Cathy

Never use the historical type for issuing non-group O red cells. A simple registration error, now or when this patient was seen in the past is a recipe for disaster. Never, never, never give type specific until you have done a type (or two depending on your policy).

We just use zip loc bags, single, not double bagged. Make sure they are sealed tightly before issue. Get rid of them when they start to tear.

BankerGirl, Do you pour off your eluates when you spin them? I recommend spinning a couple of times, (pouring off into a fresh tube each time). You may see brown crud (red cell stroma maybe?) left in the original tube after the pour off. I never see mixed field reactions anymore with eluates.

We do the same as clmergen.

We are reporting the titers as <1 if reacting in gel but not in tubes. I think the reason we continue to perform gel crossmatching is just for consistency, positive antibody screen = coombs crossmatch.

It was the procedural changes I was thinking about, that would be hard to keep up with / keep updated cd's. I guess if each area had its own cd that would easily managed. I just though of something, I wonder if Sharepoint could prompt the supervisor making the change to make a new cd. I bet it could, I'll check.

Thank you Linda. Good information to consider. I have printed the thread and will pass it along.

On our website we have posted links to the CDC and our state lab. They can find the latest info as well as testing requirements, treatment guidelines, etc. We have increased the amount of naso pharyngeal swabs we have on hand.

If I am reading this right, I think you have a couple of issues going on here: I do not agree with your vendor: reserved should not be considered available. The BB manager says it can be available but the system should tell them it has not been retyped. Red cell units should not be available until the reytpe is done. We have cerner classic. We can reserve a product prior to retyping. If we tried to emergency release it prior to retyping, we would need to supply the password as aakupaku mentioned. I'm not exactly clear on what the finger pointing is about but personally, I think you can allow the BG to Reserve. We want our autologous units reserved immediately. They should stay on the quarantine shelf until the retype is done and users should not be allowed to do anything else with it in the computer until the retype is done. Good luck.

We are in the process of converting. We are using Sharepoint. I have only seen a demo so far but it looks like it will be great. We haven't figured out a way to get rid of the large, bulky notebooks yet (in case of a network downtime). Any ideas?

We have seen a similiar case, sent it to the Reference Lab and they had no answers either. Please keep us posted.

When using the pneumatic tube for transport we use plain old ziploc bags. When a unit is being transported by hand we just use little brown paper bags for the squeamish visitors. We don't use biohazardous bags. If the two nurses came in to check my armband, like we know they always do, and the unit was still in a bag labeled as biohazardous I'm not sure I'd want it infused into me (even though I am fully aware of the potential risks and benefits). Perhaps the bags are discarded prior to the unit being at the bedside, but we didn't know at what point the blood would be removed from the bag and didn't want to take a chance that it would scare or worry the patient.

I agree with David, you may want to consider having an additional panel on hand. Using your screening cells in your rule outs or as one of your three positives/negatives may help but again, if your dealing with something other than a K or E you may have trouble. How are you doing your ruling out? We prefer to rule out cells with homozygous expression. If we have to use heterozygous we require two negatives, (when using gel or peg). When doing rule outs and using LISS as the testing media, we do not use cells with heterozygous expression.

Congratulations on your quick advancement to a supervisor position! I think you will find this site to be a wealth of helpful information. We don't carry anti-A,B so we test with anti-A and anti-B. We test immediate spin D's only on the Rh neg units. For those of you using A,B and an LIS, did you make a separate field to result the A,B instead of the anti-A and anti-B?

Johnny, Has your question been answered? Are you asking for help in ruling out antibodies or other aspects of testing?

I think I would focus on generating the '2nd' label earlier, like at the time of the draw and avoid the re-labeling all together. We are not automated so I'm not sure if this is even a possibility.

Ditto. We have been very happy with all of our Helmer products.

We test the ABO/Rh and DAT on cords of all Rh-neg and O pos moms.

We have recently switched to 5 day plasma. It's been great for the MTPs or even for routine orders. We use what we have thawed and thaw more. We go right to the 5 day expiration.

We do them on all shifts 24/7, mostly generalists. We have pretty good luck freezing our control slides and that saves a great deal of time.

We use the Hollister band. As long as the band is still on the patient and remains legible we leave it on. When a new sample is needed, we have the phlebotomist hand write the "R" number on the new sample. We extend our eligible pre-ops for up to ten days. These patients wear their bands home. If they show up without it we redraw.

We use Hollister (red) wristbands and do allow computer generated labels as long as the sample also contains the unique "R" number.

We still generate a paper flowsheet and require two signatures for the id section (at the bedside). The rest of the documentation can be done on the paper flowsheet or EMR.

I agree Mabel, some of the questions are specific to someone else's policies. I like the case study idea.

Still using the scope.