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jojo808

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jojo808 last won the day on March 14

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  1. I wouldn't think you need to create a new policy, you should already have a policy regarding situations requiring path approval or regarding a deviation from your SOP. Agree with what was mentioned previously in that a conversation must happen with your medical director and ordering MD. The blood shortage is worldwide with the donor pool going up and down so this shouldn't come as a surprise to the MD. We also switch male patients (not that often) but the MD's understand the situation. We note it in the patient files the date and how many Rh pos units were transfused just for tracking and in case an anti-D is made.
  2. For those who call these units 'incompatible' and transfusing them, what does the wording in your waiver say? I assume you are not just issuing "incompatible" units without some kind of deviation form. Please help us out; those who are still using the rubbish term "least incompatible", to start discussions on what kind of language to use. Here are some terms I recall from older posts about this subject, please refresh my memory as these are the only ones I can remember so far. Thank you in advance for any help. 1. Suitable for. 2. Serologically compatible. 3. Most compatible.
  3. To emphasize Exlimey's point: "One event does not indicate a trend - changing the whole system to address a single cut-finger incident is unreasonable". Also of concern is the use of plastic, who knows in the near future if this will be available in test tube form in abundance? We need to look at how and why this accident occurred? Everything in our lives cannot be padded so we don't fall, trip, get our feelings hurt (sorry had to add that), or get a cut. I know it's very serious to get a cut from a blood-contaminated item but I personally would look at what is reasonable and prudent. I know we have 'seasoned' techs on this site, probably 20-30 years in the field that would think it strange for that incident to happen, I would think getting a cut from grabbing "clean" tubes from the dispensary would be more likely because you are grabbing a bunch of tubes but normally you grab tubes with samples in them (contaminated tubes) from either the centrifuge or tube rack and can clearly see what you are grabbing.
  4. So the facility we receive our Platelets from recently added anaerobic culture to their process. Several months later, we receive notice that one of the units tested + on day 5 of anaerobic testing for propionibacterium acnes. I wanted to know how others are reporting this to the physicians. The unit was transfused, no ill effects were noted in clinic notes and the patient was discharged prior to my receiving the notice. I do want to be careful on how to approach this because you all know how something like this can be taken out of context and then you hear that the lab gave out contaminated platelets. Some of you will say let the pathologist decide or let the donor center provide direction and that is the kind of information I would appreciate but can you also elaborate on details and the outcome and how you close out a case like this. Thank you very much in advance!!!
  5. Let me start with an example: Oncology patient is admitted and has a critical WBC of 1.0 I'm going to assume everyone has to call the floors with this value. Now my real question is if the patient has a CBC Q6H how many of you have to keep calling the critical value. Is it not necessary in your hospital to call subsequent critical WBC values? Same for other critical values? Any other scenario can be used, and thank you in advance for any response.
  6. I understand now, had to read the thread over again and the reasoning with my simple mind. Well if the patient's antibody screen was negative prior to Darzalex treatment, then given K neg units once the antibody screen was affected by the DTT technique, then I can understand how giving 'regular' units once the antibody screen is negative would be acceptable because none of the units given would have caused that immune response (Aha moment). duh. Thanks everyone.
  7. I don't see the difference. Just because you give Kell neg units due to DTT denaturing Kell antigens, doesn't mean a Kell antibody was never there in that very sample. Is there any way you can prove that? Yeah I know I'm playing the devil's advocate, I really don't want to but if we are saying we can't rule it out, then you have to consider it may have been there right?
  8. I need clarification. I once asked on this site that if you could not rule out an antibody could you 'ignore' it once your screen is negative and I believe the answer was no. If in these cases with Patient's going off Daratumumab, if you could not rule out Kell (due to DTT treatment of cells), even once, don't you have to consider that a permanent problem even though we know that the probability that an allo anti-K developed is probably null?
  9. I think we need to add an OMG emoji to our selections!
  10. Some physicians are requesting that our IT build an Emergency release XM test to avoid having to sign 'the paper' for it. It will be a normal crossmatch test with the understanding that it is uncrossmatched and 'emergency released' via the verbiage that will be attached to it. Does anyone know if that is not acceptable to any agency? I will definitely require that the phone call to blood bank still be in the process, this is not my choice but I feel being forced upon us. I feel I'm the only one who objects to these things. Thanks in advance for the comments.
  11. When you say that the antigens are soluble and will inhibit the patient's anti-Lea in vivo, does that mean there will eventually be no Lea antigen on the donor rbc's? And let's just say it is certain that this patient has anti-Lea. Would there (theoretically) be no further problems with the first unit? or subsequent units?
  12. Fast forward: We think the cause of the incompatibility was (maybe) an Anti-Lea. We came to this conclusion because the 2 units that were clean were LeA negative and the other 2 that were reactive with the patient's plasma were LeA positive. This would be the only antigen that did not match the patient's phenotype. Anyway we are hoping our blood supplier can continue to get these (few) donors in. I think I've read in the past where anti-LeA is not clinically significant, but if this is an anti-LeA, it is not being detected by our ref lab who uses solid phase and tube. We use Ortho Gel (we do not have automation yet), soon to get the Biorad IH 500. Can't wait with all our antibodies!
  13. So we did perform the tried and true tube method with Peg enhancement (actually our secondary method) and both units came out a clean negative. The MD wanted to transfuse only one unit and see how the patient does. I'm so ok with doing that. I will try and keep you all posted thank you all again.
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