try seraplex or zenbio,

we are pediatric hospital, we use AS-3 only

Thanks much. I will look into it.

I am looking for some reference books to understand molecular genotype of erythrocyte antigen. Are there any recommended books? So far  I have found The Blood Group Antigen FactsBook to be very useful. Thanks

...same question as R1R2...Our says not required

4 hours ago, DebbieL said:

Do you document that the cooler was cleaned or is that something you automatically do? Trying to keep up with cleaning documentation of multiple coolers sounds like a nightmare. Our coolers sometimes go out several times a day.

We have never consistently cleaned our coolers. Sounds awful doesn't it

We currently have tape on the outside of our coolers and were told by Quality that it has to go. The thought of a "naked" cooler going to surgery scares me. I have thought of using one time use disposable paper tags that we could put a patient label on and attach to the handle so it would at least have the patient name on the outside.

How do others make sure the correct cooler gets to the correct patient? How do others document cleaning after use?

 

......by disinfecting, I mean using the wipes. We wipe our coolers every time they are returned. And, we don't have documentation after they are cleaned. So, depending upon tech and work load; sometimes they are cleaned and sometimes not.

We have plastic pocket that is attached to the cooler where we put the piece of paper with patient's name, date/time of issue and date/time it must be returned.

Do you disinfect your coolers after they are received from OR/floor? Or OR/floor disinfects them prior to returning them? Or do you even bother to disinfect them?

We disinfect every coolers after they are returned from OR/floor. 

We use Safe-T-Vue 10 in our blood products: RBCs and thawed Plasma (obviously plasma should be cold enough to attach Saf-T-Vue). Beside, visual inspection of products; we depend upon Safe-T-Vue coloration for our products return.

For platelets, we return the products upon visual inspection and room temperature return.

We are pediatrics Level I trauma with donor center. Our supplier is 45 miles away and we usually keep 4 platelets in hand; and depending upon situation sometimes we may go as low as 2 platelets. Our turnaround time of platelets availability from our supplier is at least 4 hour. 

On 3/18/2017 at 3:25 PM, Likewine99 said:

Dan87 do you get reimbursed for all of this "extra work"?  

I haven't done complete XMs since the early 1990s and have worked in a variety of places, large, small, adult, pediatric.

Change is hard but it really is time to drop the "unnecessary" testing, imho! 

 

Likewine99, I am sorry. I donot know the answer to your question. I do agree its completely unnecessary task. When I started here, I was pushing for EXM; but seeing the resistance, I have started to advocate for IS XM at least for now. 

I haven't heard anyone using sysmex for WBC count on donor units. It may be possible but you need to do validation. We used to use nageotte chamber; recently, we got our rWBC ADAM by Nanoentek validated.

5 hours ago, Smarty pants said:

I think Verax is the only one available.

Yup, Verax is the only one that is FDA approved so far.

2 hours ago, BankerGirl said:

We also bought our glycerin from the local pharmacy.  Dilute it to 10% with water.  I keep a diluted bottle in the refrigerator for top-offs and the concentrate at room temp.

BankerGirl, why 10% ? We do 30% and I am wondering if we are over concentrating our glycerol.  

1 hour ago, spavlis said:

What is formula (recipe??) for making this up??

C1 x V1 = C2 x V2

1 hour ago, R1R2 said:

Before switching to immediate spin crossmatch from AHG crossmatch on everyone, we would find many of those antibodies, that you mentioned, Dan87.  We did not blink when we switched to immediate spin (and then electronic (sorry Malcolm) crossmatch).   We are a large urban hospital system with many sicklers.   We knew that we would miss the occasional low freq ab that could not be detected on the screening cells.  (One note, many of our sicklers require full AHG crossmatch due to history of clinically significant antibody, but they would get IS XM if they qualified)   I have not seen one incident of a HTR due to the antibodies you mentioned.   I am sure that they occur, but rarely, and not a reason to stick with AHG XM for all, IMO.     One document that I love to review is the FDA report on fatalities due to transfusion.   It is always a good read.   https://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/TransfusionDonationFatalities/

I absolutely agree with you, R1R1. The value IS / EXM bring to blood bank work flow out weighs doing AHG XM on every single patient; but it would be a herculean task to change the conception of our leaderships.

While I have personally identified antibodies like Kpa, Jsa, V, Cw; our facility have identified antibodies like anti-scianna, anti-Wr(a), anti-henshaw, anti-Do(a), VS.

Scianna antibodies, Wr(a) and henshaw are the antibodies I have never heard before.

.....among few, one of the reason cited by our BB leadership for not switching into IS or electronic XM was our patient population. Most of our patient are Sickle cell patients who get chronically transfused and leadership are right to some extent as we have been able to detect rare/weird antibodies during our full XM.

Just out of curiosity, how many of you do full crossmatch no matter what the antibody screen is? We do full crossmatch in our facility for every crossmatch, that's right, for every single crossmatch.

SweetieShellie,

I guess I understand what you mean. Whenever I have such reaction in my gel cards, I look for other factors before I call it positive or negative. Firstly, I look for my negative controls, which will give me an idea of negative reaction. I also look for patient diagnosis, pregnancy hx, transfusion hx or any thing that has potential to cause positive reaction. I am very conservative about grading my reaction.

 

Does anyone know what's the maximum volume of platelets one plts bags from ARC can hold?

......these apheresis plts bags have volume ( which is infact weight) limitation.... So pouring the contents of one into another changes the expiration....

On 8/18/2016 at 10:16 AM, heathervaught said:

 

For anyone who stores RBCs like this for pediatric use, how old are the RBCs in the refrigerator?  Do you irradiate them? 

 

 less than 7 days old and they are not irradiated. 

I have used both the indicators. I prefer hemotemp over Safe T Vue and the reason being safe T vue easily gets deattached from the unit. Also, safe T vue, after activation, needs to be in refrigerator which could affect the workflow if you don't have refrigerator next to your issuing station. 

We stopped using ABO Rh confirmation label; with LIS in hand and shelving unconfirmed and confirmed RBCs in different refrigerator, we found confirmation label was redundant. Confirmation label rather adds unnecessary costs and labor; however, the inception of this process was uphill task. 

6 days for presurgical with signed documentation of no transfusion or pregnancy hx within last 3 months.....3 days for inpatients..... First day being 0.