Eoin

We also had the same problem some years ago. We now routinely spin on receipt (could be small trapped bubbles due to disturbance in transport) and store upright - Problem solved.
Also where is the authority to spin a second time when reading coming from??? Never seen that in the literature. -

Same as Dankset.
First void collected and kept - examined for haemoglobinuria & bilirubinuria only if other work-up is positive. Would be looking at Haptoglobins then as well.
 
Cheers
Eoin

Same Time????? Where did that come from?? We have ISO15189:2012 and Joint Commission Int to adhere to and I have never been challenged on that. I would ask to see the regulation! We generally do it first up in the shift - repeated if new reagent opened - but not if in the middle of urgent XMs. Crazy stuff!
 
Cheers,
 
Wayne

We get ours serviced and calibrated yearly. In between, provided your QC is good, there should be no need for additional work on them. Experienced bloodbankers will pick very quickly if a pipette is not delivering the correct amount form the density of cell suspensions and hight in the cells afyer each additon and the size of the spun button at the end as well.
Cheers
Eoin

I have heard similar stories many times and am a bit disheartened that the narrative never changes.  Do you think there would be value in having a person from the transfusion service "issued" along with the first units when a mass hemorrhage plan is activated?  I imagine this person acting as a liaison/translator/educator/helping hand/cool head with respect to transfusion.  I can imagine that when things are going badly in OR or Emergency, all the little details that are important for transfusion are NOT priority in the minds of those involved in direct treatment of the patient.  Perhaps the TM service could provide a little assistance. 
 
From a broader perspective, as lab professionals, are we too attached to our labs? Whether it is true or not, we tend to feel that we are undervalued and under appreciated, but at the same time we stay hidden away in the lab making demands that seem like nit picking to those without training in laboratory practices.  I think, traditionally, that pathologists have been the link between lab professionals and primary care providers (i.e. physicians and nurses).  But pathologists can be very busy with their many other duties, is there a place for non-pathologist lab professionals to step in make more direct connections with primary care providers?  

Ah yes, it is indeed the O.R.  We don't have the time to sit down and watch a play at the theatre (which is also theatre - same as OR, but with actors instead) - Mind you some of our surgeons are actors!!!!!
 
What an interesting language English is. 
Cheers
Eoin

Ah yes, it is indeed the O.R.  We don't have the time to sit down and watch a play at the theatre (which is also theatre - same as OR, but with actors instead) - Mind you some of our surgeons are actors!!!!!
 
What an interesting language English is. 
Cheers
Eoin

Ah yes, it is indeed the O.R.  We don't have the time to sit down and watch a play at the theatre (which is also theatre - same as OR, but with actors instead) - Mind you some of our surgeons are actors!!!!!
 
What an interesting language English is. 
Cheers
Eoin

Ah yes, it is indeed the O.R.  We don't have the time to sit down and watch a play at the theatre (which is also theatre - same as OR, but with actors instead) - Mind you some of our surgeons are actors!!!!!
 
What an interesting language English is. 
Cheers
Eoin

I work at a blood center that collects thousands of donations a month. We have our fair share of antibody positive donors who are regulars.  Whenever we identify a positive antibody unit, we work hard to identify the antibody. If the antibody can not be identified, we discard the whole unit. We discard all plasma products from antibody positive donors.
We service multiple hospitals, some small and some very large ones. With that being said, only ONE of those hospitals will take these positive units for transfusion and it is frustrating. Thanks AMcCord for shedding light on your usage of such units. It was so very refreshing.

Damn, I've still got 7 months (well, six and a half, not that I'm counting!) before I retire. Good for you.

The Chemistry of Beer Phil!!!! Is that before or after it is in the BBer On-Call??
Like Malcolm, we can but wish from our side of the pond - but hey I'm not complaining - retire in three weeks time - so I'll just follow the advice from Lyndon Baines Johnston -
I’m not in the speech making business nowadays. I’m following the advice of an old mountain woman who said: ‘When I walks, I walk slowly. When I sits, I sits loosely. And when I feel a worry coming on, I just go to sleep.
 
Cheers
Eoin

This side of the pond O Negs (Typed as CDE Neg, possibly plus Kell Neg) which are held as emergency blood have traditionally been described as "Flying Squad" blood (maybe because people fly around madly with it in an emergency hemorrhage situation).
Theater person would apply to anyone coming from theatre (or theater as you spell it) to collect units (could be a nurse, theatre assistant or theatre porter in our case). Hope this helps with the "Lost in Translation" DCeDCe.
 
