Sara B

I've worked at a large 450 bed medical center and CAH (25 bed hospital). We only scoped DATs and tubes that were questionable when shaking out. We used the concave lighted mirror for everything else.

Hi from Iowa. We also use the Pall EZ prime filters and have had very good luck. We've used Pall filters with every transfusion since before I started at our critical access hospital. As of this month, we have switched to pre-storage LR units. We are one of the last hospitals in our area to switch to pre-storage LR units.

Our computer system allows us to enter "TNR" (Test Not Reported) to replace the wrong patient result values. The report will then be noted as "amended" and you can add a comment stating the results did not belong to the patient. I prefer making a change this way because of cumulative patient reports. I can just see a provider looking at a cumulative report and not noticing the footnote stating that the one set of results still appearing didn't belong to the patient!

I've been in the position of having a patient tell the treating physician that he was "A Pos" (before passing out from acute blood loss) and we typed the patient as "O Pos"! The treating physician was angry that we would not take the word of his patient and we insisted on giving "O Pos". Since this experience, I think the only result that I rely on is the one that I can verify is from a properly drawn and banded patient. Why risk it?

The fact that the IS crossmatch was NOT noted as a 3 or 4+, just doesn't make sense. I think that is one point that really needs investigating. It just isn't possible, is it? So is the tech falsifying the record? Falsifying the record would certainly be grounds for firing. I've worked with and without a computer system over a number of years. The computer is only as good as the information put in it. We still need to always be engaged when working. I, too, have taken call and performed crossmatches in the wee hours of the morning when I was really tired (It's the pits to start over because you added Coombs at the wrong time!). You still are responsible to do that one last check - that one last IS that makes sure you didn't goof anything up.

Our reference center does perform a complete crossmatch, state the units are compatible, and their tech signs a transfusion tag. Now if we do have units in-house that are compatible, we will send pigtails for antigen testing. If the antigen testing is negative for the identified antibody, the reference lab faxes all of the results. We then tag the unit and include the reference lab results in the patient's records.

We are a small hospital and do not retest, since we only carry Anti-D! We send a banded specimen to our reference lab and they perform the crossmatch. We do not repeat their crossmatch, either. As was stated above, they are certified by AABB, FDA, CAP and perform anitbody ids and crossmatches for many small, critical-access hospitals. I know bloodbank is an area where we recheck and recheck things, but at what point do you stop repeating? I would hope in the instance of incorrect results that a QI report was filed with the reference lab.

We have the option of choosing Rophylac for our patients instead of the Rhogam that we've always used. Does anyone have experience with Rophylac? Any reason to not switch from Rhogam?

Greetings from Iowa - trying to be as cold as Canada lately! Well, temps are actually in the single digits on the plus side, but cold enough to make the dog walks short! Our hospital is critical access, so we're a very small lab. We implemented gel last year and wish we would've done it sooner! I appreciate the different info and questions I see on the forums. As the lab manager, it helps keep me up on the blood bank side of things. We use HMS (Health Management System) for our computer system and report all of our blood banking in the system. I guess that's all for now. Have a great week!