luhubert

We don't draw donors and use weights only to calibrate the scales we use for therapeutic phlebotomies. We aren't FDA inspected. Do you think we need to recertify our weights?

We, like "sgoertzen" have Meditech and do the prospective review at the time we issue the blood. However, we don't have a form that the nurses fill out. If we see something that appears inappropriate, the blood bankers turn it over to a Pathologist who in turns calls the attending physician right then and gets the reason for the transfusion. We also run a report every morning of all those patients with a Hgb. of 7 or below (O.B.'s below 6)from the previous day. If any weren't transfused, we give the name to a Pathologist who calls the attending and finds out why. Many times, its a patient refusal or a "DNR" but once in awhile, the attending didn't know and really does want to transfuse the patient. At our quarterly Blood Utilization Review meetings, there are very few charts that have to be reviewed for appropriateness, usually less than 3.

We provide a card (business card) with the antibody I.D. on it. We also give them their choice of a medic alert bracelet or necklace to wear that says: St. Joseph 979-776-2404 I have antibodies Tell blood bank We recently got a call from another hospital who said an "old guy" had come in and insisted his nurse give the bracelet to the blood bank. We told them we knew him will and that he had an anti-E and anti-K that were both below detectable levels. The person calling excused himself and in the background you could hear him yell: "come back here with that blood". That bracelet may have saved our patient from a transfusion reaction.

When I first came to the lab where I currently work, the pre-warmed technique was being used every time someone saw weak reactions. That's the kind of use that got the technique "poo-pooed". I went to a great lecture not long ago by George Garrity who expressed his agreement that there really was no place for the pre-warmed technique in routine blood banking. He did say that in the reference lab setting, expecially when dealing with Auto's, it might be useful. We have switched to plasma, don't do immediate spin, or 37 readings on any of our screens and we have done away with pre-warmed technique. After reading that 37% of significant antibodies were missed when the pre-warmed technique was used, that was enough for me to stop it's use in our lab. If our I.S. crossmatch shows agglutination, we just do a "mini-cold panel" including cord cells to show Anti-I and then XM through AHG.

Our computer company provided a very large notebook full of scenarios to validate all aspects of our system. Your best bet would be to ask your company for something. Otherwise - Meditech in Boston, Ma. does have a validation guide for their system that might be worth buying. It would show you everything you need to do. It's a long, time-consuming process. Ours took about a month.

We use Meditech for all: BB, Lab, Micro, Hospital, etc. We have 4 off site hospitals and lots of doctor offices all set up to integrate. I like the system although it's not as user-friendly as some.

C'mon - it only takes 20 seconds to perform that 2nd type. Don't make it mandatory that it be a different person to perform the confirmatory type. Just make sure the person starts over with the original specimen tube. We never have enough platelets so we can't give type specific. We do give type specific or compatible FFP, but doing the "RETYPE" just doesn't take long enough to ever be a problem. If we don't have a specimen on the patien :roll: t, then we give AB Plasma.

We use the I.D. band on an empty tube for the baby and use Mom's plasma for the Xmatch. The part of the band that goes onto the patient is usually put on the baby's chart or fastened to its nametag on the isolette. We don't have a big Neonatal intensive care so we are usually only transfusing one baby at a time. We give O Neg, leukoreduced, CMV Neg, irradiated blood to all neonates unless an antibody in the mom precludes this. We also use syringes with filters so that we can issue just a syringe with filtered blood, ready to be transfused.

We need computer documentation and when it isn't there, I send the patient name, date and unit number(s) to the Nurse Manager of the floor where the transfusion was done,- in your case ER. They have to get the chart and see if the documentation is written anywhere and then report back. Most of them sit on the Blood Utilization Review Committee and they don't like to have their number of undocumented transfusions reported out loud to the Committee. Usually they get the documentation completed as soon as it's brought to their attention.

We do just a forward type on the same red cells but make another suspension from the original tube. We record the results in the computer but the test is a "No Charge" test. This extra typing assures us that the blood banker typing the specimen didn't make a mistake but it doesn't assure us that the blood is from the patient listed on the label. We do try to have a different person perform the type but when only one person is working, they check themselves.

We have a great Red Cross Consultant who sends up all the codes every time something upgrades. You can reach him at : Removed e-mail address, spammers get lots of them this way, please send a private message to luhubert if you want to learn the address.

I agree and I have a tech who not only scopes everything and reads at every step but also holds the tubes over his head and looks toward the light to read them as he shakes them off. I've spouted safety, time and regulatory constraints to no avail. How do you get them to change? Lu :?:

You may have to go with just the practical. You were able to find 2 compatible units. You may have to antigen type and then crossmatch and know that you will only get a certain percentage of the antigen negative units to be compatible. Considering his positive DAT, you will only be able to judge those 1+ 's as incompatible, anything microscopic must be discounted due to the DAT. Did you see anything at 37? This may be developing like the S and you might get a better idea from its IgM reactions. I'm sure it's more important to find compatible units than to identify the culprit.