Cheers
Eoin

Ah yes - Having had to put up with all sorts of ??? over the years, now we have the real stuff. Just keep it away from the fan!!!!!

The Chemistry of Beer Phil!!!! Is that before or after it is in the BBer On-Call??
Like Malcolm, we can but wish from our side of the pond - but hey I'm not complaining - retire in three weeks time - so I'll just follow the advice from Lyndon Baines Johnston -
I’m not in the speech making business nowadays. I’m following the advice of an old mountain woman who said: ‘When I walks, I walk slowly. When I sits, I sits loosely. And when I feel a worry coming on, I just go to sleep.
 
Cheers
Eoin

The Chemistry of Beer Phil!!!! Is that before or after it is in the BBer On-Call??
Like Malcolm, we can but wish from our side of the pond - but hey I'm not complaining - retire in three weeks time - so I'll just follow the advice from Lyndon Baines Johnston -
I’m not in the speech making business nowadays. I’m following the advice of an old mountain woman who said: ‘When I walks, I walk slowly. When I sits, I sits loosely. And when I feel a worry coming on, I just go to sleep.
 
Cheers
Eoin

The Chemistry of Beer Phil!!!! Is that before or after it is in the BBer On-Call??
Like Malcolm, we can but wish from our side of the pond - but hey I'm not complaining - retire in three weeks time - so I'll just follow the advice from Lyndon Baines Johnston -
I’m not in the speech making business nowadays. I’m following the advice of an old mountain woman who said: ‘When I walks, I walk slowly. When I sits, I sits loosely. And when I feel a worry coming on, I just go to sleep.
 
Cheers
Eoin

The Chemistry of Beer Phil!!!! Is that before or after it is in the BBer On-Call??
Like Malcolm, we can but wish from our side of the pond - but hey I'm not complaining - retire in three weeks time - so I'll just follow the advice from Lyndon Baines Johnston -
I’m not in the speech making business nowadays. I’m following the advice of an old mountain woman who said: ‘When I walks, I walk slowly. When I sits, I sits loosely. And when I feel a worry coming on, I just go to sleep.
 
Cheers
Eoin

I like that Terri,
Maybe we could include necessity of getting Consultant Haematologist, BB approval before recommencing any unit. Mind you, if we find anything in the workup, the unit is taken down immediately. We educate them to be very cautious. Apart from minor allergic reaction where they are given meds and recommenced slowly, I would rather a unit come down even if unnecessarily wasted than a patient go on to develop a major reaction.

I like that Terri,
Maybe we could include necessity of getting Consultant Haematologist, BB approval before recommencing any unit. Mind you, if we find anything in the workup, the unit is taken down immediately. We educate them to be very cautious. Apart from minor allergic reaction where they are given meds and recommenced slowly, I would rather a unit come down even if unnecessarily wasted than a patient go on to develop a major reaction.

I like that Terri,
Maybe we could include necessity of getting Consultant Haematologist, BB approval before recommencing any unit. Mind you, if we find anything in the workup, the unit is taken down immediately. We educate them to be very cautious. Apart from minor allergic reaction where they are given meds and recommenced slowly, I would rather a unit come down even if unnecessarily wasted than a patient go on to develop a major reaction.

Like David, we cover all disciplines - so up to scientist investigating possible reaction (or TTI).

I like that Terri,
Maybe we could include necessity of getting Consultant Haematologist, BB approval before recommencing any unit. Mind you, if we find anything in the workup, the unit is taken down immediately. We educate them to be very cautious. Apart from minor allergic reaction where they are given meds and recommenced slowly, I would rather a unit come down even if unnecessarily wasted than a patient go on to develop a major reaction.

This is correct if you are accredited by the JC, you will get cited for having the physician order the reaction or continuing a transfusion when there are signs/symptoms of a reaction. Ours is policy based (medical staff approves the policy), they have signs/symptoms, they get the workup...period. We even have a statement in the policy that the physician cannot restart a transfusion that the nurse has stopped until the Medical Director evaluates the workup and gives the OK to release more units.

This.
 
Transfusion records are entered directly into the patient EMR. There is a list of things on the 'Blood' tab (where vitals, etc are recorded) that are automatic triggers for a reaction workup - if they click one or more of those items because their patient is experiencing that symptom, we automatically receive the order for the workup. The record also has a place for them to document when they called us and when they called the doctor. It all rolls from there. The physician's decision is whether or not to treat the patient based upon the symptoms reported, not whether or not the workup is done..