Hi all,

Does anyone have a PowerPoint presentation about Trasnfusion Medicine, i.e. blood types, clincially significant antibodies, type and screen and crossmatch, that would be appropriate to present to nursing. Not too technical please. Thanks in advance.

JB

We are a hematology/oncology POL with 8 separate sites and hematology analyzers. We are looking at purchase of an information system. We are considering LabDaq. Has anyone had any experience with them? Interested in your implementation experience.

Albumin is dispensed from the blood bank. Recently nursing has been questioning the need for patient consent to administer albumin. Is there a standard for such consent?

Our blood product supplier is going to start using more variable content platelet apheresis units. My medical director has asked me to think about guidelines and a proposal to take to the transfusion committee advising when it is appropriate and not appropriate to use variable content products.

My question is do any of you have it outlined in your procedures. I don't feel the blood bank techs should be making the decision.

Thanks for your help.

Michael Black, MT(ASCP)
Freeman Health System, Joplin, MO

Prior to a HSCT transplant our blood bank receives 2 specimens for ABO Rh from the donor. One is peripheral, the other is an aliquot from the actual stem cell collection.

For many samples upon centrifugation of the stem cells, there is barely a cell button of rbcs remaining. We do MTS gel testing & only need 10ul of cells. When aspirating the rbcs at the bottom of the cell button, they become contaminated with stem cells, and any gel typing is junky looking and the control usually comes out positive. We often end up using an extremely dilute specimen and perform tube typing, disregarding the flocculation caused by the stem cells and make an educated decision by the most experienced techs of the blood type (which we have already presumed from the peripheral specimen).

Increasing our sample aliquot would deplete the volume of cells to be transplanted, so that is not an option.
Does anyone else have this problem or a better way of performing ABORh's on stem cell aliquots?

Hi all, I am needing your expertise. Does anyone have a blood management policy that they would be willing to share? I'm really looking for information about indications where the patient needs transfused now, versus waiting until the next day.

This is for our cancer program-they have tripled in patients in the last year, and the docs are wanting everyone to be transfused same day--it's taxing our nursing staff who never get to leave on time anymore, our blood supply (they will wipe out our stock and the regions stock of irradiated platelets in a day), and it's difficult for scheduling purposes. So rather than have a patient waiting hours (our supplier is an hour away) for the product to get here, we are hoping to come up with some criteria to discern if the patient can wait a day and be scheduled for the transfusion. We hope to take it to the docs and try and get them on board with this.

Any help at all will be appreciated.

Michaele

Pos Antibody Screen gel method
ABID panel all neg
next step: report Antibody as Inconclusive and give gel(IGG) crossmatch compatible units

or perform cold screen at 4 deg 15-30 mins. If pos, report Cold Agg reacting at 4 deg. Perform LISS tube Antibody screen and recommend LISS crossmatch compatible units.

I'm seeing a lot of Cold Agg in our facility since majority of our patients are elderly. Inconclusive reporting is not routinely practice . Has anyone wrote a procedure suggesting "if all clinically significant antibodies are ruled out", report the Antibody as Inconclusive?. The previous facility I work has this practice but theres no written procedure thats directive to the process. I would like to eliminate unnecessary work but still provide a safe practice.

My busy transfusion service is inquiring as to what other facilities do for QC? We have recently been using the corQC kit from Immucor. There are some who think all phases of the antibody screen (IS, 37, Coombs, and Check Cells) need to documented. The product insert specifies adding potentiator, incubating for 15-20 minutes at 36-38 C, washing, adding Coombs serum, grade and record results. Just wondering what others do who may be using the same product or doing QC another way.
Thanks.

We are in the process of transitioning our factor concentrates from Blood Bank to Pharmacy. Do any of your hospitals require a blood consent for factor products, or is it handled like a medication?

Please bear with me, this will be confusing to explain. We provide transfusion services for 2 different institutions - owned by the same corporation. These two institutions utilize separate Medical Records Numbers, one is an outpatient cancer center and one is and inpatient hospital. Often times, the patients will be drawn at the outpatient facility, and then due to their status, be admitted to the inpatient facility for transfusion. We've devised a policy, that when the patient sample is drawn they will put both Medical Record Numbers on the patient sample, so when they get the CBC results and dependent on patient status, the patient can be transfused at either facility. We just need to know which Medical Record Number to perform the workup under. This policy has worked reasonable well. However, recently we have had instances, where due to patient time constraints, or deterioration in status, they will transfuse one RBC as an outpatient, and then want to admit the patient as an inpatient the next day and continue to use the same blood bank sample. In this circumstance, we feel the patient should be redrawn. The workup was performed under one Medical Record Number, the patient was transfused under that Med Record Number, and then is admitted with a different Med Record Number and visit number. The facility does not understand why we are having the patient redrawn under these circumstances. We base our decision solely on the fact that the patient was transfused. If a patient were discharged and then re-admitted the next day, we would require a knew sample, and this seems to be a similiar scenario. Does anyone have an opinion, or function in a similiar situation where you are the transfusion service for places that utlize different Med record numbers? I cannot find any regulatory standards that address this type of problem. (We use a separate Blood Bank armband system for all blood bank samples and the patients know to keep this armband on.)

