lkg1972

We have been up on BCTA (that's what they called ETAR) for about 6 weeks. Some of the problems and solutions we have encountered are: 1. If more than 1 unit is at an issued status at the same time - make sure the correct unit is highlighted. If the wrong unit is highlighted the computer will give them a warning that the unit doesn't belong to that patient. 2. If the patient is crossmatched on one account number and admitted with a different account number - the computer will not let them proceed. 3. Sometimes the scanner "loses" its mind. It will scan the account number and the BB Bracelet number but not the product code. Have the nurse try another scanner. We print a Blood Bank bracelet number out of Meditech that is used in addition to the hospital bracelet.

I was a member of the user group that requested the Product Group dictionary. The intent was to make it easier to deal with the many ISBT products in the Blood Type dictioary. Each individual product is then created in the Product dictionary and assigned to the Product Group. For example: Product Group "PLT" would have all the apheresis platelates and platelet concentrates, irradiated, leukoreduced, washed, etc. In the Blood Type dictionary you would list the Product Group "PLT" and not have to list each of the ISBT platelets. On page 3 in the Product dictionary you may use the Product Group for substitutes if you choose.

I don't know about Cerner but there is an ISBT product - E5298 Fresh Frozen Plasma Pooled. We have been using it with Meditech. We use the same process as for pooling cryo or platelets.

We have 12 Playmate Igloo coolers that are re-validated every 1-2 years or when units start to come back warm. A max of 4 units with 2 large blue ice packs that are stored in the -30 freezer are put in the cooler. Each cooler has a cardboard box for the units so they do not come in contact with the ice. I have found that the units will stay less than 10C for 7-8 hours. So the coolers are issued for 6 hours and then they must be returned to be checked and new ice if the CVOR wants to have longer. I am getting ready to test with more ice to see if we can maintain less than 6C since I have been reading that I should consider the cooler as "storage" not "transporting".

We retype anyone without a history using a new specimen. I believe the risk of collecting the wrong patient or mislabeling the specimen to be greater than that of the tech making an error in testing. We use a second specimen collected by a different person - it may be a specimen already in the lab in another area. We only have to recollect from the patient about 1x per day.

We have 13 hospitals that can see the patient histories from each other. My policy is 1 blood type must come from a current specimen. If the patient has a history at one of the other 12, that counts as a second blood type. If the patient is type O, we do not do a second blood type (no transfusion danger if given O). If the patient is not type O and does not have a blood type history in the computer, a second blood type on a specimen collected by a different phleb (at a different time) is required. That specimen may be one collected for another area of the lab (for a CBC or chem test as long as no gel). We do between 15-30 blood types/day. Only 1-3 require a second specimen and only about 1 patient needs to be re-stuck. We do not accept donor cards or patient statements for blood type verification. We have had instances when the current type does not match history. Another specimen is collected and tested - so far, all histories have been incorrect and the new specimen type matches the first current specimen type.