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Brenda K Hutson

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Yes, something like that was my worst nightmare. Patient had previously identified 2 significant antibodies and this time I could not rule out 3 more antigens.......and anyway.....he wasn't gettin' anything too fast......I had to call the Rare Donor Registry to try and just get something that may have been compatible. I'm in a Red Cross reference lab trying to work, and the hospital lab called, and called, and then the nurse called and called.......then finally the Dr. called and said "IF MY PATIENT DIES I'M GOING TO HOLD YOU PERSONALLY RESPONSIBLE!!!" I then decided I wasn't getting paid enough!

Last week a patient came through ED with a 7.6 hgb and was told to come back the next day as an outpatient for the transfusion. The patient had an extremely strong auto-antibody that we had to send to our reference lab, so instead, we drew additional blood for the workup. Two days later her primary care physician wants to know what is taking so long. He asked if the patient would get the blood faster if she was an inpatient (we told him no) but he sent the patient back to the ED. By this time the workup is done and they have found an underlying anti-Jkb. We informed the ED physician that HE would need to sign the incompatible form. He asked if the patient would get "better blood" if he transfered her to another facility (just makes you feel good, doesn't it?). We told him no, that we had the blood ready as soon as he signed the form. Two hours later, we called to ask why we hadn't received the form back so we could issue the blood and were told that the patient was transfered out. I am sure that the patient got much better blood, and faster, at the other facility, since they had to start the entire workup over!

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:crazy::angered:The MD just dumped the problem on someone else and delayed the transfusion again.

This is why my facility is lucky to have an great medical director...that NEVER would have happened. He would educate the ordering physician and put him right in his place. We get these antibody situations not uncommonly and it always works out whether the blood is incompatible or the transfusion is averted, which is often the case.

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I was in a Hospital in Phnom Penh (Cambodia for the geographically challenged) recently patiently explaining, through a translator, why it was important to group the patient twice in seperate events and from seperate cell suspensions to a med tech. Out of the cornor on my eye I saw a ward nurse come in with an unlabelled blood tube, hand it to the tech on the next bench who grouped and Immediate Spin crossmatched it with a unit of blood while the nurse patiently waited. The IS crommatched (I can't make myself say compatible) unit was handed unlabelled to the nurse who flip-flopped back to the ward, undoubtably to transfuse it in the patient she may have collected the blood from.

This is in a place with no wrist bands, no real ID, often multiple patients per bed and all the while family members cooking in and outside the ward and literally hundreds of Dengue patients with drips in just wandering all over the place. Maybe grouping twice is not the priority here?

How am I "geographically challenged" if I didn't know that Phnom Penh was in Cambodia? Do you know all the capitals for all the countries in the world? All the med tech knowledge has pushed the non-essential info out of my brain. The capital of Cambodia? Non-essential.

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You'd make a lot of money if you could clone your medical director, PammyDQ! Sounds like a gem!

LOL I'd make a lot of money if I could clone ANY human!

But seriously

he is a gem, always taking time to explain/educate the hows and whys things to the BB techs and the medical staff (he's a walking encyclopedia of immunohematology & coagulation facts and figures). He's a similar to a "consultant" here, pops in a couple hours a day(or less), yet accessible 24/7/365 no matter where in the world he is. He is the full time director of 2 other local hospitals in a different system than ours. He is well published and conducts research studies freqently (see us in TRANSFUSION soon) and gives/attends lectures nationally and internationally. We're very lucky that he has our backs in ANY transfusion medicine situation!!! Keeps the "stupidity" to a minimum. I don't know if I would want to work in any other situation now that I'm accustomed to this level of support...it ought to be a requirement!

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Yes, but who is this mysterious person PammyDQ?????????????????????????

:please::please::please::please::please:

Joseph D. Sweeney MD (from RI, there is another one elsewhere) born raised and educated on YOUR side of the pond, Malcolm :)

Edited by PammyDQ
oops
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Scary story (and this took us FOREVER to figure out):

There are a set of identical twins. Their birthdays, obviously, are the same. Their first names are a little unusual but only one letter apart (a vowel). Their social security numbers are one number apart (the last number). They do NOT (small blessing) live at the same street address but live in the same city. Their kidneys started to fail at the same time. They go to the same dialysis center, for which we do bloodwork and furnish RBC for transfusion. They have the same doctor. They appartently had been registered interchangedly by the kidney center and by us. Medical records merged their two records. Then they unmerged them. Now, do you think I have any great confidence that you could go back to a CBC result from a year ago and say for sure which one of them it was on? We transfused one of them (I'm somewhat sure which one) - request and transmittal from the dialysis center matched up fine with the tube info, except it turned out to be the wrong one. Yikes.

