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Our labor and delivery doctors order a type and screen on every patient. In our computer system, we have it built that when we have a female between the ages of 11-55 a question of Rhogam candidacy is triggered. If the patient is not being seen for obstetric reasons, we result as not indicated. If the patient is pregnant and not currently here for delivery (such as miscarriage, bleeding, etc), we attach a message that depending on the patient's clinical condition RHIG may be indicated. Then if we have a mother that is here for delivery, we leave the question blank until we get a cord blood workup. This remains on our pending test list until completed. After the cord blood testing is performed, the tech answers the question with yes or no and the baby's type/Rh. If the tech answers yes, the computer automatically orders a Rhogam Workup which gets a new specimen. -
I had a doc, in a rush, insist that he could not wait any longer for FFP. I explained that it was thawing, and he said he didn't care he wanted it right now. I told him I didn't think it would go thru the IV line in its present state. He didn't understand. I had to explain that it was a big chunk of ice. He said he wasn't aware that it was frozen.
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We only use our specimens for the 72 hour window. Often, pre-surgery patients present too early for this specimen to be used on their surgery date. For our benefit, we go ahead and draw their type and screen. This is to gather a history on this patient. If they have an antibody, we have time to work it up and get units available. A very simple form is filled out that says this patient must be redrawn prior to surgery. A copy goes to blood bank, and a copy goes to the patients chart. The initial draw that is for our benefit is performed at no charge. We order a different test, we call it a COMEBACK.
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About what % is 40 records? How many units do you transfuse per month?
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You don't have to receive the card back, however if you are like us we use this as a quality monitor for JCAHO. Our nurses record the vitals, reaction, signatures, etc exclusively on the hang tag.
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I don't know what lot number it was, but we had a lot of gel cards that well #6 didn't look like it had all the gel, liquid in it. We had some screens that came up positive in well #6 (guess no one looked at the card before use), but when repeated it was negative. We had this happen several times before one of our techs pointed out the problem. During this time we had a proficiency test that was missed. Tech noted on paperwork that even though ABO, and Antigen negative, crossmatch was positive (however did not repeat). When reviewing the xerox copy of her card, it was noticed that the volume level and gel did not look like the other wells.