DMR

The company we are looking at (Temp Trak), indicates that the new NIST solid state probe is not sensitive to the door opening events and has been verified by CDC. I am checking on FDA and CDC Approval and requesting that information in writing. The facilities I talked with are still using the probe in glycerol for at least their alarm checks or are still using Chart monitoring along with Temp Trak. Looking for answers.

Is anyone not placing their CTM temperature probes in liquid for their blood refrigerator monitoring. If so, how did you validate that the probe w/o liquid temp matches the temp within the blood bag? Were you able to obtain information from the vender concerning the validation process that was performed. Also are these CTM systems FDA Approved?

Thank you all for your comments concerning your CTM setup and processes. We are looking at installing a CTM system at our facility. The system has solid state probes that are NIST Traceable that may be in glycerol or w/o glycerol. Are any of you still using glycerol with your temp probes? Is there a requirement that indicates temp probes need to be in glycerol or is this a left over from our past experiences? I have search for such a requirement but have not had any luck in my search. If possible, please share reference if you have found Glycerol use is required.

We are looking for information from users of the Quality Managment Systems Title 21 and iPassport. Please give us your point of view as users of either of these systems. Questions we have include: How much support did you recieve from Titie 21 when building the system for your facility. Time involved for administrators to front line staff training on the syste. How difficult/ easy was the transfer of documents from your current system to either of these systems. When reviewing documents with multiple versions are you able to trace / capture all changes made? How easy / difficult was the review and training of updated SOPs for front line users. SOP Approval process - painless / painful? Your comments are greatly appreciated.

I have been a SoftBank user since 1997 - What is your question? Feel free to call me at 701-234-2493. DMR

When we trained on Ortho Gel, we were told that the 37C warming is only for the reaction chamber above the gel Microtubule. So the gel area is not warmed at 37C during incubation.

Along with cephalosporins, for AHIA, watch for cefotetan administration pre-c-section. We had a situation where post c-section delivery the patient developed severe anemia Hgb <5.0 gm/dl. She had been given penicilin G post delivery, Cephalosporin, Aldomet (both given during the pregnancy) and Cefotetan. We sent her specimen out for testing and they found antibodies to penicillin and Cephalosporin that were weak. The also found that she had a strong reacting antibody to cefotetan. After searching her chart, we found one notation that cefateton in the anesthesia notes being given pre-c-section. Our Anesthesiologist indicated that cefatetan pre-c-section is quite common. The reference lab BB Specialist, says that when they see severe hemolysis post c-section, they often find antibodies to Cefatetan. I believe there are articles on this written by Garatty that explain the mechanism.

When making components and relabeling with ISBT label, how are you documenting the label recheck before issue? Documenting on paper? computer system? Thank you, DeLilah

For those of you who are performing QC on panel cells, how often are you performing QC on panel cells, expired? or indate lots? Upon Receipt, daily, day of use? Thank you in advance for your response, DMR

We have been with SoftBank since 1997 and are currently on 23.1.2 w/SoftScape. Feel free to call with any questions. DMR

I called Ortho Technical Service for their advice on adjusting 0.8% to 3%. They do have a "procedure" as indicated above. Ortho recommends that this procedure should not become a "routine" process. Also, these cells need to be QC'd using tube method when used for patient testing. DMR

I would like to survey Blood Bank / Transfusion Service members concerning the amount of time allocated for the Pathologist / Transfusion Service Medical Director to perform document review of Blood Bank / Transfusion Service Documents (SOPs, QA Documents, Txn Rxn workups, etc). We are especially interested in those circumstances where the Txn Medical Director is also responsible for Anatomic Path / Cytology and other duties. Thank you for your response to this request. DMR

We are currently performing patient esting using ProVue, Manual Gel, PeG and an occasional LISS. We are now trying to figure out if we could/should be cutting back on the amount of QC testing, by performing QC for PeG and LISS on the day of patient testing instead of daily. The problem, we encounter is that when we do these additional "non-routine" method, the situation may be emergent and result in delays since patient results are not to be reported until QC is reviewed and accepted. Please share what with me how you are handling this QC issue. Thank you in advance for your comments, DMR

We are currently performing Donath Landsteiner testing and would like to know what others are doing for proficiency testing for this test. Also, if you are sending this test out - what reference lab are using to perform this test. Are there other test(s) (molecular / Flow) that are available that would be more specific for PCH? Thank you

We are looking into the possibilities of providing pre-transfusion testing and blood products for Nursing Homes. At this time, it appears that the plan is have specimens collected and labeled at the Nursing Home using a BBID Labeling system. We would then perform compatibility testing blood products. These units would be sent via a courier system in monitored cooler to the Nursing Home. If you are providing this service, I would appreciate any information that you would be willing to share about your process. Thank you, DeLilah Rosecrans, CLS(NCA), MT(ASCP)SBB Laboratory Manager Transfusion and Quality MeritCare Medical Center P.O. Box MC-0041, 737 Broadway Fargo, ND 58122 Phone: 701-234-2493 Fax: 701-234-7316 e-mail: delilah.rosecrans@meritcare.com

We are seeing an increase number of patient scheduled / emergency for procedures who are on Plavix. Our providers are requesting pheresis platelets on hand for these patients from 1 to 8 or more units. Does anyone have any set protocols that they are using for these patients and their possible platelet needs when scheduled for various procedures, colonoscopy, cardiovascular, AAA, etc. Your comments are greatly appreciated. Thank you, Dmr

I am too interested in your SOP concerning Re-freezing pooled Cryo. Are you saying that you are thawing and pooling cryoprecipitate and then when it is not used, refreezing the product for use at another time? If so, can you share with me your referenced in standards/technical manual etc, and your procedure on how you perform this task. Are there studies that indicate that refrozen pooled cryo has appropriate concentration of Fibrinogen and Factor8 present? Please direct us to these studies and information? Thank you.

What do you mean by double dilute the patient's plasma? DRose

We are new gel manual testing users and are looking for protocols for how OB Titers can be set up in Gel - Do you have any protocols you would be willing to share? Thanks, DRose

We have 2 ABS intruments and have experience problems with CCC negative on multiple occasions on both instruments. My understanding is that Immucor went to a new formulation CCC's in April / May 2007. Our repeat rate was close to 50%, so we stopped using the ABS until we had preventive maintenance performed on both and received a new lot # of CCCs. The new lot # had the same problem. As of June 13th, we received another lot # of CCCs that is from the original formulation. Since the receipt of the new lot received on June 13th, our repeat rate due to invalid CCCs decreased to less than one invalid screen due to CCCs / day. A this time, we are seeing the number of CCCs invalid increasing - Immucor has been notified, but no new action has been taken by Immucor. We are keeping them posted. From my point of few, this is a CCC's problem and Immucor has yet to fix it. We too are looking at different automation / reagent system, but I'm not sure that what is out there is any better. I'm just hoping that it is not any worse.

We have had SoftBank since 1994 and we use a fake "Trauma Patient" to allow emergency issue of blood products to patients. I like the suggestion of Trauma, ________ This would allow the person administering the unit to add the name to the transfusion slip / unit tags.

We recently implemented the 2 specimen (historical or new draw and current specimen) different times / phlebotomist because of a sentinel event (non-fatality). With the variety of individuals who collect specimens for lab testing, we felt that this was the only way to prevent any future sentinel events. We explain to the patient the 2nd draw is for their safety. We only give O's until the 2nd type is available.