Liz Posted March 11, 2011 Share Posted March 11, 2011 Well, as long as we are mentioning embarrassing things Nurses and Physicians say or do, I may as well own up to my own (though it isn't horrible). Was so busy at work one day and in the middle of a Transfusion Reaction work-up that when the phone rang, I answered "Transfusion Reaction, this is Brenda." To which the OR Surgeon replied, "well, I hope not!"Oh well, we both laughed...Brenda HutsonOh Brenda, I am so happy to hear that! I thought something was wrong with me... Often when I am signing results I will write the name of the person I just spoke to !!!! oh my!!! So it is common for the brain to hold on to its last thought. That was hilarious Brenda. also when I answer the phone I will say "Come in" and if some one knocks I may say "Hello".. Its so hectic.. Link to comment Share on other sites More sharing options...
CM2 Posted March 11, 2011 Share Posted March 11, 2011 Many years ago, training as a new tech in blood bank in the evening (which was just coming up on gel technology), I got given the golden gem of advice - "If you get a weak positive in the gel card just respin it and it will go away". Needless to say this was just one of several symptoms that got this guy permanently banned from working down in blood bank, and eventually from the laboratory entire =P Link to comment Share on other sites More sharing options...
Brenda K Hutson Posted March 11, 2011 Author Share Posted March 11, 2011 Well, I coined my own phrase (and method of testing) at one large Medical Center I worked at; it was called the "Scorch and Vortex method of Antibody ID." But of course I was only kidding...Yesterday I was observing one of our new employees (last year's CLS student) for annual competency on Type and Screens. He called me when he took his GEL screen out of the centrifuge so I could observe him read it and enter the results. He held it up to me and said, "so it is negative." My reply: "Yes, it goes much better when you don't add the plasma, doesn't it?" He paused for a second; then laughed.Brenda Hutson Brenda Hutson Many years ago, training as a new tech in blood bank in the evening (which was just coming up on gel technology), I got given the golden gem of advice - "If you get a weak positive in the gel card just respin it and it will go away". Needless to say this was just one of several symptoms that got this guy permanently banned from working down in blood bank, and eventually from the laboratory entire =P Link to comment Share on other sites More sharing options...
DPruden Posted March 14, 2011 Share Posted March 14, 2011 Oh, no.....not Micro.......they keep changing the names of those organisms!!Speaking of changing names, there is a bug that used to be Pseudomonas maltophilia and it was changed to Xanthomonas maltophilia. Soon after it was changed again to Stenotrophomonas maltophilia, I was working in Micro (I know micro and blood bank is a weird combo!) and a doctor called the lab and said "I'm sorry, I'm hoping you can help me because my patient seems to have a dinosaur!" Link to comment Share on other sites More sharing options...
AMcCord Posted March 15, 2011 Share Posted March 15, 2011 Speaking of changing names, there is a bug that used to be Pseudomonas maltophilia and it was changed to Xanthomonas maltophilia. Soon after it was changed again to Stenotrophomonas maltophilia, I was working in Micro (I know micro and blood bank is a weird combo!) and a doctor called the lab and said "I'm sorry, I'm hoping you can help me because my patient seems to have a dinosaur!" Good one!!! Link to comment Share on other sites More sharing options...
AMcCord Posted March 15, 2011 Share Posted March 15, 2011 I saw this article today as well, and told my coworker that I might have to relearn the Genlab so that I can still have a job. It also brought to mind another article 1-2 years ago about researchers that were able to remove A and B antigens from RC surfaces to make O blood that would work for anyone. I haven't seen anything about that since!When I was in Med Tech school 30 years ago, the use of 'artificial blood' was supposed to be imminent. Still waiting....... Before stealth blood hits the market, maybe I'll be retirement age and I won't have to relearn Chemistry (yikes - scary thought! especially if I have to learn how to use a Cobas analyzer). Link to comment Share on other sites More sharing options...
Deny Morlino Posted March 24, 2011 Share Posted March 24, 2011 (edited) Have been training a new tech for the last few weeks. About 2 weeks ago we were experiencing a standard day in blood bank. Within a five minute period we suddenly had 2 STAT cross matches and a transfusion reaction going. Happened to have a MLT student with us that day too. After the "deer in the headlights" look from the new tech and the student, I assured the new tech it would all be fine. I assigned him one of the STATs and took the other STAT and the transfusion reaction myself. During this period we also had several other things going on as well. After things settled down a bit, the student said that she had been a bit afraid of blood bank prior to that point, but now was certain she was terrified of it. I told her that was a good thing as blood bank is a place to NOT make any mistakes. We reviewed the choices that were made "in the heat of the moment" and looked to see if anything should have been handled differently (decided we were satisfied with the way things progressed). Trying hard not to laugh I explained that the calm disposition exhibited during the "mini-crisis" we had experienced came from extensive training and practice. After rolling my eyes to demonstrate my sarcasm at the statement I had made, I did remind them that the scenario was a good example of why it is necessary to stay organized, focused, and if at all possible to avoid interruptions in blood bank. Edited March 24, 2011 by Deny Morlino Link to comment Share on other sites More sharing options...
