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comment_32521

I am curious as to how many folks perform the fetaldex or kleihauer betke test, whatever you want to call it, in the Blood Bank as opposed to in hematology.

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comment_32544

We used to do FMH Screen and K/B testing in BB. Our facility has discountinued it's L&D department.

I have to say however, that outside of the K/B test being a staining procedure I have grown to see the impracticality of performing the staining in hematology when the information is most useful in BB; what BB doesn't have sinks, and BB techs don't know how scan slides and count cells?

comment_32545

We do the FMH screen in the blood bank. If the FMH is positive we take the sample to hematology where they do the KB stain.

BTW David S, the fetaldex is a kit for doing KB stain, sickledex is for HgbS screen :)

comment_32554

Thanks - I knew it was something-dex

ds

We do the FMH screen in the blood bank. If the FMH is positive we take the sample to hematology where they do the KB stain.

BTW David S, the fetaldex is a kit for doing KB stain, sickledex is for HgbS screen :)

comment_32558

We do not do FMH screen in Blood Bank it is in Haematology. We do not observe RhoGam administration also. It is considered as a drug and pharmacy dispense it on prescription. I remember TJC has included it in the drugs?

Please Comment Thanks

comment_32568

:oWe do both Fetal Screen and KB in Blood Bank. We also issue the Rhogam.

comment_32718

How many Fetal screens do you have that are positive annually? We only have a handful each year and our L&D dept. delivers about 40-50 newborns month. Our reflex method on positive fetal screens is Flow cytometry for Hemoglobin F and it is performed by our reference lab. They are located 1 1/2 hours from us and even on weekends we have next day reporting. Also, Pharmacy dispenses our Rh-IG to Labor and Delivery.

comment_32722

We do Fetal screen in the blood bank and send to Hematology if KB (Fetaldex is needed)

comment_32768

What is your promised Turn around Time for KBs? We have begun accepting KBs from outside hospitals who are demnding a 4hour TAT which is just about impossible especially on night shift.

comment_32772
What is your promised Turn around Time for KBs? We have begun accepting KBs from outside hospitals who are demnding a 4hour TAT which is just about impossible especially on night shift.

Unless these other hospitals are sending in their specimens close to the 72 hour mark (which is their fault), what is their justification for requiring a 4 hour TAT???

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

comment_32820
How many Fetal screens do you have that are positive annually? We only have a handful each year and our L&D dept. delivers about 40-50 newborns month.

Good question....it made me go pull up our data. We have about 30-35 births a month. We did 73 FMH Screens in 2010 and had no Positives. (In the past, we usually have 1-3 Positive FMH's a year.)

comment_32821
Unless these other hospitals are sending in their specimens close to the 72 hour mark (which is their fault), what is their justification for requiring a 4 hour TAT???

Probably because they discharge the patients so soon after delivery (often around 24 hours.)

Donna

comment_32823
Unless these other hospitals are sending in their specimens close to the 72 hour mark (which is their fault), what is their justification for requiring a 4 hour TAT???

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

Our medical center has both trauma and OB patients. The KB's we do because of a positive Fetalscreen (rosette test) are not stat. However, all the ones ordered to determine possible fetal bleed are STAT. Most of these are traumas or OB patients when doctors are worried about a fetal bleed in a high risk OB patient.

We would prefer not to do them - it's not a great test, but don't have a choice.

We do testing for other hospitals - except we will NOT do KB's stat for anyone other than patient's registered at our medical center. We only have a limited number of techs trained in this (Consultation Techs who do Blood Bank problem workups), and if one is not working (middle of the night, weekend evenings), they would have to be called in.

comment_32828

Thanks Donna and BSIPHERD.

comment_32830

BSIPHERD,

Why are there only a limitted number of techs trained in a procedure that your facility offers 24/7 for traumas? It would make sense to train all of your BB staff to perform this procedure. The primary problem with K/B staining is the lack of use of the procedure; when it is used more readily it is not that difficult. I have turned around K/B staining results within an hour to two hours; and I thought two hours was too long at times. The K/B stain procedure is not difficult you just have to practice it like any manual procedure.

comment_32839
BSIPHERD,

Why are there only a limitted number of techs trained in a procedure that your facility offers 24/7 for traumas? It would make sense to train all of your BB staff to perform this procedure. The primary problem with K/B staining is the lack of use of the procedure; when it is used more readily it is not that difficult. I have turned around K/B staining results within an hour to two hours; and I thought two hours was too long at times. The K/B stain procedure is not difficult you just have to practice it like any manual procedure.

We did 31 KB for Fetal Bleed last year. We have more techs than that who perform blood banking. Performing less than one a year of any manual test does not keep you competent. Plus I'm sure man of the techs who perform it would disagree with you about it being an easy test to master.

We would love to pass it on to Hemo, but can't get anyone else to love (or at least not hate) the test either!

comment_32847

We stopped performing the KB stain a number of years ago due to low volume and being able to maintain competence. They are now sent to a hospital about 1hr 15 min up the road. They have a TAT of 4 hours. I can't actually remember when we had one performed due to a positive fetal screen. The ones that are ordered are part of a Placenta Previa workup. Often, the patient has been dischargeed by the time we have the results.

:peaceman::peaceman::peaceman::wave::wave::wave:

Edited by KKidd
can't spell

comment_32856

We average about 1 FMH per day and some of those are sent in to us. Of those, We had about 9 positive last year. We did 76 KB stains last year with about half of them positive. We don't have the staff to do them on the night shift. KB stains are not offered stat unless the woman is in a trauma situation.

comment_32874

We do both Fetal Screen and KB in Blood Bank. We also issue the Rhogam. We also do a fair amount of KB stains on Rh positive patients from the ER, the doctors are looking for evidence of a fetal bleed.

comment_32887

We use the rosetting fetal screen from immucor, and if positive send the kb out to our bb reference lab.

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