TreeMoss

The unit was just sitting on the counter.

We do 5 transfusion observations per month as part of our Blood Bank Quality Improvement. There are several CAP items this could fit under -- between TRM.41000 to TRM.41300.

That is definitely what we do here. We do not have what we would need for an autoabsorption, and our ARC Reference Lab folks serve us well.

We did a validation a few years ago where we set a unit on the counter in lab, ICU, and one of the other patient locations. We took the temperature of the unit every 5 minutes. We found that the temperature was within range in all locations tested for at least 30 minutes, so we validated our 30 minute rule.

Yes, you do need to crosscheck the kit. We test the new kit against the old kit -- use the cells from one kit with the anti-sera from the other kit. We just record our results on our regular QC sheet for the FMH Rapidscreen test.

We use a blood cooler for PCs and FFP taken to the OR. The units are logged onto a log sheet that accompanies the cooler. The log sheet has a sticker with patient ID. When we deliver the cooler, the person we hand off to has to have something with the patient ID and we check two identifiers before giving them the cooler. We also issue the units to the patient so the OR folks can use BCTA (barcode-enabled transfusion administration) to transfuse the products -- only one nurse and the computer verify the units. Like the others, if emergency blood is needed, we prepare the uncrossmatched units - writing the information on the cooler log sheets -- and deliver those units to the OR along with the paper for the physician to sign taking responsibility if anything happens.

Follow policies / procedures. Pay attention to details. Don't be afraid to ask questions. Pat yourself on the back when you make it through your first Massive Transfusion Protocol! Let the adrenaline work for you -- keep calm and work on. Enjoy Blood Bank -- I've been doing this for 30 years, and I love it!

We always work up a positive DAT with elution and antibody ID.

Thank you for posting this information. I just listened to the podcast and was thrilled to have another opportunity to learn something new and get CE at the same time. I plan to listen to other podcasts from the Blood Bank Guy.

We also use O Pos for males and females over 50. We use O Negs for all children up to about 20.

Yes, we want actual products -- so we can thaw the FFP and Cryo to see when they would actually be ready for use.

We are going to begin running Mock Massive Transfusion Protocols in our facility. We need to "manufacture" some blood products to use in these drills. Do any of you have "recipes" for making up packed cells, FFP, Platelets, and Cryo products to use for practice? Thank you

This is what we do to crosscheck the fetal bleed kit, also. The fetal stain (Kleihauer-Betke) just requires pos and neg control slides. We made a change a few years ago after COM.30450 came out -- when I read it, I didn't do anything because I didn't think it dealt with blood bank. Our inspector had other ideas! Change was then made, and we have been crosschecking all reagents on arrival in the lab against those reagents already in use. When I did a recent CAP inspection, the lab argued that this item states "suitable reference material" may be used -- and that would be a positive and a negative control. I called CAP to clarify and was told that checking new lots of reagents with a positive and a negative control is all that is needed. Yes, I'm going to revise my procedures back to how they use to be! I should have challenged that deficiency from a few years ago -- but live and learn. We do, however, check our new screening and panel cells with the old screening and panel cells when the new sets are received.

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.