Morals of the story: unique ID #s are better identifiers than birthdays. Have the patients check their info if possible. Never name your twins something like Tobias and Tobiaz, however cute you may think it is. And never get sick because then you might get treated.

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I had a babysitter for my kids years ago that named her twin girls Jolyn and Joline and got mad that the local college combined their records. I shuddered to think what could happen in health care. Fortunately, one of them got married and changed her last name.

We had a case in our hospital last year where 2 moms with a common last name, say Smith, had babies of the same gender on the same day. Our naming protocol is Smith, Baby Girl so we had two of them with the same name and same DOB. The next day, a Saturday, they called down looking for the cord blood results on Smith, Baby Girl which we told them was A pos. Pretty soon they called back to say the parents both knew they were O pos so something must be wrong. We retyped the cord blood and still got A pos. So they decided to draw the parents and have us type them. When we get cord samples the mom's name is usually added to the tube. When we got the new samples on the parents the tech noticed it was not the same mom's first name on the cord specimen. Only then did BB find out that there were 2 babies. Cord blood had been sent down on only one and the phoned request for results seemed simple enough to just require name & DOB, but it was for the other baby with the same 2 identifiers. Yes, they had different medical record numbers but no one was using that over the phone.

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I had a babysitter for my kids years ago that named her twin girls Jolyn and Joline and got mad that the local college combined their records. I shuddered to think what could happen in health care. Fortunately, one of them got married and changed her last name.

We had a case in our hospital last year where 2 moms with a common last name, say Smith, had babies of the same gender on the same day. Our naming protocol is Smith, Baby Girl so we had two of them with the same name and same DOB. The next day, a Saturday, they called down looking for the cord blood results on Smith, Baby Girl which we told them was A pos. Pretty soon they called back to say the parents both knew they were O pos so something must be wrong. We retyped the cord blood and still got A pos. So they decided to draw the parents and have us type them. When we get cord samples the mom's name is usually added to the tube. When we got the new samples on the parents the tech noticed it was not the same mom's first name on the cord specimen. Only then did BB find out that there were 2 babies. Cord blood had been sent down on only one and the phoned request for results seemed simple enough to just require name & DOB, but it was for the other baby with the same 2 identifiers. Yes, they had different medical record numbers but no one was using that over the phone.

I met my wife Sue at college. Her roommate was Nancy. Two other rooms on her dormitory wing had Sue and Nancy roommates. And there was an extra Sue. (Someone in the housing department must have had a little fun.) This was long before cell phones - each dorm wing had a pay phone. You can imagine how many conversations went "Is Sue there?" "Which one?" "Nancy's roommate"......

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Just saw this one this week as a comment on a patient's admission paperwork. "According to nursing home, patient is to do CPR."

My question is this...........Is the patient supposed to do CPR on other patients in need or is he supposed to do it on himself?

That actually happened to a co-worker of mine...she had some problem with her heart...she missed a few days of work...she came back and another co-worker and I noticed she was doing something akin to heart compressions..we asked her why she was doing that and she said her doctor told her until she got her pacemaker, when her heart started to act up on her "she was to give herself cpr"...her words...well needless to say we were on edge all night thinking she was going to code on us....real freaky!!!

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Had a new one the other day....a request for "Irrodent" blood. It was the first time any of us have seen "irrodent"--it did provide quite a good laugh for all of us. Lots of jokes about mice/rats and other rodents that might possibly be donating the blood we need were made. It did make for a fun day!

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We had a sample in today with an anti-M.

The Diagnosis was "Pregnant 24/40 - tightenings".

I think that this is more commonly known as "contractions"!!!!!!!!!!!!

:confuse::confuse::confuse::confuse::confuse:

We not infrequently see an admitting diagnosis of abdominal pain on an obviously VERY pregnant woman--ie. about to deliver. I have no clue why they can't just put "In Labor" or something of the sort. I just don't get it.

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Had a new one the other day....a request for "Irrodent" blood. It was the first time any of us have seen "irrodent"--it did provide quite a good laugh for all of us. Lots of jokes about mice/rats and other rodents that might possibly be donating the blood we need were made. It did make for a fun day!

I have not seen requests for rodent blood, but we do often get requests for 'irritated' blood. I suppose a rodent would be irritated if asked to provide blood.............

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