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Specialist in Blood Bank Technology 

 

 

 

 

Blood Bank

 

 

 

 

Location:

Interim LSU Hospital

1st Floor

 

 

 

 

 

Unit phone:

504-903-4161

 

Phone

Beeper

 

 

 

 

Director:

Thomas Carson, MD

 

903-4851

 

538-2829

 

 

 

 

 

Associate:

 

 

 

 

 

 

 

Managers:

Elina Juengling, MHS, MT(ASCP)SBB,CQA(ASQ)
Transfusion Service
 Carlene F. Holbrook, MT(ASCP)SBB
Transfusion Service 3rd Shift – Michael Pettingill, MT(ASCP)CM

Immunohematology Reference Lab & HIV Gilead Grant –

 Sharon Stradley, MT(ASCP)SBB

Continuing Education – Karen Kirkley, MT(ASCP)SBB

 903-4851

 

 

 

 

 

 903-3851

 903-3851

 903-3954

 903-3954

Service hours:

 

24/7

 

 

 

 

 

 

 

 

Form Downloads:

Record of Transfusion Complication (MCLN0811 B)

Policy 5022- Blood and Blood Component Use

Policy 6031 – Blood Component Administration

Transfusion Reaction Workup

Consent to receive Incompletely Tested Platelet Product(MCLN 0811)

Emergency Request for Uncrossmatched Blood (MCLN 0805)

Additional Information:

Blood Administration and Transfusion Reaction In-service

AABB Circular of Information

ILH Transfusion Parameters

Patient Blood Management FAQs

Blood Bank Forms

 

 

 

 


 

 

 

 

SERVICES PROVIDED BY THE BLOOD BANK
Issue blood components and derivatives.
Investigate blood groups and identify rare donor units for freezing.
Investigate red cell related antibodies and provide antigen negative blood when appropriate.
Consultation for therapeutic phlebotomy.
Consultation for therapeutic and single donor apheresis.
Irradiated blood components
Cryopreservation of rare red blood cell units.
Transfusion medicine consultations.
Facilitate and provide directed and autologous blood components.

HIV Antigen / Antibody Combo testing for exposure and source patients.

Note: Most Blood Donor Services, including autologous, directed whole blood collections and therapeutic apheresis procedures are performed by staff from The Blood Center.  Directed and autologous blood donation services as well as replacement donations are locally available from The Blood Center.
Therapeutic whole blood phlebotomy services are arranged through the in-house I.V. team

BLOOD SPECIMENS FOR TYPE & MATCH (TYPE & CROSS) , TYPE & HOLD, & Rh IMMUNE GLOBULIN (Typenex label required)

A. Only MD's, RN's and Hospital Phlebotomists may collect these specimens.
B. Labeling - It cannot be overemphasized that crossmatch and other blood bank specimens MUST be correctly and adequately labeled. TJC (Joint Commission for Accreditation of Health-Care Organizations) CAP (College of American Pathologist) and AABB require that the patient and the blood sample be positively identified at the time of collection.


C. Preparing Typenex blood-recipient identification band and collection of blood.
    1.   Generate the appropriate forms from EPIC for components needed.
    2.   Gather supplies including pink top tube, Typenex armband, requisition, and two computer generated labels (obtain labels from    area printer, Sunquest generated label, ADT label or blank labels from the Blood Bank)

 

    THE REMAINDER OF THESE STEPS MUST BE COMPLETED AT THE PATIENT’S BEDSIDE.
    3.   Ask the patient to state their name and date of birth. If the patient is unable to or the patient’s mental status is unreliable, the armband must be compared to the face sheet and confirmed by a second employee of the department familiar with the patient.
    4.   Compare the requisition and the patient’s hospital identification band.       

    5.   Drawer signs and dates the two Patient Labels and the requisition.

    6.   A second person verifies patient identification, initials the two Patient Labels, signs, dates and times the requisition in the spot designated “verified by.”

    7.   Lift self-laminating shield covering long patient information area of the Typenex armband and place one of the pre-printed completed Patient Labels in the center of the wristband information area.

    8.   Peel white liner from the large protective shield on Typenex armband and cover the label.

    9.   Remove a specimen tube sticker from the end of the Typenex band and place on pink tube lengthwise below the cap. FAILURE TO ATTACH LABEL TO TUBE WILL RESULT IN SPECIMEN REJECTION.

   10.   Place the second Patient Label that has drawer signature, verifier initials, and date of collection lengthwise on the pink top tube near but not covering the cap. DO NOT COVER TYPENEX BARCODE.

   11.   Band the patient with the Typenex armband, allowing one finger space between wrist and wristband closure making sure locking closure snaps securely.

   12.   Remove the tail of stickers at the perforation. Peel liner away from tail of labels and attach to the labeled drawtube OR place tail of labels in a specimen bag.

   13.   Perform venipuncture and fill labeled pink top tube with 7 ml of blood. Mix gently.

   14.   The three extra labels on the patient’s armband may be cut off OR remove the adhesive tab on underside and secure to band.

