Just For Fun

[adiescast]

It scares me when I think about how often I've heard the "just give me O Negs" out of a doc's mouth when they don't want to wait for screened units. If someone ever does come up with a way to strip off all those antigens, they will be very wealthy.

QUOTE]

We actually had a patient that we suspected had an anti-c that the doctor insisted we give emergency released O Neg red cells for. I had to get the pathologist to explain to him why that was impossible.

We also recently had a request for blood to be crossmatched on an urgent basis on a Saturday for an outpatient with antibodies. When we got the blood ready, they told us they wouldn't need it until Monday because the patient was too busy mowing his lawn to come in for his transfusion!

:explosion

[jcdayaz]

You know what would be a really fun Thread on here sometime: The funniest and/or scariest remarks we have heard from Hospital staff. We could call it "Just For Fun." Here is mine, just for fun (and it is not Blood Bank oriented; I will think more on that):

A Physician calling at one Hospital (called the wrong dept.) asking: Is it ok if I draw the Peak and Trough at the same time (drug levels). The Tech. responded: I am going to hang up now and I want you to think about that for a minute.

Brenda Hutson, CLS(ASCP)SBB :D:D

Love this thread Brenda, thanks.....

How about "Well, why does it matter that there is IV contamination in the specimen..obviously the IV is good for the patient.."

I wish I were making that up!!!!!

[Barb Thompson]

How about "I swear, I did NOT pour blood from the purple into the green!"

Really? Did your patient have a pulse? (calcium = 0, K = 20)

[bb4me]

How about "I swear, I did NOT pour blood from the purple into the green!"

Really? Did your patient have a pulse? (calcium = 0, K = 20)

BUSTED! I would hope that the employee who would both collect a spec like that and then lie about it would have been re-educated &/or disciplined. It doesn't take a rocket scientist to see how you could easily harm or kill a patient by such actions! Again, "What if were your daughter (/mother/self)?":spank:

[jcdayaz]

Oh, sorry to keep responding to my own post, but your responses remind me of things (and after 26 years in the field, I have heard a lot).

I once had a patient with a positive antibody screen and I needed more specimen for the antibody work-up. I called the floor and told the Nurse we needed 2 more EDTA tubes on the patient. A little while later a biohazard ziploc bag appeared; guess what was in it? 2 EDTA tubes (NO BLOOD in them). Upon calling her, she said she sent what I requested.. for real!!!

Brenda Hutson, CLS(ASCP)SBB

LOL Brenda!!

this one just might top anything I have...

[jcdayaz]

Scary situation:

An OR doc decided our plt pheresis were taking too long to arrive so he himself called another area hospital and told them to send him their plts. Only way we found out was because the other hopitals tech couldn't remember which hospital had called and was checking before sending them. So much for that units final disposition.

Same OR doc and same patient also decided our PRBC's were taking too long and "hijacked" our units when the courier delivered them. The OR tech grabbed them from the courier and was bringing the ARC box into the OR. Didn't matter to the OR team that their patient was an A Pos with an antibody and that box also had some B units in it, as well as the A units.(not antigen typed yet, mind you)

Oh My! Oh My!....I don't really know what else to say to this thread.....

Was there any disciplinary action taken on those involved?

I understand impatient surgeons...I once had a transplant surgeon (while on speaker phone in the OR) tell me that he didn't care if there weren't any more platelet pheresis in the entire city. I should "sh-t them out of my a-s if necessary". Nice, huh?

[mwilde]

Very nice! Of course, it was a surgeon...... Need I say more?

Margaret Wilde

P.S. And they wonder why they're called primadonnas?

[adiescast]

We had a similar situation. We had a heart surgery and a trauma surgery going on in the OR near each other. One of the surgical techs had picked up blood for both patients. He was very careful about keeping them separated. When he arrived in the OR, the trauma doctor grabbed both out of his hands and transfused them. Fortunately for the trauma patient, the heart patient was an O. We found out from the surgical tech, who came back to the blood bank nearly hysterical. That trauma doc is no longer here, but I don't know the circumstances of his departure. Of course, this also meant that we had to prepare more units on the double for the heart patient, whose need was equally high.

[jayinsat]

We had a similar situation. We had a heart surgery and a trauma surgery going on in the OR near each other. One of the surgical techs had picked up blood for both patients. He was very careful about keeping them separated. When he arrived in the OR, the trauma doctor grabbed both out of his hands and transfused them. Fortunately for the trauma patient, the heart patient was an O. We found out from the surgical tech, who came back to the blood bank nearly hysterical. That trauma doc is no longer here, but I don't know the circumstances of his departure. Of course, this also meant that we had to prepare more units on the double for the heart patient, whose need was equally high.

This should not have happened! Every facility i've ever worked, issuing blood for multiple patients to 1 individual was a big NO-NO. This situation underscores the validity of such a policy.

[adiescast]

Sorry, should have mentioned this happened a long time ago. We don't do that anymore either. Then we had a refrigerator and we issued multiple patients to a single individual to go into the refrigerator. The units issued from the refrigerator were issued to single patients.

[JOANBALONE]

Not to spoil the fun, but is issuing units for multiple patients to a single health care provider a no-no according to some accrediting agency? I know it makes good sense not to do it but .....

JB

[jcdayaz]

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?

This one is truly scarey! I think if I had been a witness to such an event I would have tackeled that "nurse" and physically restrained him/her from transfusing!

[jcdayaz]

Not to spoil the fun, but is issuing units for multiple patients to a single health care provider a no-no according to some accrediting agency? I know it makes good sense not to do it but .....

JB

We will issue Rhogam for multiple patients at the same time. We will not ever issue blood products to the same courier for different patients...we will, however issue different blood products on the SAME patient at a time. We confirm that the patient has multiple lines and the different products will be spiked at the same time. (Good practice??? Questionable to me...if there is a reaction how do you determine from what??"

