ksmith

Have you reached out to Ortho for support? They should be able to provide you with the information.

We have a new Therapeutic Phlebotomy Scale with a hanging 500 g weight. The scale has a self calibration program. Need to determine the best way to verify calibration. How do you verify calibration of your phlebotomy scales and at what interval? Thanks

Does any one have experience with the Genesis CM350 Blood Collection Monitor for collections? Looking for pros/cons of device use including maintenance and calibration. This may be used for Therapeutic Phlebotomy (not for transfusion).

We give mostly IV RhIg post-partum. I learned this because we started to get calls from nursing stating the Post Partum testing is STAT and where are the results. If I have the specimen collected, I don't consider that testing STAT especially when I have other patients needing blood products. Obviously, they want to give the RhIg so they can remove the patient's IV.

We use a Sartorius Scale (LA120s) to calibrate laboratory pipettes. We have a third party calibrate the scale on an annual basis. Our currently policy states to perform in-house calibration quarterly. When the manufacturer does not specify how often the scale should be calibrated, is there a standard or recommendation for frequency? Would someone be willing to share your policy/form for the calibration? Should the weights used be sent of for calibration on a scheduled basis? I'm new to how this scale should be maintained. The original policy was last revised in 2003. Someone else took care of this at the other facilities I have worked. I appreciate any information you can provide.

We use a Sartorius Scale (LA120s) to calibrate laboratory pipettes. We have a third party calibrate the scale on an annual basis. If you have a scale you use to calibrate pipettes or weigh out chemicals, would you be willing to share your policy/form for the quarterly calibration? We have weights the lab uses to perform the quarterly calibration. However, we need to purchase new standard weights. I'm a Blood Banker that has never been responsible for this aspect of the Scale. Need guidance to make sure we are in compliance with the CAP COM.30880. I believe they need to be Class 2 weights. I'm curious at what measurement range we should have on site. Original policy was written in 2003 and doesn't look like it has been updated since. Thanks - any information will be appreciated.

After 2 years, we are getting the E1 error message on our Ortho Workstation multiple times a day when we go to start the device under normal operation. I'm a 'fix it myself if I can' kinda person. Has anyone experienced this error? If so, were you able to fix the Workstation or did it require something more. Thanks.

We are updating our Massive Transfusion Protocol. We are a 400 bed non-trauma facility that does not keep FFP thawed. We would probably have 2-4 MTPs per year. How are other similar sized facilities handling these? Do you include only blood products in the initial phases? At what point do you add other labs or meds to the protocol? Who do you designate to contact the BB of the initiation & to stop the MTP? If anyone has a flowsheet or process map that they are willing to share, it would be much appreciated. Also interested if anyone has designed a review form to evaluate each MTP after the event to look for ways to improve the process. Thanks.

We just purchased a new Helmer refrigerator. We need new dividers or trays to store RBC bags. Has anyone purchased trays or dividers recently? I'm interested in options from sources other than Helmer. Thanks.

Does anyone have the title of the national guidelines so I can search for it? I have desperately wanted to stop investigating the positive DATs when the treatment is the same. But, I'd like to review the reference prior to stating my case. Or more likely, having the reference to use when my Medical Director notifies them we are no longer performing certain testing. This would save us lots of time when it doesn't add any value.

I haven't seen anything defined in writing and was concerned that I was overlooking something. Our goal is to give them some general guidance and remind them about TACO. That's what the newer nurses are looking for.

With our current multi-facility EMR, there was no rate built with the component orders. It was decided each facility would have 'recommendations' of a time frame or as the physician orders.

We are revising our blood component administration policy to flow along with our RBC administration policy. I cannot find the original source for our current administration rates for FFP, platelets or cryoprecipitate. Looking for a reference/best practice for administration guidelines for blood components.

For Mom, we routinely perform Type & Screens on all OB patients. For Baby, we routinely perform cord blood testing (ABO/Rh & IgG DAT) from deliveries of all Rh Negative and Group O moms. We still perform additional testing when the baby has a positive DAT (IgG testing only). When there is an ABO incompatibility or mom has a current detectable Anti-D due to Rh Immune Globulin, are any facilities still doing more testing on the cord blood? We still do even though the baby is going to be treated the same way. Our protocol is use of a bili light and for a bilirubin to be performed 12 hours after delivery. I haven't reviewed recent literature on the subject. Curious to see what other facilities are doing for positive DATs when the is not a clinically significant antibody involved.

Thanks, that's good news. We purchased one. I'm getting ready to write up a validation plan.

Has anyone purchased the new cell washer from Thermo Fisher, the Cell Washer 3? I'm interested in your experience with it and any advantages/disadvantages you see. Are there any extensive maintenance requirements you wish you would have known prior to purchase? I was unable to find the operators/service manual online. Our old Sorvall 2+ finally died, may it rest in peace. I've reviewed the operators manual to the new Helmer. It looks nice. Not sure how long the display will last with my staff. I also thought a negative was that they recommend running distilled H2O through it daily or after it sits for more than 4 hours. We don't use it often, so we'd be running distilled water through it prior to every use. Thanks!

It is, but I use this environment throughout the year for new employee training and competency. I didn't think there were any actual regs, but wanted to make sure. The other option is to purchase another server for the upgrade environment to use until we implement the upgrade.

We are about to embark on a computer upgrade. We currently have 2 environments (production & training). To save money, the question was asked if there was any regulatory reason that would not allow us to move the upgrade onto the training server. This would leave us without a place to validate/train/implement any change for about 6-9 months until we went live on the new version. Thanks.

TreeMoss - Do you know if CBCs are run from placenta blood at your facility? If so, could we reach out to your facility to talk to them? Thanks.

They are drawing from the baby side of the placenta from the fetal vessel. I’ve not decided if I consider this any different from the cord blood. When I said it must come directly from the patient, they said it does. I think since there is nothing written definitively stating this type of sample is not acceptable for pretransfusion, they are just looking for a way to not take blood directly from the baby. I’ve asked for info to contact other facilities with this practice, but haven’t gotten anything yet They are just beginning to look at this process, so we’ll see how it goes.

No David, you’re not an old timer (or we both are). I feel the same way. We would never transfuse from a cord blood. I had never heard of such a thing before yesterday. There is a video on YouTube about it. I hoping someone has some experience with this request.

Is anyone using blood collected at birth from the placenta for Neonatal Type & Screen and transfusion? Our facility is looking at doing this for initial labs and they want to include the Neonatal Type & Screen which could be used for transfusion. If you are using this, are there any special considerations you made when implementing this process?

We have always participated in CAP Titer surveys and staff performs competency annually as well and haven't had any issues. When we have a previous specimen, we perform the titer using the current & last specimen. In reviewing our testing for CAP's IQCP, our validated procedure is from the technical manual. I was reviewing CFR493.1256 (d)(3)(iii) for this test system. It states "Test procedures producing graded or tittered results, include a negative control material and a control material with graded or tittered reactivity respectively." I was curious how others were meeting this CFR.

Since an antibody titer is a semi-quantitative test, what is everyone doing for QC for this test?

This isn't a regulatory requirement unless you do not maintain your BB history to compare records for the last 12 months, which we all do. We receive a lot of specimens from physicians offices, etc. As with any test, our results are only as good as the initial patient verification/labeling. Even though we are comparing records to our historic data, many of these patient's are new to us. We were considering some type of statement to indicate we did not have another sample to compare the results to or no previous ABO/Rh history record on file. I remembered seeing that someone was adding a similar statement, but I could not remember where I read it.