BloodBankGuy

Hello, We are going to be moving forward with testing cord blood gases. We currently run venous gases and arterial gases on our ABL 800 series. Now since a cord gas is still technically a blood specimen, does this require a new set of validation? We are not running reference ranges with this, so I don't know if that would make a difference. Thanks for any input.

We have started to use AimTab. They are not FDA approved but we are using them as a LTD and they correlate perfectly with Clinitest tablets.

Thanks for the info!

We do not. There was a validation done on these 10 years ago when we first received these devices, so we were piggybacking off of that a little bit. And in us doing that it brought up a lot of discussion. So far the consensus is we went over and beyond what we should do and biomed checks are sufficient.

Hello Everyone, Need some guidance on validation of blood warmers. Recently our clinical engineering bought 24 new blood warmers, same model and brand of what we have already used and validated. We have just recently validated 6 of the 24 new ones with running blood through them and taking whole blood potassium levels at hourly intervals. The question we cannot agree on is do we need to validate every single blood warmer or is the 6 that we have done a sufficient sampling to be able to make a blanket statement that the warmers are ok for patient use. Anyone have any evidence based answers to this? At this point I'll take just some good advice! Thanks in advance.

If you attend any Medicare billing conferences they discuss this in detail. You can only charge for an antigen typing to one patient. Now if you want to charge it to the patient you initially screened OR the patient that is receiving it if the first didn't need it that is fine, but charging bothing for something you have done once is a mischarge. At least that is how it is discribed.

Actually if you look further CAP TRM.40800 says, "There is a mechanism to ensure that Rh immune globulin is administered to all identified candidates within 72 hours of an Rh alloimmunizing event, whenever possible" So blood bank does need to be involved in distribution some how. This cannot be just left to Pharmacy and nursing staff. Whether its a followup daily or something else. If you are not distibuting RhIg, you need to be aware of who is and who isn't receiving RhIg from Pharmacy.

We use "Titer too low to measure: Enhancment reagents used for antibody identification are not recommended for titers." We do not enhance our titers as we do antibody identifications to prevent falsly high titers. We treat it as in vivo where we see how it demonstrates without the addition of enhancment reagents.

Thanks for the replies. I have never heard of anyone doing a comparison like that and I don't know what the real benefit is, but just following up on a request. But I will contact financial and see what reports they can get me. Thanks again.

Hello everyone, Looking for some help/direction based off of a request made by my Medical Director. Do you have a way to track blood utilization in a macro fashion rather than just micro. Not looking at individual patients and their clinical indicators but looking at severity indices in a hospital system as a whole. For example if a severity index for a hospital is 1.3 the average number of transfusions for a patient should be “x” amount. Also, if that number goes up and goes down what is the number of transfusions that should be followed? Request comes from medical director to see if there is a number that hospitals should be shooting for, for average transfusions based off of this variable. Thank you. AABB Tech Manual basically just hits the micro portion of blood utilization(hematocrit, clinical indicators) on certain patients. From what I read there isn't much concerning macro utilization. Just looking at the amount of transfusions per 1000 patients with a severity index of a certain number. Any info or direction to look would be helpful!!!

Our blood bank policy is if there has not been a transfusion in 3 months we would not do the elution. Granted if you do not have any previous history on the patient you are relying on their word, but its not like you are asking if they took a certain medication that they may or may not remember. Most patients, will remember if they received a transfusion or not. Now I have some older techs that will still run one to see, and if we have a patient that looks to be a WARM auto we will run one, but in general we don't unless proof of transfusion But there is a small possibility that you have bad intel as goodchild said and you may miss something. Kind of a judgement call.

I was meaning the ABO discrepency as we had a previous and the current ABO did not match. The only thing I cannot remember off hand was the back type results. But I do believe that, like the OP, it was non reactive.

Interesting enough my hospital had a situation just like this less than a year ago. We were not informed of the bone marrow transplant but saw that the doctor was an oncologist and when we typed them (previous and we saw they were now an A, we thought we needed to do some digging. When we finally found out that they had a transplant we gave them O cells as we could not fix the ABO discrepancy even though we had a reason why. As Shily said, O cells are not rare so we kept as such to not cause any potential effects since no one had ever experienced something like this before.

Yes, there was not any negative results from this.

Our pathologist does not have input in the identification of antibodies and they do not review the records after. Significant/insignificant is made by the supervisor (Me) if there is any question as to whether it is or not. Granted it's easy as 98% of antibodies are significant that are identified on a daily basis. But as I said no pathologist comments on antibody identification.