TreeMoss

I had the same thought. If you don't modify products, you don't need to have the FDA registration -- and you don't need the privilege of having them come to inspect.

You need to follow manufacturer's recommendations, so review the user's manual and see what they require. Ours says that we must do an inspection of the weld at least once a day, so I built a log sheet to record patient name, unit number, wafer cartridge lot number, bag/syringe lot number, weld inspection, weld alignment, corrective action, and tech initials.

We give antigen-matched units when the patient is on Darzelex so they hopefully wouldn't build any antibodies. Would you continue that when the screen was once again negative, or would you just select any compatible unit?

We did the same, sharing the information about the availability of AB FFP and how the majority of patients are A or O. They agreed that we could make that change.

We have pre-determined Doe names -- we go down the phonetic alphabet with a different number as the "middle" name each time through the list, i.e., Doe, Alpha 35; Doe, Bravo 35; etc. As a level II trauma center, we have 2 levels of traumas -- full and partial. We usually have a name with the partial traumas, but the full traumas are assigned the Doe names and are given a new Medical Record #. The admissions dept. quickly registers the patient when word arrives that the patient is coming in. We use the Mobilab system, so the armband label is placed on the patient and labels made by scanning the armband are placed on the specimens -- so we have the two identifiers that are needed. When the real patient ID is made, admissions puts in the name but leaves the Doe name in parantheses on the armband and other patient ID. The new MR# given stays with the patient at least as long as that initial blood bank specimen is valid (72+ hours to midnight). At that time, if there was a pre-existing MR# for the patient, the accounts are merged. When uncrossmatched units are issued, we place them in a cooler and write the unit information on a cooler log sheet. Since this is an extension of our blood storage refrigerator, the nurses sign the unit out of the cooler using the log sheet. We have patient ID information on the log sheet, but we do not go over all of the unit information at the time the cooler is issued. We use Meditech in our facility, and Barcode-enabled Transfusion Administration (BCTA) is used -- so one nurse can check the unit with the patient when using the computer for the other nurse. We also use Electronic Crossmatch that makes our lives much easier. This system works very well for us.

The book has the answers included. Per the preface of the 2013 manual, "a digital version of the questions without the answers, to better simulate a serologist's progress in solving these problems, is available for purchasers of the printed volume." Access to the file is by a link listed.

I would suspect so -- if agglutination is happening at lower temperatures in a test tube, I would expect the agglutination to be occurring in the cooled down patient.

So excited that you are being recognized for your contributions to our field. This is well-deserved.

I'm sure that would only be in cases where the patient was cooled down. I'm sure there have been times when a blood warmer was used in surgery just as it can be on the floors.

They usually are, so I'm sure that is the case in heart surgeries, as well.

The physicians would use cold cardioplegic solution -- 4 degrees - when putting the patient on bypass.

We simply used a beaker with water and ice and maintained the temperature during the 15 minute incubation period. This procedure was brought to us by a perfusionist who had been an MLS prior to becoming a perfusionist. She developed these procedures as part of a project when she was in perfusionist school.

We used to use that same procedure when we were doing open heart surgeries and the patient was on bypass. If our antibody screen was positive at 4 degrees, we would test at 10, 15, and 20 degrees - maybe even 30 degrees if the room temperature incubation was positive. Whatever the thermal range was, we would then do an antibody ID (who cares) and titer at that temperature. We would also include a test at 4 degrees using a 20% suspension of the patient cells to see if there was agglutination after 30 minutes. We in the blood bank were very happy when new surgeons were brought in who no longer wanted that testing -- working on beating hearts and doing mini valve replacements, etc. has helped us immensely.

We do the same. We also offer to do a blood type at no charge if the parent(s) want to bring the baby in to the lab in 6 months or so in order to get an accurate blood type.

I have attached the screen shots of the set up of the Order Group and Test in Meditech. Type Reflex.docx