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I work at the same facility as Scott. To expand on his answer, when we set up QC for our cell savers we also consulted the equipment's manual to see what requirements the manufacturer had. We check that the hematocrit is greater than 50% to verify that the blood collected is washed correctly before reinfusion. We also have surgery draw two sets of pediatric blood cultures. One from the patient (maybe they are septic!) and a second one from the salvaged blood prior to reinfusion. The cell saver sample should have no growth unless 1) the patient already had septicemia 2) there was a skin contaminant (staph) or 3) a problem in surgery (such as the bowel being nicked). In the case of #2, the surgical staff assures me that a skin contaminant is an acceptable part of the process and TJC/FDA has never questioned this. In the case of #3, this should never/rarely happen. The surgical staff tells me that if something happens in surgery where there is question of serious contamination of the salvaged blood, they shut down the process and discard it. In the past 5 years of reviewing these QC samples, I think I have only seen one bowel related contamination. When we set this up, we initially did QC monthly. Once the lab and surgery had a good handle on the process and results were acceptable repeatedly, we changed to QC quarterly for each cell saver in surgery. Our hospital associates handle the cell savers in surgery, not a 3rd party. Although surgery is responsible for running this equipment, it falls on the blood banks shoulders to monitor the QC process. We also monitor competency with hospital education in the form of competency module on-line annually for the surgical associates. Off the top of my head, I believe that salvaged blood may continue to be reinfused to the patient while in the recovery room, but typically it is completed before the patient would head back to his room. Again, without rereading our policy (I am at home) the units are labeled with the typical patient demographics/ID and with a bright green sticker that states it is an autologous product (purchased from Shamrock).

We use a rule that gives the user just a warning. In the event that the BB needed to provide a product w/o the marker, we wanted to have the option to override. This can also be set up as a "hard stop" if you want. How we applied this was to enter this as an assignment/issue rule for PC on page 4 of the Product dictionary. You need to create the rule in LIS Shared Dictionaries, Rule Dictionary and create a BB assignmnet rule type. Go to Atlas and enter "Lab Rules" and you should be directed to the Rules Catalog that provides examples of how to create different types of rules in Meditech for Lab. ;Marker Rule is used to flag patients that require specific blood ;requirements ie, HLA matched platelets, CMV negative blood. ;Marker Rule resides in the Product Dictionary. ;Marker applied to PATIENT must be the same marker applied to PRODUCT. ; [f bpt unit mkrs comp]^X, IF{X "Pt marker not on unit: "_X_" OK? "^X, [f basn yes/no](X); [f basn ok]};