rrcc1974

These things give me gray hairs, or more of them to cover that is. My favorite line about this is when I witnessed an ER nurse draw two patient's in one room, put the UNLABELED tubes in his short lab coat pocket (one set in each pocket) and start to walk out of the room. I stopped him and said "how do you know which patient is which?" His response was "we never make mistakes in the ER usually", all in one breath. He was fired shortly after that thank goodness.  Enough said- tubes arrive with no labels, in the biohaz trash they go!!!

Susan,
We set this up a couple of years ago.  We added several drop down boxes to our transfusion orders and made them mandatory so they have to put something there.  If they wish to transfuse outside of the accepted criteria, there is an "Other" option which mandates a free text field for them to list the justification.  Of course, they can always put in a space or some nonsense reason in there, but if they do that, then our Medical Staff Performance Improvement Committee reviews it and determines if the physician needs to further justify it.  If you would like to see our screen, I can email you a copy.

Geez, I am pretty sure that we just drew both types of tubes for our comparisons.
 
I think you have to realize that if the two do NOT match within whatever acceptability you use, then you will end up doing a normal range study for all of those tests anyway in order to validate your new tube normal and therapuetic ranges.  So maybe you should just go ahead and do that? 
 
Scott

KKidd what about the patient history lookup do you not like, or what would you prefer?
 
I'm personally a fan of the Meditech history lookup and how it's linked to the master patient index so we can identify possible duplicate medical record numbers.

We do not send qc across to MEDITECH.  The qc is maintained on CD Rom with weekly backup and on the ECHO hard drive in between backups.  Not worth the hassle of maintaining QC databases in MEDITECH when the ECHO is a perfectly acceptable database.

Report as NEGATIVE with a comment "Previously detected Anti-[] is not detected at this time."  Screen for antigen compatible unit and crossmatch.

Report as NEGATIVE with a comment "Previously detected Anti-[] is not detected at this time."  Screen for antigen compatible unit and crossmatch.

Report as NEGATIVE with a comment "Previously detected Anti-[] is not detected at this time."  Screen for antigen compatible unit and crossmatch.

Report as NEGATIVE with a comment "Previously detected Anti-[] is not detected at this time."  Screen for antigen compatible unit and crossmatch.

I know that you don't want to hear it, but unless you have your confirmatory test reflex onto the original accession number, you will be unable to fix things. Meditech attaches any new blood bank work onto the most recent active blood bank accession number, i.e. your confirmatory accession number. I have my confirmatory types to reflex onto the original number that way any crossmatches or product orders will attach there.

David, the "gentleman" "doing" the pint in the photograph is my very, very good friend Grant Webb.  I have to say that this was one of the few photographs I could find in which I was not doing the same myself!!!!!!!!!!!!

Careful Anna; I've used it!!!!!!!!!!!!!!!!!!!!!!!!!

Does anyone have their barcode scanners set up to read the Donor# and Blood Type together (concatenated) and then the Product code and Expiry together? Our IT tech thought there was a licensing issue.

Malcolm - I am glad you got that diatribe off your chest.  However, I am probably always going to refer to the expression of ags on red cells as either hetero- or homozygous, for 2 reasons (both of which are really invalid):  1: that is the way I learned them and 2: it is easier than adding"expression" each and every time I use the hetero/homo words. 
 
I do understand and appreciate your drive to provide us "iggerant" ones with the proper terminologies, usages, and whatever else your vast knowledge of the field deems prudent to divulge.  PLEASE DON'T EVER STOP!
 
ds

I'm with Malcolm. There have been so many announcements of processes that are going to make typed blood obsolete over the course of my career that I could have a big fat scrapbook from the clippings. I say....show me the money blood (with FDA approval) and then I'll be a believer.

You need to use a control that is equivalent to the reagents you are controlling. Most of the time, companies sell a reagent control. This is actually NOT a waste of money. The reagents contain lots of things in their buffers in addition to albumin and you can occasionally get patients who react with these other things too, giving you a false positive result

We have had our ECHO for 4yrs now and we love it.  Yes, there are some reactions that the instrument calls "?".  If it appears to be negative visually, we check the reading for the strength of the reaction (Highlight the specimen<Right click<Result file<then scroll down to REACTIONS)  The Assay cutoffs are on page D-6 of the ECHO manual.  It helps us decide how strong the instrument feels the reaction is.  Then if we question, we go to PeG as our backup.  If we get positive screen, then negative or inconclusive panel, we repeat screen in PeG.  If negative, then we crossmatch on the ECHO and if compatible, consider our reactions due to capture technology.  Otherwise we address whatever specificity is determined.  You must keep in mind that some antibodies react stronger on the ECHO while others react better in PeG.  That is why it is good to have two different methodologies available.

I've always wondered how on earth people had the time and money (and slave laborer research assistants) to do this? How many other seed extracts did they have to search through before finding the dolichos, ulex, vicea etc that did something with certain red cells and not with others. And finding the best recipe for preparing it. What a colossal amount of tedious work! I have trouble just finding the second blue sock in my sock drawer. Happy Thanksgiving to all.
Phil

I agree that doing a DAT on every patient is almost certainly wrong but never underestimate the power of a DAT - for Haematologists move in mysterious ways !
I used to tend the needs of 4 Consultant Haematologists who all used completely different (and secret) criteria for selecting which patients required a DAT.
The only thing they had in common was their immense gratitude when, based on other serological findings, we performed a DAT which gave an unexpectedly positive result - they appeared to find this extremely useful in their diagnosis and treatment - even though they never explained exactly how.
It seems a relatively cheap and easy way of keeping an important and fairly benign alien species happy.

Time for a little philosophy.  I have often described healthcare as an upside down pyramid with everything balanced on it's weakest part.  Generally speaking, and I really intend no disrespect here but, our entire system is at the mercy of the lowest paid, least educated areas with the highest turn over rate.  You will rarely encounter a career admissions clerk.  Their training generally consists of "see one, do one, teach one".  Granted this is based on my limited personal experience but it is what I and my wife have both seen in our careers in healthcare.  As to a solution, I'm sorry to say that I don't have one that is very palitable in the current climate of financial restraint.  (How is that for attempting to be PC!)  I have found over the years when ever the opportunity to educate those folks responsible for obtaining patient information on why it is so critical, from a blood bank perspective, to get it right they were quite surprised and became much more diligent.  Which brings me to another of my favorite axioms, "If they don't know why they can't or won't comply!"
 
Ok, I'm done.  Have a nice day. 

Awesome! It's stupid, too long, and laced with profanities!  Just add some mysoginy and you would have a real hip-hop chart contender!
 
Scott

If they caused a fatal reaction, would they be killer bees?

Dalmatian firehouse dogs:
 
http://www.windsorfire.com/fire-buffs-traditions-dalmations

In your line of work, "seldom" should be used with caution  . 
 
Connie Cottman, MT(ASCP)SBBCM
 
I agree entirely, but, NOTE, I never said NEVER!!!!!!!!!!!!!.........and never would!