[jcdayaz]

Very nice! Of course, it was a surgeon...... Need I say more?

Margaret Wilde

P.S. And they wonder why they're called primadonnas?

Oh yeah! The whole "God Complex" issue is multiplied in transplant surgeons!! Even more than regular DR's and regular surgeons!!

[Mabel Adams]

I know of no regulatory requirement to not issue blood on more than one patient at a time--but it is deeply entrenched BB tradition. So, I envision the runner taking the second unit up to the ward and setting it on the counter next to the first unit that is still sitting there from his last trip. Sometimes I think a bigger risk might be when a nurse finds only one unit and assumes it is for her patient--if there are two she might think to look to see which is for her patient. Of course, they always check all ID perfectly--except when they don't and wrong blood gets given.

[Malcolm Needs ☆]

I'm going to be controversial here, and also show my age and reactionary nature, but...

I still hanker after the days when each ABO type had its own coloured label, and the print colour of the written RhD type depended on whether it was positive or negative.

I know the reasons this was abandoned (no standardisation between countries and, even between civilian and military blood within the same country, and the perception that the colour system discouraged people from checking the units properly), but I never bought these arguments and still don't.

I thinki a colour code helped to highlight overt errors.

:(:(

[jcdayaz]

How about..."where are my units of ****?

BB reply..."well, we never got an order for ****.

Well, the DR wrote the order in the chart this morning.

BB reply..."We don't have access to the patient charts, you have to physically enter those orders in the computer system.

Nurse: "Really? I never knew that before now."

[Steven Jeff]

I actually agree with Malcolm which also shows my age. I cannot remember when we all standardised to black print on white labels.

However, I always had the impression that once we had all forgotten about the coloured labelling system that it might be reintoduced enabling us all to standardise with the same colours, assuming we could agree on the colours.

I would welcome seeing a bit of colour back in the blood bank and remember it was much easier to spot which units were not in the right stock area. Like Malcolm I think colour coding was more helful in spotting errors

Steve

:redface:

[Malcolm Needs ☆]

Hi Steve,

I'm not sure this really "fits" into "Just For Fun", but...

In September 1990, the first NATO Civil/Military Blood Conference was held at the (then) Army Blood Supply Depot in Aldershot. During the conference, a review of the colour coding of blood group labels was undertaken. The attachment shows the different colours used for different blood group labels for certain different countries (wear sun glasses!).

Concerns were expressed that , as a result of deployment of multi-national forces, the difference in colour coding of blood group labels could cause confusion.

The ISBT suggested a time of five years, after which time standard colour coding could be introduced. During this time, labels would be black and white.

Well, there was no agreement within the 5 years, and it is now almost 2010, and the "5 year" experiment is still continuing!!!!!!!!!!!!!!!!!!!!!!!!

Strange that.

:bonk::bonk:

Colours.doc

[adiescast]

I actually agree with Malcolm which also shows my age. I cannot remember when we all standardised to black print on white labels.

However, I always had the impression that once we had all forgotten about the coloured labelling system that it might be reintoduced enabling us all to standardise with the same colours, assuming we could agree on the colours.

I would welcome seeing a bit of colour back in the blood bank and remember it was much easier to spot which units were not in the right stock area. Like Malcolm I think colour coding was more helful in spotting errors

Steve

:redface:

Does everyone have the same reagent colors? Perhaps we could go with a variation on those: Blue for A, Yellow for B, White for O, and Green (yellow plus blue) for AB. We would have to figure out a scheme for the Rh, but the black and red would work.

[Malcolm Needs ☆]

Does everyone have the same reagent colors? Perhaps we could go with a variation on those: Blue for A, Yellow for B, White for O, and Green (yellow plus blue) for AB. We would have to figure out a scheme for the Rh, but the black and red would work.

I could not agree more with your suggestion as it is totally logical, but, for that reason alone,the cynic in me says that being logical is precisely the reason the "suits" will not adopt it!!!!!!!!!!!!

:devilish::devilish:

[Mary**]

:pI sometimes reply to things like that by saying "the mind readers called in sick today".

[AndyMiller]

Does everyone have the same reagent colors? Perhaps we could go with a variation on those: Blue for A, Yellow for B, White for O, and Green (yellow plus blue) for AB. We would have to figure out a scheme for the Rh, but the black and red would work.

Beware reds on blues and greens for us colour blind bods! I simply can't read red on green.

Andy "spanner in the works" Miller

[Steven Jeff]

I have to confess Andy I am also Red/Green colour blind but is has never caused a problem for me. It is the intensity of colour rather than the actual colours, i.e. dark blue and purple; dark green and brown are problems to me. Bright blue, Yellow and pink no problem.

As Malcom says though, the "suits" have been thinking for more than 15 years. I bet I will have retired before there is any change - gives them another 9 years

Steve

[Malcolm Needs ☆]

Beware reds on blues and greens for us colour blind bods! I simply can't read red on green.

Andy "spanner in the works" Miller

I have to confess Andy I am also Red/Green colour blind but is has never caused a problem for me. It is the intensity of colour rather than the actual colours, i.e. dark blue and purple; dark green and brown are problems to me. Bright blue, Yellow and pink no problem.

As Malcom says though, the "suits" have been thinking for more than 15 years. I bet I will have retired before there is any change - gives them another 9 years

Steve

I think that there is possibility of misinterpretation here.

I am not suggesting that coloured labels are the "be all and end all" for identification, and that we should remove the printed ABO and RhD types on the labels (far from it). All I am saying is that standardised coloured labels would act as an extra aid to identification that, in most cases (colour-blind individuals excepted), would be overt.

:)