ksmith

For any non-transfusion ABO/Rh specimens, does anyone add a statement to the test result indicating there was no historic type of file or testing was performed on a single specimen? We are considering doing this for our outpatient ABO/Rh typing for prenatal patients. If so, what language do you include in the statement?

We are planning to implement a second ABO/Rh specimen collected at a separate phlebotomy on patient's without a history. Would anyone be willing to share their policy?

Thanks for the replies, very helpful!

For those of you using hi/low thermometers, do you only document the actual temperature reading and that the hi/low was within range? How often do you reset the hi/low reading (after alarm checks, etc?) I'm putting these in place for my generalist staff to verify the hi/low reading as well and working on my forms. I'm sure I'm over thinking this process! Thanks.

For any of you who uses only the high alarm setting on your BB plasma freezers, how are you going to "meet" this "revised" standard for the low alarm setting? Our -40 freezer did not come from the manufacturer with the low alarm pre-set. We can set it, but to what temperature & how do you simulate the alarm activation at such a cold temperature. TRM.42750 reads - All component storage units are equipped with an alarm system that is monitored 24 hours/day (in laboratory or remote), with documented alarm checks (for both low and high settings) performed at least quarterly. Thanks.

The checklist item is COM.30350 Reagent Storage - All reagents....stored as recommeded by the manufacturer. Under the Note it states "If ambient storage temperature is indicated, there must be documentation that the defined ambient temperature is maintained.....

Yes, it is a stand alone. The probe attached with the facility alarm isn't accessible. I have an independent thermometer that we document the temp with. The alarm has activated at the appropriate temp. The alarm probes are not calibrated on any schedule, etc. CAP changed the wording of one of the checklist items (cklist is not in front of me). Something about how do u ensure rt storage temp is maintained. Docu the temp once a day doesn't meet the rewording. A lot of facilities in my area are being cited for this. Malcolm, do you record both the min & max temps or just the current temp & state the min/max reading was within acceptable range?

We store reagents at room temperature. We currently document the temp daily & Engineering has a continuous monitor set up to activate when the temp reaches 20.5 to 23.5C. However, I am unable to periodically simulate alarm activation with the current monitor to "prove" the alarm activates at the set temps & functions as expected. I am looking for an economical way to satisfy this requirement. I would like to purchase a monitor with a probe that would activate when it’s out of temp & that I could simulate an alarm activation. Is there anyone who has a room temperature monitor they would recommend? Thanks.

Thanks for replying to my question. You've been very helpful!

Our Micro Supervisor is revising our policy for culturing BB products. Our current policy states to incubate blood product cultures at 4 degrees C, 25C & 37C. In reviewing a Clinical Micro SOP handbook, it does not discuss the 4C incubation. Do any of you still incubate blood product blood cultures at 4 degrees? If so, do you have a current reference. Thanks.

Thanks to those who replied, you've been a great help!

There has been some discussion at my facility as to the timing of blood draw for specimens to be used for the fetal bleed screen test following delivery. The issue arises during the middle of the night when we complete our cord blood testing & need to go draw a specimen from mom. Nursing & the patient doesn’t want to be disturbed in the middle of the night, which is understandable. Of course, it’s better to collect the specimen as early as possible. Do you know of any references concerning the time frame of draw or have a facility policy you would be willing to share. Thanks!

I'm in the market for neonatal syringe sets. I am aware of & have used Charter Med sets before. Is anyone using a different manufacturer they would be willing to share their experience with?

Thanks for your insights!

The last facility I worked at, we still used glass microhematocrit tubes for cell separations. We went to the local hardware store and purchased a small 3 sided metal file. The edge worked well to score the glass. If you apply too much pressure when you slice the glass, it may shatter.

There will be a tube system connecting the buildings. I am not sure of the locations. We are having our first meeting about this in a few days & I was wondering how other facilities handled this. We're working toward issuing blood products in a syringe set. Just in the initial phase of this. I actually wasn't sure if a syringe set could be sent in a tube system. The BB will be moving locations once the current tenants move to the new building and renovations are complete. We do not tube anything currently, but we will be discussing that as we plan for the new BB. That will be a couple of years down the road. If possible, I would like to go to a validated tube system. But, will need to look at other options in the interim. A tube system under a river, that sounds fascinating.

Our NICU will be moving from next door to an adjacent building in the next year. Currently we transfuse about 100 blood products a year to them. We see the numbers increasing in the coming year. My question – for those of you who are further away from the NICU, how do you handle delivery of blood products? Who delivers them & what is your TAT once the product is ready for issue. Thanks.

I am in the market for a replacement Blood Bank Refrigerator for our surgery area. The current one is an old under the counter model, which does fit our needs. We are looking for a small unit, preferably with a build in chart recorder/alarm. We do not need a full sized frig. Does anyone have a small BB frig that they would share their experience/manufacturer information.

I am looking to purchase a new centrifuge to spin down BB specimens. My first choice is a Helmer EBA 20. But we are still looking at other options. I pulled out an old validation on the last specimen centrifuge placed into service to see how we validated these in the past. The validation didn't include any actually centrifugation of sample tubes. I wondered what others are currently doing and if anyone had a validation plan they would be willing to share.

I have used both Clay Adams and Helmer EBA21. I have experienced the same hinge problems with the Clay Adams. I have inherited 3 Clay Adams, so far no problems. I prefer the Helmer, even though I have broken a couple of the metal spring hinges in it too. Of course, I miss the old Baxter/Dade immufuge.

Lara, What are you using for your forward typing QC? The current practice here is to use A1 & B cells against straight Anti-A, Anti-B etc. That QC's both reagents. This doesn't really follow the manufacturer's recommendation. We use Ortho Gel as primary & Ortho tube reagents as a back up. We also have Immucor onsite at times if Ortho is unable to supply us. I'm trying to find a SOP that meets the requirements of all three. Immucor seems to be more vague, so that works well. This is an inherited In House QC procedure & I want to see what others are doing before I decide what changes need to be made.

I am in the process of revising my SOPs for Daily QC. Historically, Anti-D & Anti-c had been diluted in house to test the screen cells (tube) day of use. For gel, we use dilute Anti-D. I'd like to know what other facilities use to make their dilute antibodies for In house prepared QC.

We used Biotest at my previous employer. The panel reacted very nicely. Never used the ABO reagents. We thought the Jka, Jkb and K reacted slightly weaker than Immucor/Ortho, even with the correct spin times. Lea reacted well; however, didn't like suspending the cells in PBS prior to testing. M and N reacted strongly. P1 & S reacted well, these were made with albumin & we were told if the patient had a positive DAT, the results of these 2 reagents may be invalid. I am preparing to validate the Biotest panel at my current location to use for rule outs. Overall, I was pleased with the products I used.

When performing cell separations, we currently use microhematocrit centrifugation. We have an old metal 3 sided utility file (non-sharp) to aid in cutting the capillary tubes to recover the retics. We are looking for something to replace this file. For those who perform cell separations by this method, what tool do you use to aid in this process? Thanks.

We ordered Anti-k and Anti-Lub from them in February and their unlicensed Partial D kit in April. We were happy with the products. I can't comment on the stability of these products yet, it's too early to tell. We bought directly from them, they shipped the products to us overnight using our FedEx account. We used to get monthly price listing from them, but I haven't seen one recently. We have recently been contacted by a third party saying they are now distributing Alba Bioscience products. We have not contacted Alba yet to verify this and the pricing.