TAT for T&C in OR

[Mary]

I would be interested in comparing turn around times for a stat T&C for 2 units from the OR. Assume the specimen is collected by the OR and the patient has a negative antibody screeen in gel. Thanks.

[Eagle Eye]

If T&C is completed and you receive a call to crossmatch ....10 mins

From the time you receive the specimen from OR to the time 2 units available-----1 hr. (if antibody screening is negative)

[OPUS104]

First question that came into my mind Mary was what shift?..........and I don't even work in the Hosp. anymore.

[rcurrie]

We do computer crossmatches, so we can have 2 units ready in 5 minutes. I have done it in less than 2 minutes, with the longest part of the procedure being the printing of the ticket.

BC

[Mary]

Does that include the antibody detection if it is a new specimen?

[rcurrie]

You said: "Assume the specimen is collected by the OR and the patient has a negative antibody screeen in gel."

BC

[bbbirder]

From the time we first get a specimen, 1 hour (to complete type & screen).

If T&S already done, 5-10 minutes for 2 units.

Linda Frederick

[DHarts]

Type Screen and 2 units - 30 min if using plasma (pink top)

2 units, IS crossmatch - 5min or less

Nine times out of ten, if there is a delay, it's because the specimen is not labeled correctly.

[galvania]

From the time we first get a specimen, 1 hour (to complete type & screen).

If T&S already done, 5-10 minutes for 2 units.

Linda Frederick

I'm curious. Why does it take an hour to do a type and screen?

Anna:confused:

[rcurrie]

900 AM- Receive specimen

901 AM- Receive phone call from OR asking if blood set up on Room 3- spend 3 minutes on hold while OR finds out name of patient in Room 3, 1 minute looking up patient in computer and answering "No, no specimen was submitted for testing," 1 minute explaining why it will take 40 minutes to an hour to perform a stat workup ("it's STAT! Don't you understand!?"), 1 minute to explain that emergency release blood is always available, 1 minute on hold because the surgeon wants to chew someone out, 1 minute to explain to surgeon "no specimen- no compatibility testing, no mind readers on duty in the blood bank"

909 AM- Accession specimen into computer and place in centrifuge

910 AM- Take specimen to testing rack and begin pipetting

911 AM- Release 2 emergency release units for patient in OR 3 to angry anesthesiologist (2 minute rant), explain that testing requires a specimen (1 minute)

915 AM- Back to bench- pipet screen cells and plasma into gel card and begin 15-minute incubation

917- Phone call from Day Surgery saying that a specimen was drawn for compatibility testing on patient in OR 3 only five days earlier; spend 3 minutes explaining that specimen is good for 3 days unless waiver is signed, and no waiver (not transfused, not pregnant) on file, and no date of surgery on request, and no mind readers on duty in blood bank when request for T&C received; 1 minute giving Day Surgery phone number of medical director so they can report us for not having mind readers on duty, 1 minute kicking side of file cabinet to keep from going down to Day Surgery and throttling the Day Surgery nurse, who has an associate degree and knows all there is to know about blood.

923 AM- Issue 2 units of RBC to ICU, 1 unit to PACU, two platelet units to Hem/Onc (can someone give me a hand at the issue window?), and 15 FFP for exchange transfusion.

940 AM- Do ABO/Rh and place gel screen in gel card centrifuge (5 minutes)

945 AM- Field call from Medical Director, who has spent 10 minutes on phone with surgeon of patient in OR 3 (5 minutes saying who said what and when)

950 AM- pull gel card from centrifuge to read, then answer the phone call from 5 South wanting to know if we have a current specimen on Room 517 Bed A, explain that we have some metal shavings from the left leg of the bed, but that they were rusty and we needed a new specimen, and if she needed any blood on the patient in Bed A, then we would need a blood specimen from the patient as well, and be sure to find out what that patient's name is.

955 AM- read gel card, enter results into computer

1000 AM- Confirm results in computer for Type and screen

Any questions?

BC

[bbbirder]

You covered that pretty well, Bob.

I'm sure we aren't as busy as you over all, but we only have one tech in BB (night shift it is 1/3 of a tech since only 2 techs cover our entire lab, so they are running ABGs, CBCs, you name it.)

It doesn't really take us one hour, but that is what we publish.

It takes 10 minutes to spin the specimen.

1 minute or so to dispense plasma (we use manual gel testing for Ab Screen)

15 minute incubation

10 minute spin (by the time it brakes it is 11 minutes.)

Then result in computer (and get units labeled)

total time 10+1+15+11+1 = 38 minutes. But, that is when everything goes perfect and is without interruptions at the critical times going to the next step.

So when we beat 1 hour, they think we are great!

Linda Frederick

[Cathy]

Well I needed a good laugh today, thank you Bob. It's amazing how things can be so similiar so far away. I have just printed your analysis to share with others.

If the type and screen is already done, 5-10 minutes to get blood up to the OR. If we need to do the type and screen, I tell them 40 minutes as long as the screen is negative.

[Mary]

This was great! Exactly where I am coming from!

[GilTphoto]

909 AM- Accession specimen into computer and place in centrifuge

910 AM- Take specimen to testing rack and begin pipetting

Any questions?

BC

Only 1 minute to spin? must be a fast centrifuge!

[rcurrie]

10,000 Rpms