KKidd

We require a blood type with each account for plasma just incase there has been a registration error. Usually a CBC tube is available for use or type and screen has been performed. Historical type is sufficient for platelets.

This is included on our Emergency Release form. We have a category for testing problems. It includes unidentified antibody of unknown significance, probable cold agglutinin is present and may mask alloantibodies, a nonspecific autoantibody is present and may mask alloantibodies, the crossmatches are incompatible. Finally there is the "other" with an explanation. The physician signs the the statement "I understand the risk involved, but in my opinion, an emergency exists that requires the transfusion of potentially unsafe blood. I release the facility from any and all liabilities attendant to the administration of this blood. The medical director is consulted prior to release of blood in these circumstances. Hope this helps.

We centrifuge the plasma again and repeat testing with a 30 minute incubation time. For most samples, this seems to clarify things one way or another.

We make a 1:20 dilution of Anti-Fya and test the panel cells prior to first use.

We require that 2 licensed individuals(RN, LPN) perform the bedside check. A CNA can come to the transfusion to pick up the blood. The transfusionist finds another nurse to perform the bedside check with him/her and sign the form.

There is no CPT code and we only charge for actual procedures performed. Most of the "extra" samples that we get come from the oncology department. I know that if I were having treatment, I would want to minimize blood draws.

Make sure you check your state regulations for compliance. They may require a longer retention.

This was our procedure before FMH kits were available, like 30 years ago. Glad to have the FMH screen now.

We just had an in-service with nursing and they prime the tubing with saline and then use it to rinse the tubing after completion to make sure it's good to the last drop.

The lookback form from our supplier has a code for records no longer available. I would get input from my medical director for how to proceed.

Repeat testing to make sure that plasma was added to the panel.

Congratulations Malcolm! I can always hear your voice in my head as I read your posts. Looking forward to joining the club in a few years.!

I ran into this about 5-6 years ago with an AABB assessor. Previous assessors had accepted "current edition" but he required specific edition and wanted page# of the tech manual. With every change, I add a statement to the end of unchanged procedures - references updated (date) no changes indicated and initial. It is very time consuming.

I currently have 2 patients on the therapy and am trying to get a handle on frequency of ref lab workups after transfusion. Our first patient has been transfused. at that time we sent a sample to our ref lab for a workup to confirm that no allo-antibodies were present. We transfused Rh, K, FY, and JK matched blood. We do not have DTT in-house. Suggestions on frequency of workups - after each transfusion? Thanks!

My pathologist asked me to look up information on a "Purple Slide Test" in blood bank. The only thing close that I can think of is a KB stain. Does anyone know of this test? Thanks!

at our facility, when a unit is being issued, we ask if the IV is patent, consent signed and vitals obtained. These are the 3 most common causes we see of delaying the transfusion and wasting the unit. Checking vitals before getting the product gives the nurse a chance to contact the physician if there are any problems.

As I read 5.16.2.2 It seems like it refers to an electronic crossmatch. If an immediate spin crossmatch is performed, that will detect ABO incompatibility. A second type is still a good practice.

How often do you do RPM and timer checks on your centrifuges? Everything I read says periodically. Since I am a Blood Bank dinosaur(30+ years), we have been doing this quarterly as long as I can remember. My bio-med folks say this is overkill.

I also review all forms. Ware usually at around 90% compliance. If all information was recorded it would be more like 95% or more

We discard the unit. If the set has been inserted, nursing has 4 hours to complete as much of the transfusion as possible. For infection control purposes, units that have been entered must be discarded on the floor.

Yes, we just had our Joint Commision inspection last month and the regs do not specify departments. My manager asked and she was told that daily QC should be done at the same time every day. We use gel technology for our antibody screen/ID and AHG crossmatches. Everything else is tube. In order to get 2nd/3rd shifts to perform QC, it is a part of their annual competency test.

Our transfusion service has one tech scheduled for day shift. I have been informed that our daily QC must be performed at the same time (+/- 30 minutes every day). This works fine if you are not met with STAT work. I would love to know how other small labs are scheduling their QC and how the time is documented. Don't you just love inspections!

For our BB freezer, 2 degree variance is acceptable. We record daily temps in BB, but I am trying to help OR set up their protocol for thier new tissue freezer. It has a date logger, but my instincts tell me that they should check the temp daily. Help please!

Thanks for that info, my manager may be interested to hear this little tid bit,

No standard, the question was posed by my manager during an inspection. We didn't get cited and she just wanated me to check with my peers! Thanks for the input!