Baby Banker

I avoid giving O Pos to male trauma patients because if we give them an anti-D and they manage to show up as a trauma patient in the future, they are at grave risk of a serious reaction. I would note though that since I am in a pediatric institution, this is more likely to occur than in a general hospital. Thankfully, we have never been faced with having to use O pos for a female patient. There is usually not much delay in getting a sample; we generally go to type specific pretty quickly.

I avoid giving O Pos to male trauma patients because if we give them an anti-D and they manage to show up as a trauma patient in the future, they are at grave risk of a serious reaction. I would note though that since I am in a pediatric institution, this is more likely to occur than in a general hospital.

I use my Validation Environment.

I use the FIN for my facility, the year, and a random number. I make a label using the stand alone HemaTrax software.

How old is this patient? Newborns and geriatric patients may have weakened cell typing reactions.

It is my understanding that if you use a computer system that is validated and has been set up with logic to recognize valid typing reactions (and reject others) that you meet this requirement.

I agree with R1R2. Just be sure to rule out all the antibodies that the FDA requires that we screen for.

We titer plts. Our cut off is 1:50.

Congrats!

This is what we have always done, but I am in the process of rebuilding the verify type to include a serum type for just this reason.

And we do aliquots in syringes and bags. We also reconstitute whole blood to a specified crit.

We are a pediatric hospital with about 330 beds. That does not include the bascinets. We have a very active Heme/Onc program, as well as CV and neonatology, and Level 1 trauma service. Those are the services that use the most blood. We do stem cell, heart, liver, and kidney transplants.

You could do a selected cell panel. Just make sure you cover all the antigens that are required in Canada. Here it is DCEce Kk FyaFyb JkaJkb LeaLeb P1 and MNSs, I think. Immucor has a 20 cell panel that has the upper ten cells are all D+, and the lower ten cells are D=. Cells 11, 12, & 13 can be used to screen for antibodies other than anti-D.

We have dedicated blood bankers on each shift. This was suggested to us by an FDA inspector. We supplement with generalists on evenings and nights.

I forgot to mention that I am at a pediatric hospital which is a level one trauma centre, and we also do heart, kidney, liver, and stem cell transplants. We have a large Heme/Onc practice. We have just under 350 beds, I think.

We have SafeTrace Tx, and I have used Cerner in the past. The blood bank manager has used Mediware's HCLL, and I have seen a demo. SafeTrace is a good system from my point of view, but the techs are not overfond of it. There are a lot of places where the system will stop them cold. It is usually the case that they should be stopped cold when this happens. I will say that the canned reports are terrible. You can write Crystal Reports and query the data base, and they have a new analytics package that is supposed to make up for the shortcomings of the reports. We opted not to take it since we were told we would get it gratis as an established user. This did not happen and we are looking for a new system. We've had SafeTrace for about 15 years, so we don't take the decision to change systems lightly. As far as a new system goes, HCLL is at the top of the list. It was designed by blood bankers, and it shows. I would urge you not to make a decision without seeing a demo from HCLL. BloodTrack can be used with either of the systems.

We use fresh (less than seven days old) irradiated RBCs. We wash the units only if they are not fresh.

We used to get them back from OR. What with bags returned with needles attached, and units clotting to the counter, it became a biohazardous nightmare. Now we only get back bags associated with transfusion reactions.

Both of these are good examples. We do our validation in three parts: Installation Qualification, Operational Qualification, and Production Qualification. The IQ just shows how it was installed. For a piece of equipment it could be the installation checklist. For a test it could be screen shots of whatever was changed in the computer to create the test. Operational Qualification shows that a piece of equipment does what the manufacturer says it will do. What I do for a test is build it in my Validation Environment and test it there. If that passes, I build it in the Production Environment and test it again. I can't move a computer build from one environment to another. So the testing method for OQ and PQ for a test is usually the same. However you validate, be sure to get your Medical Director to sign off on it.

Send him on his way now, while he is in his six month probationary period. It will be much harder to do later. You cannot manage an employee whom you cannot trust.

The Technical Manual used to have a list of antigens that must be represented in screening cells. I haven't checked the newest edition. I circle the required antigens at the top of a panel antigen profile, and then circle the cell number of each cell selected for the screen on the left of the profile. Remember to take zygosity into count. It almost always requires more than three cells. I usually do this when a patient has a known antibody. I omit that specificity, and what I am left with is a screen/short panel that will only be positive if the patient has developed a new antibody.

Since I work in a pediatric hospital, our patients are minors. We will approach the parents for consent. If they will not, we get a court order and proceed. I'm told the parents usually consent.

We test if the patient already has the antibody. We've had units come in that were marked one thing but were actually the opposite.

I remember from somewhere that Kell doesn't or is least likely to show dosage.

Going into the bag with a needle would make it an open system. Does the bag not have segments attached?