DANDERS

We use the BBK Specimen Expiration function found under Edit to extend the expiration date up to 30 days for our pre-op patients only and they have to meet the criteria of not being pregnant or transfused within the last 3 months. Everyone else expires at 72 hrs and that is set as the default in Meditech. AABB Technical Manual, 20th Edition, 2020:506-7 allows 45 days before surgery but I chose to say 30 days.

We do not extend the expiration date but love to know if others find you can because we never use the entire bottle and it seems like a big waste of money.

I am wanting to go paperless with Emergency Issue and MTP. How do you meet the requirement for capturing the Dr's signature for taking responsibility for the uncrossmatched blood?

I'm having the same issue. I too assumed it was the camera. It's been adjusted and a new one ordered. I thought it was just me. Good to know.

Can anyone tell me how you're utilizing the barcode itself. How are you reading them in the blood bank and then at the patient's bedside?

Does anyone have a policy they'd share regarding when it's okay to not repeat an AB ID on a repeat patient with a known antibody. I have a patient who comes in every week for blood. A+ with an anti-K since 2003. I worked up the antibody everytime at the beginning, then was told about a policy I could implement and not work it up every time. Before I implemented it, her screen went negative and stayed that way for the last several years. Well, all of the sudden, her screen is positive again. The reactions are consistant and there's no other antibody. If it's possible to not work this up every week, I'd love it know how to properly word a policy.

What policy does everyone use to insure a returned unit of blood is between 1-10oC in order for it to be returned to the Blood Bank?

What about if using the gel system? Is weak D testing necessary?

Depending on the patient's insurance and it's rules, registration gives a Pre-Clinical V# for pre-op testing and a Pre-Inpatient V# or a Pre-SameDaySurgery V# for the surgery. If the Pre-op visit is close enough to the surgery date they're given one V#. We use the MR# in blood bank so the different V#s don't cause us any problem. We also use the Move to Another Acct routine.

We are about a 100-125 bed hospital using the ProVue and LOVE it. It's generalist-friendly; if down (rarely), the manual get is great; you can have continual flow; IS and IgG xmach; donor reconfirmation is very easy. The only thing we don't put on the ProVue is Fetalscreens.

When we used tubes, we would repeat the screen using a 1:28 dilution and reported like you said. I don't know where this came from but we used it for many years until we switched to gel. Now we run the full panel and confirm the patient did receive RHIG. We report "Residual-D - patient received RHIG on dd/mm/yy".

We use the DOB & V# except in BBK where we use the MR#. Our oncologist's office is the only area outside the hospital allowed to draw crossmatch specimens. They have a list of their patient's MR#s, but call us when they don't have one. If the patient doesn't have a MR# yet, we have them use the DOB.

We don't re-check any of our reference lab's antigen testing, but we do perform a full IgG crossmatch in gel for any units being given to a patient with a known antibody.

We switched to Rhophylac some time ago. Like David, the nurses weren't interested in the fact that it could be given IV. Now they are.

We've been using the ProVue for over 3 years and love it. I was sold on automation by the Immucor sales rep and the ABS 2000. By the time I convinced upper management, Ortho had the ProVue out. We had on-site visits with each and preferred the gel technology over the Capture method. We have never been sorry. We've had rare down times - only one probe crach. All of our techs took to it quickly. We use the gel for back-up, but kept the reagents to type in tube if necessary. We do everything on the ProVue. The only thing it does not do is Fetalscreens.

We do exactly what you do - clerical check, visual check for hemolysis and a DAT on the post sample. We also never have to go any further with our testing. Our pathologist signs off on it and could request any additional testing.

We perform ABO/Rh & DAT only on cordbloods of Rh negative moms. We keep them all and the doctors can order tests for up to 7-14 days later.

In our 129-bed hospital, we do a TS and a Hemogram on all OBs.

OK, what am I missing? Why can't this baby be AB+? Is it the weak reaction with the Anti-A that's causing the question?

We have a 72 hour cut-off for everything. It's easier that way.

We have used a 2 cell screen for over 20 years.

I am new to gel and can't get over the number of Anti-Ds we are working up on our moms. What protocols are being used to report these out? Do I need to titer each of these or sent it out for IgM/IgG determination? Is there anything to support a "negative screen at 28wks, RHIG given within last 3 mon and 1-2+ reactions" concludes "Anti-D most probably due to antepartum RHIG"? Any responses would be most appreciated! Debbie

At the end of each month, I do an audit of all units given. Our H/H policy is 8.5 and 27.0. Anything that does not meet that criteria is passed on to our Performance Improvement department. They have someone who then reviews the chart to try to "justify" the transfusion. If she can't find documentation to justify it, it then gets sent back to the Dr. for his justification comments.

We went straight from tubes to the ProVue. It did take a bit of adjusting, but I am happy with our decision. The 2nd shift loves it. I use it primarily, doing manual gel where needed. To Sue Miller I have some questions about doing Cord Bloods on the ProVue. How are the samples being collected? L&D can't use pink tops because the sterilization process required for anything present in the delivery room will affect the EDTA. They are considering collection by syringe and then a nurse transerring into pink top. You could respond directly danders@stillwater-medical.org