We have been having problems for a couple of weeks now with our Revers A1 cells on the ProVue. We are getting a lot of NRD results. When we look at the cards, we do not see any problem with the A1 cell well (and these are on patients who should be NEG with A1 cells). We have:
1. Had both machines serviced since then (we have 2 Hospitals); though it would not make sense to me that both machines would suddenly have the same problem (and we are seeing this at both locations)
2. Received a new Lot# of Reverse Typing Cells (still have the problem)
3. Tried a new Lot# of Cards (still have the problem)
4. It is an intermittent problem; not with every patient who should be NEG

It is getting to be very frustrating! :( I have had the Techs. repeat them manually (in tube) to see if we could "see" anything in the tube; nothing...

1. Any others having this problem recently?
2. Any thoughts/suggestions/recommendations?

I am not new to GEL, but I am new to the ProVue. But as a Blood Banker, I am used to looking for "patterns" and for things to "make sense;" and I can't find the sense in this.

Thanks,
Brenda Hutson, MT(ASCP)SBB

I am just posting this questions as it has come up by our pathology group. Are your pathologists allowed to order a Transfusion Reaction Workup or RhIG for an Rh negative patient who has received Rh pos platelets?

I ask this just because we have had instances where a patient's physician has not ordered at times when they probably should have. We then consult our pathologists and some will order and some refuse.

Thank you in advance for sharing your practice with me.

I hate to post this question but its bugging me for the last 2 weeks :(

In my monthly usage report, I have to calculate % RBC utilization. I look at our existing policy which was originally written in 1992 and was revised in 2004. According to the policy; % utilization of RBC is calculated by dividing the number of RBC transfused for the month by the number of RBC transfused. The total should be 100%.

That don't make any sense to me. If we transfused 263 and wasted 6 for the month, I guess my calculation should be 263/269 X100=97.77%. The policy should say; % utilization of RBC is calculated by dividing the total number of RBC transfused for the month by the number of RBC transfused + total number of wasted RBC x 100.

Inputs are greatly appreciated. Thank you.

Hi

I need some info on the sample number used in your blood bank specimens, do you use the barcode number generated from the Meditech or the specimen number with a prefix. I have an issue with Meditech since it stores the barcode for only two years i believe and if the same is used for sample identification in the analyzer then i wont be able to search for the results as i do not have the Barcode number. i think there is an issue with Traceability of results and would like to get the opinion as as many people as possible. In few words if you could say what analyzer you are using and how it is linked to the interface and whether you use the barcode number generated from the Meditech or the sample number using BB as prefix. I am writing up an abstract for a conference about the traceability so please input your thoughts.Thanks in advance

Regards,
Jeby:confused:

We are in the process of installing the Terumo Trucise system for our sterile connecting devices (TSCDs). I am hoping that some of you are expert users of this system and can offer some advice on how we might be able to build our system to capture the required "second check" of the labeling affixed to the aliquot bag we are welding to the original container (AABB Std. 5.1.6.3.1-5 &6). I know some folks have computer systems where the "label verify" is actually built into the aliquot/modify/pool routines, but unfortunately ours does not offer that feature (Meditech). I've reqested that Meditech add this as a customer defined option to these routines, but as far as I know, they haven't taken any action on this enhancement request.

I'm hoping to completely eliminate writing anything down on a paper log, so we need to figure out a way to somehow document that second check within the Trucise system or "somewhere else" in Meditech. Any ideas would be very much appreciated!

Can anyone tell me where to get the small MTS card holder racks? The small clear plastic ones that hold about 20 cards?

Thank you!

Hi all, I was wondering if any of you have any experience dealing with donor breast milk. Our maternity wants to have it available (only when needed) and of course, this has fallen on my desk. If an infant is in need they would aquire the milk from another local hospital and then want to have it stored in the blood bank. I am just wondering how it is handled in other hospitals and is it really necessary to have it stored in the BB.


Thanks!:confused:

We are currently having a discussion regarding the" expiration" of the PAT T/S. We expire the sample at midnight(2359) on the the day of the surgery (unless the sample is already within 72 hours and would not expire until a later date OR there is a special circumstance postop that would allow the tube to be used until "AM" routine collection"). Does anyones else have an opinion on this subject? We like to collect a new sample the morning following the procedure for easier record keeping and consistency with "the other patients" rules. All opinions are welcomed. Thanks for your input!

Hello everybody !

If a donor has received a B12 injection for asymptomatic decrease in his serum B12 level ,or as a supplement , is he deferred ? for how long ?

Our laboratory has purchased a new Coulter hematology analyzer-I've been told that we need to do a 'mixing study' to evaluate how long the EDTA samples shopuld be mixed before placing on the instrument. Does anyone know of a procadure for this or where to find this?