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Everything posted by slsmith
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Other than myself everyone that works the BB also works another department or more. I currently in a battle with the Lab Manager who seems to want everyone trained in BB. It is very hard to get her to accept that BB needs to keep their skills up more than any other department, not to mention the yearly competencies. The dayshift and night shift isn't so much a problem as the Techs rotate into BB quite often and at least for dayshift the other Lead and myself are usually here for questions. The evening shift however some Techs don't get into the department for a month at a time and are terribly uncomfortable when they do and that is where she really wants more people trained. Grrrrrrrr, the frustration
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We keep them because it is a AABB standard to retain them for 10 years. If your hospital isn't AABB accredited then there shouldn't be a reason to keep them
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Our traumas are assigned MR#s before they are arrived and given a doe name, it is usually a name of a car (Mercedes, Doe). The sex is usually known and the dob is the same for all patients (100 yrs old). The computer system we use (Cerner Millennium) allows us the dispense the units with a exception flag telling us the unit isn't crossmatched ,do we want to override and why (we pick emergency). A transfusion tag is generated but the area which usually states compatible says uncrossmatched and across the blank area of the tag which usually has special attributes(irradiated) there is a statement saying "emergency dispensed, uncrossmatched.
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If the blood product isn't going to be started right away or just to have on hand due to a procedure being perform the blood is sent in a cooler under wet ice. The coolers are validated to maintain a temperature of 1-10 degrees for 8 hours. But we switch the ice out at 4 hours if the cooler is still out. For the transport if not needed in a cooler the blood is sent in a clear zip lock bag.
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We transfused with O pos or O neg less than 28 days from t he draw date unless it will be a large volume transfusion (greater than 60 ml per day), than its less than 5. If we do give non group O red cells (direct donor) we perform a IgG crossmatch to make sure the baby doesn't have anti-A or anti-B from mom. The babies stay on the same unit until it is too old for neonatal use (>28 days) The plasma we get from the supplier is AB and split in 4 aliquots of roughly 75 mls each
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1. For pre-ops usually when they come in. But if the patient doesn't want to be stuck a second time at this point, the aborh 2 is drawn the day they come into surgery. The night before the BB sends down to pre-surgery a copy of the surgery schedule and note the patients that need aborh 2's 2. Our outpatient transfusions get O positive until we know their blood type. The population is children so really can't get the kid stuck twice in one sitting. 3. If no history the ABORH 2 is ordered the time the type and screen/cross is being processed. We don't hold up blood for the ABORH 2 especially if it is emergent. 4. Second phlebotomist is preferred. But same phlebotomist different time is acceptable
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1. Positive DAT with IgG, transfused in the last 14 days. 2. Acid elution 3. Gel 4. Start with the screen and then select panel if cross outs are obtained on the screen
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We actually take the temperature upon return and if the temperature is greater than 10 degrees it is discarded, doesn't matter if it is returned within 20 minutes. And this was changed after one of our inspections. I don't recall if it was CAP/AABB or FDA.
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All of the hospitals in our system follow the same policy as although they may not receive the traumas that the trauma center has they do go on massive with other patients, such as OB.
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Eluate testing? Screens first or straight to a panel?
slsmith replied to IRLtech's topic in Transfusion Services
I always do a screen first so if I am able to eliminate some antibodies from that I can do a select panel. Especially helpful if you perform CAP eluates as they only give you like 2 ml of blood. -
Once a year with a direct observation of making the auto control and making 3% cells to 0.8% cells. Also Techs are required to perform at least 1 ABID a quarter.
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Perform the unit and patient retype like you do normally, just make sure you fill in the bubble "not performed" Yes have your IS department make you a new product so you can crossmatch electronically.
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Does anyone distinguish between passively acquired D and actively acquired D when performing antibody id's on Obstetric Patients? Or do you "presume" the Anti-D is due to RHIG if the reactions are weak and there is a history of injection? If so is it only if the Doctor demands it or it is your SOP. And how do you do so? Titer?
