slsmith

Only time we crossmatch ahead of dispensing to the floor is if the serologic crossmatch is required. Then we electronically crossmatch usually crossmatch/dispense when the floor calls for the product. We attach the order to a form we have(we call it the WIP) that has the patient's identifiers, ABORH/antibody screen interpretation, date of collection and special needs. We keep it in a file at our dispense area until the clot expires or patient is discharge. After that we filed it away in storage boxes that are kept for 10 years. Since we have been doing this we seldom have red cells expiring on us. Now is I could say the same for the platelets ):

thawed cryoprecipitate is to be stored at room temp for 6 hours.

Just a ABORH

When a patient has had a bone marrow transplant and it has been several years and they have totally engrafted( is that a word?) when is it safe to give blood products that are no longer irradiated ? Or is it a life time requirement. My pathologist is investigating this and so far any literature I have read is vague.

We don't antigen type for Lewis. However, we do perform a prewarm antibody screen. If negative we prewarm xm. If the Lewis doesn't prewarm away then it is a gel xm.

The sites that don't have a NICU have a filter syringe on hand that can be use in case of a emergent neonate transfusion(my hospital supplies them). And they are to give the freshest O neg they have.

It depends what the supplier is sending you. When we use to get single cryoprecipitate that the supplier called a "button" we put sterile saline in it to make it more liquid. Now it is all liquid ( of course when thawed). The pooled cryoprecipitate( 5 CP) is all liquid , not saline added

At my facility as soon as the ABID is resulted it is charged. If the scenario you mentioned happened to us the ABID would be reported out as a "see note". The way our computer system is set up a "see note" allows for a computer xm. Only down fall with this policy the patient is eligible for a preadmission workup.

For plasma we require a current blood type(same admission). If platelets or cryoprecipitate a historic type is acceptable

I didn't see this additional information.

Sorry no help here as we have a backup system that we can check patient history(backed up weekly). There is more to check for other than historic type such as antibody history, or special needs. And for history that may not be backed up yet there is a Patient Activity Report that prints daily that is reviewed for accuracy of result input, among other things. We use that for current information, not much help for special needs or previous antibodies but still something

Haven't had one in my career but it is a symptom of a hemolytic transfusion reaction

If the supplier is the one we use and the product is packed appropriately we bring it into the inventory, notify the sending facility and notify the blood supplier. If the blood comes from the other supplier which we don't have a contract with we notify the sending facility that we don't bring this supplier into our inventory and asked them what they want to do. Either we can send it back to them at their cost or if our couriers go to their facility we can send the product back to them . Of they can asked the blood supplier if they want it back (sometime they do as we share a parking lot with them). Don't ask why we don't use the blood supplier we share a parking lot with. Long sad story.

1. retyping with the same sample but different Tech is a CAP requirement, no matter what the order is. 2. then a 2nd sample drawn by a different person or a different time is required for anyone possibly getting a transfusion. I don't know if this is a CAP requirement yet although I know it on their check list. But I do believe it is a AABB requirement

We keep 6 low titer A liquid plasma on hand . Right now our medical director only allows it for MTP and traumas so we can't give the product to another patient if they become shortdated. We do waste quite of a bit of product, guess it is the cost of doing business but it is frustrating.

We report the ABORH as "corrected" with a footnote of the ABO result and that the RH couldn't be deterimined at this time(submit another sample in a couple of weeks) due to the positive DAT.

I would say no as not sendng a high risk form doesn't affect the potency, safety or purity of the product. One could say not having the doctor sign the form affects the safety because perhaps they won't watch the transfusion more closely than usual but should the transfusion still be monitored ? Anyway you could always submit a deviation just to cover the BB behind, if it isn't reportable the FDA will let you know. This I know as I have filed reports that were questionable to file or not to file and received notification that it wasn't . But the non-conformance (not following the SOP) should be reported in whatever way the lab reports their errors internally.

We have a monitored and locked refrigerator between the two trauma OR's , adjacent to the ED. It has 6 O pos red cells and 6 A liquid plasma and access is made by RN's trained to use it and they have to scan in their ID(linked to some training module) and the Patient's MR#. Blood bank and has a computer screen on the wall that shows that the refrigerator is being opened and you can see t he patient's information, what is being taken out and who is taking it out. Problem with this has been: 1. nurses trying to access it who haven't been trained to use it and they can't get in so they call the BB and complain and want help. We then send a trauma pack from the refrigerators in the BB 2. The trauma nurses are the only ones trained and sometimes they say they are too busy to access it so ask the BB to send a pack but they really want what's in the refrigerator. The powers to be are discussing the possibility of have the OR runner access it. Which works for me as they are the ones that pick up the blood in the BB anyway and really have a better concept of storage and handling of these products than some of the RN's. Note: yes it is O pos red cells so if the patient is of child bearing age it is up to the provider to make the decision to use the blood in the refrigerator if get O= from the BB

Yes we test for weak D in cord bloods or even capillary sticks if that is what is drawn and we have seen weak D's. Also keep in mind (sorry if you already know this) if the DAT is positive the positive weak D isn't valid

I would really question the time of draw versus when the rhig was given. We had a similar situation and when all said and done it ended up she was injected before the blood draw.

We have a order for emergency uncrossmatch blood in EPIC and it has an electronic signature attached to the order so no other signature needed. How the IR department built it I don't know. And a phone call is still required as there are times the order was placed in error (darn residents) and the fact that when an order prints we don't necessarily jump to see what just printed .

We use the containers from the blood supplier. Then take the temperature every four hours.

We use the shipment container the blood supplier uses which is validated for 24 hours. However, the platelets never stay that long in the courier car as when the platelets are shipped to another site it is usually a direct shot.

The charge(how we do it) comes from the hematology when they perform the sickle testing as requested. Sorry, that wasn't any help

The in house irradiated product label doesn't say "irradiating in house" but it does in the lower right corner of the label have the hospital name and the FDA registration number. Probably the same thing? Anyway my hospital is inspected by FDA, AABB, CAP and ISO; never have we had a issue with this process.