Alana
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Posts posted by Alana
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I have a physician who is asking us to prepare washed red cells with a hematocrit of 75% - 78%. The process we have today only allows for a range of 70% - 80% with no way to regulate it further.
Is someone willing to share their procedure or process to obtain a washed red cell product that has a specific hematocrit.
Thank you. Alana
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Sherie
I am part of a large system with a shared BB LIS. We enter everything in the training side of the computer (also shared). The staff member will create a 'unique' patient name. Enter the components and pick the components for the 'unique' patient to complete the EXM. The person completing the EXM will print screen shots with the patient info/unit EXM. The only way to 'discover' the name is to look on the printed paperwork which does not leave the location.
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Good morning.
How do you interpret and/or comply with this CAP checklist items for your FMHS kits? Thanks for your help. Alana
COM.30450
New Reagent Lot Confirmation of Acceptability
New reagent lots and/or shipments are checked against old reagent lots or with suitable reference material before or concurrently with being placed in service.
NOTE: The purpose of this check is to confirm that the use of the new reagent lot or shipment does not affect patient results. Matrix interferences between different lots of reagents may impact the calibration status of instruments and consistency of patient results. Improper storage conditions during shipping of reagents may have a negative impact on their ability to perform or exhibit the same levels of reactivity as intended.
Qualitative
For qualitative nonwaived tests, minimum cross-checking includes retesting at least
one positive and negative sample with known reactivity against the new reagent lot. A weakly positive sample should also be used in systems where patient results are reported in that fashion.
Examples of suitable reference materials for qualitative tests include:
1. Positive and negative patient samples tested on a previous lot;
2. Previously tested proficiency testing materials;
3. External QC materials tested on the previous lot;
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Thanks everyone. Alana
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What is the source you use for a 24 hour expiration? alana
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Thank you David. An Expriration of 4 hours was my thought as well. alana
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Does anyone have a source that can be cited for an expiration date/time on a pheresis platelet that is received from the supplier in two attached bags and combined into one bag at issue?
FYI: The system remains a closed system but the surface area for O2 exchange has been decreased.
thanks for your help.
Alana
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David
We have had poor reactions with the current lot of Immucor FMH Rapid Screen. I ordered a new kit from Immucor, thinking something happened during shipment and the new kit (same lot) is equally as bad. We have moved all testing to K/B until a new lot comes out.
We have made multiple complaints to Immucor throughout this week.
Alana
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How do you resolve ABO discrepancies without knowing what you are pre-warming? The back type cells are really screening cells with a flavor (ie blood type).
What do you do to resolve IM xm that are reactive? Just pre-warm without knowing what you are prewarming?
My fear is the patient that is developing a new aby that is present in the IgM phase but is clinically significant.
Alana
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My system will only do the transport training once at new hire orientation. Documentation for the annual transfusionist training (blood administration and recognization of a transfusion reaction) and the blood transport are part of our LMS and electronically administered and documentation retained.
The BB develops the training or approves it before it is loaded into the LMS.
Good luck. alana
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I validate the coolers with the minimum and maximum volume the cooler can hold. In your case that would be 1 unit and 8 unit. My reason is to ensure the 1 unit doesn't freezer and the 8 units are not to warm.
In the patient care area, there will be times only 1 units is left because they are using them. And you may send the cooler out with eight. The goal is to qualify the equipment at low and high ends.
Alana
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Malcolm and David, thank you. This confirmed what I thought but wanted to make sure I was correct from those who had more expertise.
Alana
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Does anyone titer warm autoantibodies during pregnancy and if so can you share your procedure? thanks Alana
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Was the screen cooked at rm temp, 37, and AHG?
Could you have an allo-antibody that is on the A and B reverse cell and not on the O cell and only detectable at Rm temp?
Alana
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There are two issues with the new MTS workstations.
1. No area to incubate tube (i.e. weak D test), so if you do not have a waterbath or dry bath you must purchase one.
2. only a light to indicate the temperature is within limits. Per CAP, I believe we should be doing daily temps. (See below)
COM .30750
Temperature Checks
Phase Il
Temperatures are checked and recorded each day of use for all temperature-dependent equipment and environments using a calibrated thermometer.
NOTE: Temperature-dependent equipment (e.g. refngerat ors. freezers, incubators) containing reagents and/or patient/client specimens must be monitored daily, as equipment failures could affect
accuracy of patient/client test results. Items such as water baths and heat blocks used for procedures need only be checked on days of patient/client testing.
If specific instruments, equipment, kits, or supplies have specified ambient temperature ranges for proper operation or use. there must be documentation that the specified ambient temperature is
maintained and corrective action taken when tolerance limits are exceeded.
The two acceptable ways of recording temperatures are: 1) recording the numerical temperature, or 2) placing a mark on a graph that corresponds to a numerical temperature (either manually, or
using a graphical recording device). The identity of the individual recording the temperature(s) must be documented (recording the initials of the individual is adequate).
The use of automated (including remote) temperature monitoring systems is acceptable providing that laboratory personnel have ongoing immediate access to the temperature data, so that
appropriate corrective action can be taken if a temperature is out of the acceptable range. The daily functionality of the system must be documented.
For heat blocks or dry baths, thermocouple probes may be used as an alternative method for checking the temperature.As far as taking the daily temps, I asked my rep about the problem in the design and his answer we would need to purchase a 'special' thermometer from Fisher: NC0006583.
Not a good answer in my opinion.
alana
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We normally only do the immediate spin D typing. But will complete the weak D if a decrepancy is notied in the historical review, the FMHS is strongly positive, or if a request is make by the provider.
In the bb computer, the weak D defaults to "D neg" on the displayed results (the at-a-glance bar in the Safetrace TX system) but ALL results and interpretations are easily retrievible. Additionally, we enter a comment in our historical comment section of the computer about the weak D status.
We provide Rh immune globulin to weak D moms.
Alana
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We report these units as incompatible. We prescreen the units for compatiblity in the method the underlying allos were ruled out in and xm in the method that has reactivity. We like to give the units that are not any more reactive then the warm auto (compare with the auto control) but this may be totally acedemic and making us feel good.
The pathologist is notified with the goal of having conversion with the MD about the patient, the need for transfusion, the risk and benefits of this treatment, and other treatments that may help like IV iron or EPO.
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We do use expired panel cells and wrote this practice into the procedure. The techs are required to prove reactivity of the cell by testing with the appropriate antisera prior to use. (i.e. if trying to r/o Jka, the cell is tested with Jka antisera to prove it will work as expected and the antigen has not deteriorated.). Alana
Antibody Panel QC
in Transfusion Services
Posted
Hi all,
Thank you for the conversion on this topic. I have found it very interesting.
I'd like to mention that the package insert for OCD panel A/B says 'should be tested periodically' and Panocell from Immucor says, 'may be checked periodically'. Neither say must or shall. With that being said, the manufacturer is recommending but does not say it MUST be done.
Therefore at this time, we QC the test system (solid phase, tube and gel) with a known positive and negative but not each panel.
Alana