TreeMoss

We print out spreadsheets for patient results because we don't have computers right on our workstation benches. This will change when we do a remodel -- whenever that happens. Of course, we check the computer results at the end of each shift against the patient worksheets. We also check all results from worksheets against the patient master log every morning as part of our morning paperwork.

We have Meditech version 5.6.7. Our Transfusion Report is found by going into the Blood Bank module -- Management Reports -- Transfusion Report. By entering the dates needed, you will pull up all patients transfused on those dates. We use BCTA (Barcode-Enabled Transfusion Administration) which includes the ER using TAR to access blood transfusion. Our vitals show up under the transfused units given to each patient.

We are also a level II Trauma center. Our adult MTP 1st pack is 6 FFP, 6 PC and 1 PLTPH. Initially, we issue 2 PC and 1 PLTPH because we already have the 2 PCs ready for emergency issue. The assigned runner returns to pick up the other 4 PCs and then the 6 FFP once they are thawed. We are going to be stocking liquid plasma as soon as we can arrange for that from our blood supplier. After that, we will issue 4 units of liquid plasma at the beginning of an MTP. We felt that whole blood was too costly, but we think the liquid plasma will work well for us. The second pack includes 2 pooled cryo with the 6 FFP, 6 PC, and 1 PLTPH -- and we alternate contents as the MTP continues. We have also defined 2 pediatric MTP packs, based on the weight of the patient.

Our facility uses MobiLab and vinyl wristband labels. Patient barcodes are scanned to print labels for specimen identification. In this way, we are able to use specimens collected earlier in the day for blood bank testing -- as long as the label is printed from the patient's wristband. Our downtime method is the old Biologics imprinted wristband cards -- these have been discontinued, but I think the box we have will last until the time I retire in 6+ years!

This topic has come up on this list before. Did you try searching here to see what you can find?

We have not had infusion rates defined, but our Pathologist over Blood Bank has added these for a recent revision due to the fact that we have had a couple of patients with TACO. She wanted to help the nurses be aware of what was going on with the patient before they ran the blood in within 30 minutes! Apparently our computer system doesn't have the ability to have pop-up boxes with certain diagnosis codes that would automatically alert the nurses to these situations.

We supply blood to 5 helicopters around this area. If blood is given in flight or if the units are wasted because they are out of temperature for any reason, the charge is passed on to the helicopter service. We document that the unit was given to a patient and then we change the status of the unit to a Final Status in the computer. Apparently, the helicopter service charges a flat rate to the patient no matter what is used, so the charge for the blood is just part of that service. Anne

Can we call you Scott "Charles Dickens" Miller?

If we've done a type and screen pre-delivery, we only test the mom for a feto-maternal bleed on a post-delivery specimen. We don't repeat the antibody screen in those situations. If there was no type and screen done pre-delivery, we will do the complete workup post-delivery. If that antibody screen is positive and matches the pattern of anti-D, we check with the nurses to see if the patient received ante-natal RhIG and when. We report out the positive antibody screen and comment that the positive results are probably due to Passive anti-D from RhIG given (date). We also comment that the antibody will be identified if requested by the physician. No physician has ever requested that we do an antibody identification on these patients. I did an inspection once where the blood banker was working up a patient who had anti-M. She choose only selected cells that were M negative to do the panel on in order to see if the patient had formed any other antibody. This is not currently our practice, but I was interested in that procedure. That would be the same as testing those cells marked with @ on the panel to see if anything besides anti-D was present, I guess.

Check the package insert for the Diluent. We look at the diluent for clarity and expiration date and make note of that on our daily QC sheet.

We simply add the new packed cell to the original TS specimen -- adding a comment to indicate what we did. We "NP" the IS and gel crossmatch results and result as Compatible. We write up a credit for the crossmatch and the packed cell and only charge for the aliquot and making the aliquot. We also do electronic crossmatches here, but we don't perform a crossmatch at all on the baby if the antibody screen was negative. We also do not use cord blood for any transfusion purposes because we have found that the specimens are not labeled at the time they are collected. We only use the mom's specimen for the baby's antibody screen if the baby has a positive screen -- otherwise, the NICU collects a new specimen for our testing on the baby.

Amazingly enough, our last FDA inspector was pretty laid back. I was surprised, to say the least. That inspection was so enjoyable!

We have clear plastic divider racks for our blood bank frig shelves that keep the units upright without having to use holders. The last two frigs we've purchased have not had these racks available -- they have two sides to go across the drawer and two to go from front to back! We just trim down the old racks to fit in the new drawers and hope that they continue to work well. It really helps to view the units when they are upright. It used to be a lot easier to see the expiration dates before we switched to the ISBT128 labeling, but we've adjusted.

Good suggestion -- I'll have to check in to that.

No, we don't have a centrifuge to spin blood down, and our FDA registration doesn't cover that -- although we could update that. Anne