epfeiffer

We do perform both activities.  Since we had already validated the system for transport of all other products, we validated syringes by ensuring that when they were sent they wouldn't leak or break.  We also add a little additional padding to the tubes with syringes to guarantee they are held in place.

We keep them until the monthly invoice comes and then they are discarded.  All documentation of unit receipt and final disposition is in the computer system.

The other thing you have to remember is that the charges are not for the blood itself, but for the processing needed to provide the blood.  These charges are the same regardless of how much of the unit is actually administered.

My first question is: is the ICU refrigerator an acceptable devise for the storage of blood products? If not that should stop immediately.
If so, then I suggest that any syringe loaded in the OR be discarded in the OR if not transfused in OR. If the unit goes with the patient to ICU then they could load a fresh syringe on an as needed basis in the ICU. This could still be done with out refrigeration for the 4 hours the unit has for complete transfusion. The problem is training the ICU staff to understand the limitations. While blood is, indeed a precious commodity, the risk it to great to the patients under the circumstances you have described. If there were more than one patient in the ICU with a syringe in the refirgerator..... I'm sure you can imagine all the possibilities. Good Luck. In my experience anesthesiologists can be amoung the most difficult to deal with.
:abduction :abduction

For a technical assistant: answer the phone, sign out blood, thaw products, take temps, discard samples, maintain blood and reagent inventory (with assistance if needed), any kind of housekeeping, stock supplies, any filing if you are still use any paper.
Don't discount the MLT's, they are as technically capable as a CLS. Remember it's not the letters behind the name that make a good tech it's what's in their head and their heart.

I had the same thought.  If you don't modify products, you don't need to have the FDA registration -- and you don't need the privilege of having them come to inspect.

I just answered this question.


My Score PASS  

I know I'm a little late responding to this thread, but I didn't see the answer I would've provided, so I thought it worth mentioning.  When we would EGA treat a neonate red cell to rule out weak D we would run a drop of EGA treated red cell with an in house 6% albumin as our negative control.  The control served the purpose of verifying positive reactions were truly due to the presence of the antigen and not the result of an incompletely removed maternal IgG.  We did do an extensive validation prior to using the EGA kit however, verifying which antigens were denatured, so we had complete confidence the D antigen was left intact. (Immucor was correct by the way, and the validation was completely unnecessary.)

Albaugh, we have Cerner Milenium, and you may be right it may be just as easy, I just took over and haven't had a chance to investigate.

I have used many Lab LIS systems over the years including Meditech and Soft. The set-up and underlying code of the Bank module in Soft is logic based. I am unsure what the Meditech system is based on, but it is not logic.

I know I'm a little late responding to this thread, but I didn't see the answer I would've provided, so I thought it worth mentioning.  When we would EGA treat a neonate red cell to rule out weak D we would run a drop of EGA treated red cell with an in house 6% albumin as our negative control.  The control served the purpose of verifying positive reactions were truly due to the presence of the antigen and not the result of an incompletely removed maternal IgG.  We did do an extensive validation prior to using the EGA kit however, verifying which antigens were denatured, so we had complete confidence the D antigen was left intact. (Immucor was correct by the way, and the validation was completely unnecessary.)

I think I can shed some light on to why a serological cross-match should be performed once a clinically significant antibody has been detected.
Once such an antibody has been made, it has been shown that the recipient is a responder. It has been further shown that, once such an antibody has been made, the recipient is likely to make further antibodies. These "further antibodies" include specificities directed against low incidence antigens of all specificities (by that, I mean, not just the antigens in the 701 series, but also those assigned to Blood Group Systems and Blood Group Collections). Many of these antibodies will be clinically insignificant, but some are quite definitely clinically significant, and it is to detect these, in the cross-match, which would not be detected either in the screen or the antibody panel, which require to be detected in the serological cross-match.
Whilst someone making these "extra specificities" may, in itself be rare, that was the arguement put forward in the Guidelines.