BBK710

We would NEVER use a specimen drawn in the ambulance by paramedics.

I know this is an old post but I was just reviewing reference lab charges from Red Cross. On the last two patients that we sent for testing we were charged this CPT code and not 86870 Antibody ID each panel/media as we were in the past. They appear to be charging for each panel cell tested as one patient had a charge for a quantity of 24 and the other a quantity of 39. Obviously the cost is significantly higher when charging per cell. Has anyone else noticed this? Is anyone charging their panels by individual cells?

We do the same except that we only do the perfomance testing annually. The Appendix 1-4 on page 37 of the Tech Manual (16th ediiton) suggests yearly function check for centrifuges and cell washers. We consider the procedure described (Method 8-6) as a function check and do it once a year.

Just tested a saline cube opened 2 weeks ago. pH is 7.0. So I think that our regular blood bank saline should be fine.

I have not heard from Immucor about this as yet. Are you saying that our regular pH adjusted buffered b lood bank saline can no longer be used for Immucor's fetal screen test?

I take this to mean that you must check the timer to see that the display begins at 10:00 minutes, counts down and blanks at 0:00 not that you must check it against a certified timer daily. We actually check all of our centrifuge timers against a certified timer monthly.

That is interesting. After reading these posts I decided that I would change my high alarm setting from 37.1 to 36.9. Our set temp was 36.5. We immediately saw that there would be a problem with this when everytime we thawed a unit the alarm went off and the baskets came out. I changed the set point to 36.0 and since then we have had no problems.

We treat our gel centrifuges exactly like our other centrifuges for quality control. AABB recommends that the timers be checked quarterly. Tech Manual 16th edition p.37

Interesting. I can't find that in the 16th Edition. There are major changes in that chapter and it is more vague than the 15th edition. It just says to do daily checks of temperatures and document diviatios on recording charts. There is no mention of comparison of thermometers to recording devices.

This is also referenced in an article "Two-Specimen Requirement for Verification of ABO/Rh" in the new Transfusion(July 2009 Vol.49,No7 pgs.1321-1328). Interesting reading.

Does anyone out there know why unbuffered saline and what difference it would make? Seems like alot to get unbuffered saline for a procedure that is done infrequently.

Is anyone considering switching from Immucor at this time based on the FDA letter? I am getting pressured to switch to Ortho since we already use gel.

Is anyone using the "standardized uniform procedure"? That incubation is only 30 minutes, no potentiator and w+ read macroscopically as the endpoint.

Anyone hear about this? FDA might pull manufacturing license. http://www.boston.com/business/healthcare/articles/2009/06/26/immucor_fda_could_pull_manufacturing_license/

I wish I had the answer because we have been having the same problem. Our department is usually very cool so I don't think that the blood is getting too warm while being issued. I find that the safe-t-vues will turn red if you are not extrememly careful how you apply them. We are switching to the Safe-T-Vue 6 as well and I am worried that we will have even more blood wasted.

Brenda, Were you able to get these coolers? I tried to order the Cell Safe through Fisher Healthcare and was told that they were discontinued. They suggested the ThermoSafe but it is larger (holds up to 8 units) and 3 times as expensive.

Suggested Infusion Rates from the 16th addition are: Adult Pediatric Red Blood Cells 150-300mL/hr 2-5mL/kg/hr Fresh Frozen Plasma 200-300mL/hr 60-12ml/hr Platelets 200-300mL/hr 60-120mL/hr Cryoprecipitated AHF As rapidly as tolerated As rapidly as tolerated Granulocytes 75-100mL/hr 65-100mL/hr They are pretty broad guidelines. We actually tell the nurses 5ml per minute for platelets which usually means that they are running a unit or pool over about an hour. We tell them 10ml per minute for FFP which means it runs about 30 minutes. To be honest I don't remember where we got those guidelines but they are pretty close to the rates from the tech manual.

The aabb technical manual has recommended infusion rates. In the sixteenth edition it is on p.620 Table21-1.

How do you charge when you order antigen negative units from ARC? They bill per antigen but they also charge a Screen 1-10 or Screen 11-20 etc. Can we only charge for one antigen for each unit that we order? This question was raised at a reimbursement seminar that I attended but the "experts" couldn't answer it.

We do the same as cindym. We only keep A neg and Oneg irrad. units in inventory so we often need to order B or AB units or units that are CMV neg but they are almost always transfused.

Who performs this test? Hematology or Blood Bank? Is it done on all shifts as a STAT test? If so how do you maintain tech competency if your 2nd & 3rd shift techs are generalists? What is your turnaround time? The majority of the KBs that we do are ordered by physicians on antepartum patients who have fallen or have been in a car accident. Our current policy is that this test is done on day shift only since that is the only shift that does evaluations on Rh neg moms post partum. We have a physician who wants us to change our policy to to the test stat on all shifts. Obviously our generalists are having a fit. Any information that you can offer would be appreciated.

We keep the samples for 10 days for the same reason. Do you test the cord bloods when requested after the baby has been discharged? Have you had any identification problems. We currently have the same policy and on the few occassions that the doctor orders testing after discharge the baby's last name has changed since they were born so our specimen no longer matches the order. I would like to change our policy and only test the cord blood prior to discharge.

We stopped testing ALL cord bloods 7 years ago and now routinely test only those of Rh neg. mothers. We do "hold" the cord bloods until discharge in case they suspect an ABO incompatibility in which case they can request that the cord blood be tested. It was hard to get the docs to go along with this change and we still have one older doc that requests that all of his patients be tested because he likes to be able to tell the parents the baby's blood type.

Love your reply. We pull segs when they are processed and keep in bags labeled with the exp. date of the unit. We keep each bag 7 days past the exp. date to assure that we meet the 7 day post transfusion requirement although most units are transfused well before the exp. date. We also keep them in the bottom of the frige and many times they are kept much longer than 7 days because no one remembers to check and throw them away. Some things are the same everywhere.

Our pool size is 5 units. Our policy for interchanging aphersis and whole blood platelets is the same as Linda's. We do for some but not all - based on availability from our blood supplier.