   15.   Submit specimen, tail of labels and paperwork to Blood Bank for processing.

                                                                                                                                                                                   
BLOOD SPECIMENS FOR TYPE & SCREEN (NON-TYPENEX)

Confirm the identity of the patient as in C3 and 4 above. The drawer signs the requisition and the patient label. If a patient label is not available, record the patient name, medical record number, date of collection on specimen.


UNCROSSMATCHED BLOOD POLICY
A. Uncrossmatched Blood will be released by the Blood Bank when MCLN form 0805 (Emergency Request for Uncrossmatched Blood) signed by physician is sent to Blood Bank or ordered in EPIC. A properly labeled Typenex blood sample must be submitted with the appropriate lab form. For a special provision to handle the Emergency Medicine Department's (EMD) major trauma cases, see the EMD's policy and procedure manual.

B. Blood Bank policy is to emergency issue up to four O Neg RBC's. Thereafter, O Pos RBC's will be issued if a patient Typenex labeled sample is unobtainable.

BLOOD PRODUCTS
Crossmatched units are routinely held in reserve for 3 days. At the request of the clinician, and upon approval of the BB physician units can be held in reserve for longer periods of time, provided the unit(s) is (are) within the dating period, the patient has not received Red Blood Cells units in the interim, and the blood inventory allows.

Autologous Red Blood Cells will be reserved only for the donor/patient. These products must be crossmatched with a Typenex labeled sample prior to transfusion.

Directed (designated) Red Blood Cells - drawn from family members and friends - will be reserved for the patient up to one (1) week prior to the expiration date. If not used by the patient, the blood will be placed in the general inventory.  Directed Red Blood Cell products must be crossmatched with a Typenex labeled sample prior to transfusion. 

 

Blood products are tubed via the Translogic Tube System after the Blood Bank receives an electronic Issue Form from SMS generated by the floor.

Each courier/messenger is allowed to transport/pick up blood components for one patient on each trip in cases where the tube system is unavailable. Except in emergency cases, only one red cell unit will be issued on each trip.


BLOOD COMPONENTS/DERATIVES AVAILABLE FROM BLOOD BANK & TRANSFUSION CRITERIA

COMPONENT

Red Blood Cells

Fresh Frozen Plasma

 

Plasma, Cryopoor

Cryoprecipitate

Platelets*

 

Platelets, Pheresis*

Leukoreduced Red Blood Cells*

CMV negative Red Blood Cells

Irradiated Red Blood Cells

Washed Red Blood Cells

Rh Immune Globulin

 

TRANSFUSION CRITERIA

Hct ≥ 7 or Hct ≥ 8 in cardiovascular patients

PT of > 18.8, PTT of > 55.5, INR ≥ 1.5 – repeat PT & PTT after 4 units of plasma administered

 

Need Pathologist approval

Fibrinogen level < 100 mg/dl

<20,000 without active bleeding; >50,000 with active bleeding;

>100,000 intracranial bleeding, postop bypass or Plavix

Same as for platelets

Need Pathologist approval.

Need Pathologist approval.

Need Pathologist approval.

Need Pathologist approval.

 

 

 

*Bedside filters are available for producing Leukocyte-reduced RBC’s and platelets. Leukoreducation filters are issued by the Blood Bank.



SPECIAL PRODUCTS/PROCEDURES
Requests for granulocyte transfusion, therapeutic phlebotomy, therapeutic apheresis, and other special procedures not covered in this handbook must be discussed with and approved by the Blood Bank Medical Director. Emergency consultation for these or other Blood Bank services can be obtained 24 hours daily by calling the Blood Bank at 903-3099.

 
THERAPEUTIC APHERESIS (HEMAPHERESIS)
Therapeutic hemapheresis (apheresis) is a procedure in which a blood component is selectively withdrawn from a patient in order to achieve a therapeutic goal. This includes erythrocytapheresis (exchange transfusion), plasmapheresis (plasma exchange), thrombocytapheresis (platelet pheresis), and leukapheresis.

·        Therapeutic apheresis procedures are ordinarily performed at the patient’s bedside depending on the ambulatory capacity of the patient following discussion with and approval of the Blood Bank Medical Director.

·        Informed consent must be obtained for the procedure.

·        Procedures should be scheduled at least 24 hours in advance. (Procedures are performed by staff from The Blood Center)

·        The patient’s primary physician should be available to manage the patient throughout the procedure which takes 3 – 8 hours.

 


TRANSFUSION REACTIONS
In the event of a transfusion reaction:

·        IMMEDIATELY STOP the blood transfusion.

·        Change the tubing and hang normal saline to keep line open.

·        Notify patient’s physician then the Blood Bank at 903-3099.

·        Draw a full 7 ml pink top tube of blood, properly labeled with Typenex, and submit to the Blood Bank along with the completed Transfusion Complication Form (MCLNO 811B), the untransfused portion of the blood component plus recipient set. Enter Quantifi electronic report on-line. Order Transfusion Reaction workup in EPIC.

·        Submit the first voided urine specimen, properly labeled with patient’s name and medical record number, to the Blood Bank when it becomes available.

·        Results of the Transfusion Reaction investigation will be available in CLIQ, EPIC and scanned into the patient’s chart.
    

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

Last revised 12/10/2014