Bet'naSBB

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I just answered this question. My Score PASS  

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We DO NOT allow "keep ahead" orders........... IMHO - Keep ahead orders are............

Absolutely!! And, no, in my 36 years of blood banking - I have never heard of anything like this........... But, I do think that since they went "around" you, it's not "ON" you or your hospital. The organ donation group handling the 3 - NON-Blood Bank provided units is now responsible for it. Although, I do wonder how they will document the fact that the patient received the blood and who will be notified if there's a recall or lookback.....

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Using a new pipette each time is how I keep track of how many times I've washed!..........4 washes with Working Wash? - Lay out 4 pipettes!........AND close my drawer so I won't - out of habit - reach in and get one! LOL! (I'm and "older tech" too! ) but as to your question........I don't know the true answer......... we always use a new one. But, if it does not state specifically in the IFU and their eluates / LW's give valid results.........I'd say it doesn't matter..........???

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Neil - I understand your point - but, in our case, when we're looking at the total # of patients transfused vs the outpatients with no previous record needing transfusion - the number of O's given equates to barely a drop in the bucket. We don't do it "willy-nilly" - only when delaying the blood to wait for a second sample would affect or delay patient care - some of our outpatient dialysis clinics or sister hospitals are counties away and that would not be good patient care.

We have A LOT of outpatients. Using our Outpatient Dialysis patients as an example - If we do not have a second type on them, we will give O units and do an ISXM on their first presentation. Upon subsequent presentation for transfusion, another sample would be received at which time we will do a second ABO/Rh and barring any discrepancies - will then EXM units provided the screen is negative.

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We do not require a confirmation when no red cell transfusions are ordered - ie - prenatal testing, or just an ABO/Rh. Most BB LIS systems will not "allow" the selection of ABO specific red cells if there are not TWO matching examples of the ABO on file with reactions. As an example: Our hospital just went to a new BB LIS (under duress). The ABO interpretations came across to the new system but NOT the actual reactions. Because of that we've had to perform a second ABO on essentially EVERY patient who we get a Type and Screen on - as this is the only test that allows for the selection of red cell containing products. We also went to a new version of EPIC at the same time as the BBLIS switch and it has somehow been set up by someone to recognize all patients who DO NOT have 2 ABO's with reactions on file and it will automatically order the 2nd ABO for us.

we just issue in either a validated refrigerated cooler or a validated RT cooler. (for platelets/cryo/gran - just a little igloo lunch cooler.) when we don't have enough coolers for platelets - we just use a regular ziploc bag. it was my understanding - as stated above - that OSHA requires a "carrying container" to transport blood products...... don't have the exact reg either - but, we don't use biohazard bags.....

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So, my manager (I'm the asst. mgr) has me looking at ALL our reagent IFU's to make sure that our SOP's are in line with the IFU's since this new FDA thing is coming up stating that anything used outside of the IFU is an LDT.....(or something to that effect). We are a large academic medical center and do 95+% of our own abid's. As I'm reading these IFU's for screen and panel cells they are all saying "Do not use beyond expiration". We often use expired panel cells to help R/in or R/out antibodies - does this new ruling mean that we can no longer do that....? Even if we run +/- controls? I'm stressing just a little! We also freeze some of the more "rare" antiseras - but we don't "report" those reactions or interpretations............so, basically that's just for "information"

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We have the Max-Q blue (smaller) and red (larger) coolers. Just some thoughts............ not sure what the MTP coolers use as their coolant, but the gel packs that they send/recommend for the blue smaller coolers are CRAP! We have replaced all our gel packs with "green arctic ice" blocks. More expensive up front for sure, but, well worth it in the long run. Our gel packs were only lasting about 3 months meaning every time we replaced a set it had to be validated.......we were constantly validating! Anywhoooo........... We use expired blood products (using minimum blood volume as you determine) set up the coolers as if they're going out and put a downladable global thermometer probe in the cooler between the units. The cooler is then left (here, at minimum 10 hours) in a spot in our lab - usually for about 12 hours. At the end of the time, we download the Temp report from the thermometer and determine the # of hours the cooler was within the appropriate range (we use 1-6C). Our blue MaxQ's usually stay good for 18+ hours with the new ice blocks we use.....ALL our coolers are validated for 10 hours - regardless of how much longer they qualify for. Confusing? Sorry - I tend to get carried away some times!

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maybe I didn't understand this statement.............I thought it implied that in doing "everything we can to avoid rouleaux/colds" from coming up was interpreted as us doing something deliberately to deviate from SOP??? ..........which we are not doing.........

definitley NOT deviating - just following SOP and performing IS - not IS-after-sitting-5-min-bc-you've-been-otherwise-occupied, etc..........

Totally agree! In all honesty, we do whatever we can to NOT encourage any COLD or Rouleaux interference. They're a nuisance!

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I took the SBB (about 9 years ago) after 20+ years in a large, academic BB / Transfusion service. Had I not stumbled upon an add about the "Last Chance Review" online and gone to Houston to attend the sessions (before there was an online option) there's absolutely NO WAY I could've passed! I totally agree that there were A LOT of questions that I felt were geared more towards the clinicians rather than the techs - but, then again, I'd only worked in one BB so, all I knew was how we did things...... Going to those review sessions showed me that I was studying all wrong. I came back and took ALL the powerpoint printouts they gave and picked them apart page by page, researching any topic I felt unsure about (which was most of them!). I ended up passing the first time..... I know others who have purchased the documents from these review sessions over more recent years and have passed as well.....cheaper than a program and something you'll keep forever!