R1R2

Thank you so much. There are posts now!!!! I am spreading the word to my fellow POCers.

Hi amym! I am so happy to see you here too! As a POC person now and blood banker in a past life, you are correct.

Agree with Malcolm but can be at any age. Additional testing may need to be done for some babies receiving type specific. It is outlined in CAP and AABB checklists.

Can you add a Point of Care Section with these possible topics to start: Accrediting Agencies, Computer Systems, Education/Quality, Equipment, Vendor Selection and All Other Topics? I am hoping "if you build it they will come". Thanks Cliff!

I don't think there are any regs. Keep the blood products on top shelf, followed by reagents and then urine specimens on bottom shelf and label shelves.

Nursing should have a policy not to do that and it should be part of their annual training. I could audit that on occasion - blood issue to time started.

the FDA requirement is not that blood transfusion is completed within 4 hours of issue. The FDA requirement is transfusion is complete within 4 hours of start of transfusion. You may need to update your policy?

As long as you are documenting the time of issue in the LIS you are good to go. I would not add another layer to your process by manually writing the issue time on a slip or paper or where ever. "ain't got time for that" is my 2016 motto.

Not always the case in US. Volumes can vary depending on amount requested by MD.

I would discuss how much can be removed and still be considered a whole unit with your medical director. It seems a shame to waste a unit if just 25 mls were removed.

I would not think that you would have to run other rule outs and I wouldn't bother testing 3 Lua+ cells, just 1 would do. Some labs would not confirm at all and just go right to AHG compatible blood. I agree with Malcolm in that Lua is not an antibody to spend time worrying about. Our blood supplier would die laughing if we asked for Lua negative blood.

I have seen this several times with anti D and I agree with Malcolm. I wouldn't worry too much.

My Rh phenotype has helped me remember about who can make an anti f and who can't. I asked about GEL IAT because I have seen some funky reactions when cord plasma is used in gel.

Have you considered sample contaminated with IV fluid.

3 things: 1. I would ask your peds team for recent literature that describe the benefits of this practice. 2. Your cord sample may not be an acceptable specimen for bili testing. Check your specimen requirements for the bili test that they want you to run. Some bili tests require testing within 4 hours of collection, separation of plasma from cells ASAP, non hemolyzed samples and samples collected in amber tubes etc. 3. You can send an aliquot of plasma to Chem instead of the whole sample. Are you using gel IAT to test the cord plasma?

me too.

I don't see a need to validate the bags if used for transport only and temps are taken if blood is returned. I would make sure you have validated the process and it sounds like you did. Nursing and lab SOPs should address this process and clarify that it is for transport only and not for storage of blood at the bedside, nursing unit, OR etc. and include instruction that units shall not be removed until ready to transfuse. Maybe put a time limit of return (you may have already done this) to eliminate possibility of the bags being used as storage. You may also want to look at your reasons as to why so much blood is being returned to warrant the red bags. I would make sure that the gel pack storage refrigerator temp is monitored.

pooled human urine from at least 6 healthy people used to do the trick back in the olden days.

I love this idea! Are you taking the temp when the unit is returned?

I agree StevenB. And I think the odds are much lower. I calculate 1 in 5,000. In all my years of reviewing patient's antibody hx carefully and going right to select cells when appropriate, I only had one instance when antibody was no longer detectable and I found a worthless Lua in the process.

Agree with David and Malcolm.

Agree with David.

I can't give you a reason to keep it. I think CAP is just as thorough.

To Auntie-D Can you share a reference for that?

Does the supplier use his own transport container which should be validate? If that is true I would think that you would not have to worry about temp. Taking temp of the product tells only what the temp is now. It could have been out of range during some part of the trip.