tjohnk1

We are a community hospital in a busy suburban area with about 300 beds. We also do open hearts and neurosurgery and have kept two emergency AB's thawed at all times for the past 5 years. We transfuse about 60-90 units of plasma per month and have around 2-3 MT per month. Last year we wasted 30 of 1016 units received. Because AB's are getting to be so precious we are leaning towards switching to A's instead. Our rule for using them up is if they have 2 or less days left. We will thaw type specific if they have 3-5 days left assuming the patient can wait.

We routinely call for all of our antibody work ups. I once had to "prove" that my fax was secure when a panel sheet was being sent over but that wasn't a big problem. I love getting more info.

While it's not my ideal practice, it's what was decided to be the best solution with all the push back from pre-op. Many of our surgicals don't come in until an hour or so before surgery and apparently two collections take up too much time. What I hope happens is that the patient is shown the labeled tube after collection and says "Yep that's my name and DOB" and initials the label.

We require two collections OR have the patient initial their tube to confirm their identity before transfusing type specific. We don't require a second draw if the patient is group O. The blood bank initiates all the action and one of our phlebotomists usually goes up to do the second draw. I'm not sure how patients take it as I'm not out there much but when I think about how deadly a mistake could be I wouldn't have a problem getting drawn twice! Most of the time there is a previous tube we can grab anyway. On the 2nd collection we also only do forward typing to confirm.

The previous hospital I worked at was part of the validation study for Verax. Our procedure was to repeat a false positive. If it was positive again, send it to culture. If it was negative, retest again and culture if positive that 3rd time. So basically, go with 2 out of 3. I don't know if that was from Verax or what our supervisor decided. Good luck!

We archive our control and patient results on disk weekly. I honestly don't know if we need to keep those results because they do interface with our LIS. As far as I know we archive results weekly because it's part of our Echo maintenance.

We would give a dose of Rhogam based on results of the KHB. We just had one of these a couple weeks ago! We'd rather err on the side of caution and use the thinking Deny talked about.

In the institution I used to work at there was a 40 bed NICU and we only gave irradiated, leukoreduced group O.

I have no references but it's a big no-no the two places I have worked! I've personally seen a platelet count jump from 8 to 120 because it was drawn during a plt transfusion.

At the previous hospital I worked at, blood type isn't changed until engrafment takes place and there have been no transfusions for 3 months. This was decided because who knows if it is going to engraft successfully, if ever. A comment is put in stating Give O neg RBCS and AB plts/plasma or whatever type they need based on their transplant. Many of our patients got more than one transplant as well so it was unknown which one would work. HTH!