Mabel Adams Posted March 24, 2011 Share Posted March 24, 2011 Deny, here's what I teach for dealing with crises: Ask yourself, "who's dying." If no one is dying you can take a deep breath and prioritize knowing that the outcome is not as critical as you might have been feeling. If someone is dying, that's who you take care of. If more than one person is dying you call for help. It lends a valuable bit of perspective. Link to comment Share on other sites More sharing options...
Dr. Pepper Posted March 25, 2011 Share Posted March 25, 2011 Very good advice Mabel. Many years ago we had a ruptured aneurysm with anti-K. I was working with one other tech and we had no reinforcements at hand. You try to stay ahead with the AAAs, but with antigen screening and full crossmatches we slowly lost ground until we had no more crossmatched blood. We got a panic call from the OR "Send us 10 units immediately or the patient will die!" We looked at each other, took segments and a unit# sticker off 10 units and dumped them on the dumbwaiter that went up to the OR on the floor above us. No paperwork, no testing, no nothing. The patient took those, and a lot more, but we eventually caught up with testing and documentation. I think one of the units was K+. The patient expired that day, but not from lack of blood (or a transfusion reaction - you don't have much antibody circulating after bleeding 40-50 units of RBC). For me, that's as bad as it gets, and that's what I teach my techs and students. Every place has their emergency release protocol, you follow it and do what you can to keep up. Link to comment Share on other sites More sharing options...
EDibble Posted April 2, 2011 Share Posted April 2, 2011 Thanks Mabel, I use that wisdom in my life outside BB (is there one, oh I guess so. :-)) My job is so stressful that having to stand in a long grocery line or some such is no big deal. "Is someone going to die because I can't get to the post office today? No? Then get on with the important things.:meditate::meditate: Link to comment Share on other sites More sharing options...
bduff Posted April 2, 2011 Share Posted April 2, 2011 I got a call from a Dr. yesterday about to perform a C-Section. He asked why he didn't have results on Jane Smith, I said well, I just received the specimen in the department and just set it up. It will take about 25 minutes for incubation. He said well when will it be finished. I said hopefully about 25 minutes. He continued to say, I have my CBC results and I KNOW they take longer to finish then a type and screen. He said, that the CBC takes 30-35 minutes and the TS should take less. I responded in my calmest tone. Sir, actually a CBC can take a lot less time then that and a screen takes 25 minutes. He said fine and hung up. I just had to laugh at the fact that he KNEW that the CBC takes longer then a TS!!!! Link to comment Share on other sites More sharing options...
EDibble Posted April 2, 2011 Share Posted April 2, 2011 So often one would like to quote "A lack of planning on your part does not constitute an emergency on my part." But we think of the patients first, don't we?:salute::salute: Link to comment Share on other sites More sharing options...
L106 Posted April 2, 2011 Share Posted April 2, 2011 Same here, Mabel and Elizabeth. I think part of it comes with age. (Age or wisdom from the years??)Donna Link to comment Share on other sites More sharing options...
KLBennett Posted April 24, 2011 Share Posted April 24, 2011 (edited) I so agree. I really miss those colored labels. Edited April 24, 2011 by KLBennett oops late and i can't type Link to comment Share on other sites More sharing options...
silverblood Posted April 25, 2011 Share Posted April 25, 2011 My absolute favorite is when you report to a physician that the blood for his surgical patient is not ready because of a positive antibody screen that has not yet been resolved. The reply 'no problem-we can just give o neg blood' And no-I am not kidding!!!! Link to comment Share on other sites More sharing options...
mcclanmd Posted April 27, 2011 Share Posted April 27, 2011 I must say that I'm really enjoying this post. The funniest diagnosis that I've seen was on a patient with an order for two units of platelets. The diagnosis was "Thrombocytopenis"!!! Lol. Hope my post doesn't get censored, but it's the truth! Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted April 27, 2011 Share Posted April 27, 2011 I suppose it could have been a male sickle cell patient with priapism?????????????!!!!!!!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
AMcCord Posted April 27, 2011 Share Posted April 27, 2011 I suppose it could have been a male sickle cell patient with priapism?????????????!!!!!!!!!!!!!!!!!!!!!Naughty (as usual) Link to comment Share on other sites More sharing options...
