user has to be started within 21 days from the draw date. If it is a large volume transfusion though ( >60 ml) the red cell has to be less than 5 days old. When I refer to neonatal outdate it is when the products is not longer used for neonates, it could still be used for an adult if the volume is adequate enough. So far have not had an issue with high K levels
  9. Interesting question....maybe we should be but not we don't
  10. We do a "select " panel which is confirming the antibody is still demonstrating , one cell only not the three when the antibody was discovered. And then another cells to rule out the possibilities. Sometimes it is the whole panel and sometimes maybe 5 cells if your lucky.
  11. Yes in the scenario our BB calls it Anti-M and make a note for ourselves(not chartable) that it is showing dosage. We also perform an pre-warm to determine if it is significant.
  12. Legacy is on the BPAM system which started a couple years ago which is based on a matching system. The blood being dispensed has the order scanned using the MR#, the accession # and the unit number. When the unit is to be transfused, the transfusionist scans the Patient's arm band and the unit to be transfused and there some computer field they are in and if everything is okay they can move on and if not it is a hard stop. There is an emergency over ride for cases where emergent uncrossed blood is sent that is another story
  13. I wouldn't trust a nurse in performing ABORH testing, they have a hard enough time with other point of care tests.
  14. Yes we charge for the antigen testing whether or not it is positive. or negative
  15. Here the type and screen/xm is okay for 28 days but the patient has to go through "preadmissions" for their pre-surgical testing and asked questions about pregnancy, prior transfusion, known antibodies. The outdate is extended 3 days passed the surgical date no matter if blood is given or not. If an antibody is found the patient is not a candidate for preadmission and has to come in within 3 days prior to the surgery.
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