aafrin

Our Policy states that we can issue 4 O Neg units maximum without receipt of patient sample, otherwise we will stop giving units. Our A & E and OT are quite good about it and send the sample as soon as possible - mostly when collecting 2nd unit.

Our Policy also states the same. RCs to be infused within 4 hours of issue time. We also state on the transfusion forms that units must be started within 30 minutes of issue time to offset most of the reactions. Ward nurses are also told that 4 hours is the maximum time for a unit to be transfused, initially the transfusion must be very slow for first 15-30 minutes, but then it must be completed as fast as patient's hemodynamic (HD) condition can tolerate. For patient's with poor HD condition we halve the units on request. If told from wards that a unit was not started within 30 minutes, we tell them to start transfusion immediately and try & complete it within 4 hours. Any remaining quantity after that time must be discarded.

Happy 217th Independence Day to our Blood Bank friends in the USA, & Happy Birthday America. Celebrations Galore...

Same here, but we also QC the lot upon receipt before it being taken into stock for everyday use.

Ditto in our Blood Bank.

David, can you please attach the consent here. I would also like a copy. Thanks in advance.

We use glass tubes for tube testing. Blood collection vacuettes from BD are of plastic - clear & transparent - polystyrene, I think, though not sure.

We do DAT on all cord samples, but report only the ones from mothers with group O or Rh negative.

Pharmacy handles all these

Couldn't agree more Chris.

Bio-Rad has a fully automated system called IH3 being marketed, but I don't know when it will be available in USA.

AMcCord, you are absolutely right, a buffoon who gaffe's on patient ID procedure because of no time, lengthy procedure, too much work or who's a smart---s thinking the system is dumb - is a potential for disaster. They shortcircuit the procedure and get away with it a couple of times and then become bold & smug, until their luck runs out and puts patient, blood bank & themselves in grave danger. Computers, electronic gadgets like bar code readers etc. are just helpers/tools with no mind or intelligence which is why they say GIGO about them - user intelligence is what counts.... The scenario you depicted has happened once here, but luckily for us & the patient, the second sample requirement saved us all. Sorry, if I got onto your soapbox......getting off now.

What are the regulations about sample size pool for NAT testing? Does FDA, AABB or any other agency have a regulation about what how many samples can be pooled for NAT testing or is NAT testing to be performed on single donor samples. I tried searching in the threads but found no such info. Thanks for your inputs.

Hi Mabel, It is very important to have air-gap in gel tube between the gel matrix and reaction chamber for reactants to mix and react. We use DIAMED gel and we were taught that order of addition is also very important - red cells first at an angle of 45 degree followed by serum/plasma added vertically (90 degree). This prevents showing 'dp' after centrifugation and also prevents inactivation of Coombs reagent by serum/plasma, as there is no washing step involved in gel.

We do not have special blood bank arm bands, only the hospital ones. The patient cannot be drawn/ transfused unless they are wearing one. We were toying with the idea of having a specific blood bank arm band but gave up the idea due to increase in costs as well as cumbersomeness of two arm bands on one patient. We have to review this again in July for policy purpose and your inputs will be of great help.

We have never done that as it would change the cell-serum ratio that would not be optimum for reaction in gel. Like Malcolm says tube method is what we do resort to.

So true Kate. It's teamwork, can't be handled otherwise.

The photographs and news about Boston bomb blast killings have rekindled thoughts, horror and nightmare that only those who have endured bomb blast can understand. Although I am not in Boston physically, I am there...been there... I pray for all victims and their families, also doctors and other paramedics, and our BB Talk friends for taking their care. May God bless you all with strength to get through and over this calamity. Our hearts go out to you all - Chris, Linda and Kate Murphy.

I am always available on phone 24 X 7 to my staff for conferring about any issue. I am also about 10 minutes away from my hospital. Although I speak to techs. or other physicians almost daily, I have not gone to hospital ever in all these years except one night in 2010 (Feb.13, 2010 to be precise) when there was a bomb blast in a patisserie/cafe just 3 buildings away from where I stay. We had around 50 casualties brought in and all our staff was called in for work that night by me. If I am out of town then my assistant supervisor takes charge; even she has not ever had to come to hospital. So far so good.....

Couldn't agree more, Malcolm. Never test waters when life is at stake.

The same set cannot be used to transfuse all components. Different sets must be used, for e.g. if RBCs were transfused with one set the same cannot be used in tandem to transfuse Plts. or else all the plts will be trapped in the filter. Usually the sets are changed after 3-4 units are transfused.

We too never accept any other facility's blood group report. We have also seen way many wrongly written/typed reports to believe any of them. We also do blood groups for health check-up patients (package) at our hospital and almost every week one or two patients come to tell us that their group was different from what we've reported - some show us their typed reports, others their work I-cards - and their those records are always wrong. We repeat their groups by finger-***** and voila! their group is changed to what we’ve reported. So sorry, but we will only believe blood groups done at our BB.

I agree the old timers were trained to think "one unit transfusion is no transfusion and should be avoided cause the risks of such a transfusion outweigh the benefits". In those days BBs were told to find out which doctors are giving only one unit transfusion, so that the pathologist could talk to them to avoid such transfusions. During seminars & conferences also such slides were presented. With changing times, available technology, proper scientific understanding & risk mitigation, today complete opposite view is presented. As to checking H+H, doctors usually check after 2-4 units are transfused for cost-effectiveness, as they presume that one unit will increase hb by 1gm/dl - that is also if they do check. At our hospital also we are talking to doctors, but with a very little headway.

Welcome Jamie to this great site where BB knowledge sharing is at its zenith.

I am lost...Anna, please elucidate further..........