PAWHITTECAR

I love it... I used the same with a resident who wanted to do something stupid and I wouldn't budge. He said I'm an MD so I told him I have way more letters than that after my name...He wasn't amused but after a call to his attending figured out I had just saved his behind.

We report the hold the screen result until the panel is complete. It the panel is all negative the screen is repeated in Gel again and is still positive or if the panel has random positives and everything rules out we result the screen as positive and the panel as "Patient exhibits a non identified AHG reacting antibody."

I totally agree Malcolm. We only gave O to the kidney transplant patients that were A2

Thanks for the clarification.

My first thought is why do you know they are A2. I have never worked anywhere that A1 lectin testing was routinely performed. We do A1 lectin on potential organ recipients and would automatically give them O cells. The only other people that we do A1 lectin on have a type discrepiency due to Anti-A1 and we then give them O cells.

I'm jealous...I want computer documentation...But I will settle for a BB computer system with nice forms.

David, What information is included on your transfusion form? Computer generated? I am looking at the forme we have and am thinking that they do not include as much information as I would like.

Malcolm that was a very concise explaination.. Thank you.

The main difference, as far as I can tell, is that Rhophylac can be given either intramuscular or IV where RhoGam is intramuscular only.

I have been enforcing the policy of doing an ABS before giving RhIG. The package insert states that it is for non-sensitized patients so we feel better. If there is a documented administration of RhIG we will give the RhIG proir to the antibody Id otherwise we wait for the Id.

David, Have you had cases where the nurse simply cuts the bag to remove the unit rather than opening the lock? It seems that this could be a problem. I would think that it might be wise to have them return the lock & bag to ensure it was properly opened on their end. Call me a sceptic

I'm not sure the regulatory agencies are capable of writing any rule clearly or concisely..

At my institution it would be an occurence because it was not started within 30 minutes of issue. My policy for nursing states that the transfusion must begin within 30 minutes of the blood being issued and then complete no more that 4 hours after started.

Is anyone using the Final Check system by Typenex? How do you like it?

It is very addictive!!

Welcome. I too have found this site a wealth of knowledge and having just started as BB supervisor at a small community hospital I know I have gotten a lot of help from the wonderful people here.

I have to admit to not knowing what it said before but the education requirements are consistent with what I have seen posted for the position in smaller facilities. I would think that a larger facility would have stricter guidelines for the position.

We are not currently using the BioRad reagents but will be moving to them when current supplies are exhausted. I have completed a Validation using my Clay Adams set for 3400 RPM spin 20 seconds and obtained satisfactory results with 100% coorelation.

Oh James you will give me nightmares talking about in-vivo crossmatches....

Lisa does your reference centre provide "compatible" units to your hospital? They could crossmatch with the absorbed plasma. We to are a small facility and we send segments of the "least incompatible" units to the reference lab for crossmatch with the absorbed plasma. We then do IS ans gel crossmatches in-house. The units crossmatched were less reactive than the auto and I received a report from the reference lab indicating that they were compatible with the absorbed plasma. I spoke directly to the physician ordering the transfusion and explaing what was going on so he would not be surprised.

If they wish to collect a pre-admit specimen that can be extended for >3 days there is a blood bank form that they have to fill out. The form has the questions as to if the patient has been transfused or pregnant in the last 3 months. These forms are maintained in the blood bank. We do not get this request very often maybe once or twice a year. We had a similar form at a prior hospital as well and it was used often.

Yes very interesting...I wonder if there is a placebo effect in action here?

I know that whole blood testing has to be every 8 hours but serum and urine testing is every 24 hours per CAP,CLIA and most of the alphabet soup.

If weak D is positive dosing of Rhig is determined by KB or other quantitative method for determining the size of the fetal maternal bleed

I seams to me that there would never be a time that they couldn't somehow ID who they were giving the blood to. Even if it was "teenage GSW in Lobby" at least you would have some idea of who they were picking it up for. In the Senerio #2 we never know who its going to, what the problem might be, should we expect them to need a lot more or what? It is very nerve racking when they pick up the box without having any clue where it is going. Sometimes we do not even know where in the hospital it is going, was it ER, OR the transport team or who that came to get it.