Thandar Aye-zheng Posted June 3, 2011 Share Posted June 3, 2011 I got one "real insufficiency" instead of "renal insufficiency" Link to comment Share on other sites More sharing options...
Barb Thompson Posted June 4, 2011 Share Posted June 4, 2011 I called up results of a positive antibody screen on an OB patient, 10 minutes before the start of her C-section. The anesthesiologist immediately called back and demanded to know how she could possibly have a positive screen now, when her pre-natal screen was negative! (umm...doc...how about "primary immune response?"...) Link to comment Share on other sites More sharing options...
Brenda K Hutson Posted June 4, 2011 Author Share Posted June 4, 2011 It could just be that he was surprised; given that the prenatal screen had been negative (in that I'm sure they do not like to get those kind of surprises)?? He would have wanted to monitor her and/or the baby. Also, we find that some contracted labs can be a little sloppy in their work so that we end up with different blood types and/or different Antibody Screen results. It is possible that her screen was positive before and was just missed.Anyway, just some thoughts...Brenda HutsonI called up results of a positive antibody screen on an OB patient, 10 minutes before the start of her C-section. The anesthesiologist immediately called back and demanded to know how she could possibly have a positive screen now, when her pre-natal screen was negative! (umm...doc...how about "primary immune response?"...) Link to comment Share on other sites More sharing options...
dal6164 Posted June 29, 2011 Share Posted June 29, 2011 I always loved when a surgeon, while waiting for his crossmatches to finish, and not wanting uncrossmatched blood, would state that "it's your fault if my patient dies"!That is my favorite Link to comment Share on other sites More sharing options...
Liz Posted July 1, 2011 Share Posted July 1, 2011 It could just be that he was surprised; given that the prenatal screen had been negative (in that I'm sure they do not like to get those kind of surprises)?? He would have wanted to monitor her and/or the baby. Also, we find that some contracted labs can be a little sloppy in their work so that we end up with different blood types and/or different Antibody Screen results. It is possible that her screen was positive before and was just missed.Anyway, just some thoughts...Brenda HutsonThe different Blood groups!!!!!!!!!!! that is a killer. I mean it literally.... the patient will say BUT I know I am of a different Blood Group. What can I say? "the other lab was wrong"........ never !!! those words may bring the other lab manager to his/her last day on earth. So to the next question: Can blood groups change?? I say yes of course!! all the time!! (and I am not 100% lying).. Link to comment Share on other sites More sharing options...
jcdayaz Posted July 1, 2011 Share Posted July 1, 2011 You are not lying at all here Liz. Not even considering the "human error" side of things ie. phlebotomist/nurse collecting the wrong patient, mislabel, blah blah. I could continue on and on as I'm sure we all could. I have seen a couple presentations of Bone Marrow Transplant recipients that received a transplant of a different blood type. It takes a bit, I don't remember now how long, but the recipient's blood type will change to the donor's type. I'm guessing that's not what you were referring to--but I thought it was worth mentioning because the science behind having your blood type physiologically changed is fascinating to me! Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted July 1, 2011 Share Posted July 1, 2011 You are not lying at all here Liz. Not even considering the "human error" side of things ie. phlebotomist/nurse collecting the wrong patient, mislabel, blah blah. I could continue on and on as I'm sure we all could. I have seen a couple presentations of Bone Marrow Transplant recipients that received a transplant of a different blood type. It takes a bit, I don't remember now how long, but the recipient's blood type will change to the donor's type. I'm guessing that's not what you were referring to--but I thought it was worth mentioning because the science behind having your blood type physiologically changed is fascinating to me!Well, it does and it doesn't!The Lewis type remains that of the recipient, so that, if the donor was Le(a-b-), and the recipient was Le(a-b+), even when the graft takes, it will be Le(a-b+).In addition, if the donor is group O, and the recipient group A or B and a secretor, the graft will either make no anti-A / anti-B, or will make only very weak anti-A / anti-B. This may be because of immunological tolerance, or because the recipient keeps producing enough soluble ABO antigens to inhibit the anti-A or anti-B, or both reasons.You can often adsorb and elute either anti-A or anti-B from the graft's "group O" cells in such circumstances.:whew::whew: Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now