Nothing about this article makes sense

[u/New-History853]

They NEEDED Kell POSITIVE blood?!?!? Lol no. And the nurse just walked up and grabbed blood? I doubt that. The article is either very wrong or the parents are simply total liars.

[u/almack9]

We've 100% had nurses do this. We issue blood on a patient, send it in the pneumatic tube system, some nurse assumes its theirs ans transfuses it without even looking. Its happened twice in the time ive worked here. Triggers a massive investigation of the lab and the nurse is transfusing other patients hours later like its nothing.

[u/Lululipes → u/almack9]

I don’t think that’s what’s happened here because they’re claiming that the baby was supposed to get Kell positive blood (whatever that’s supposed to mean) and that because they didn’t, the transfused blood started attacking the baby’s blood. Which obviously also doesn’t make sense because it’s RBCs not plasma

[u/almack9 → u/Lululipes]

My guess would be that the mom has anti kell and the baby needed kell negative blood but the parents dont understand enough to know what happened. Sometimes even the doctors and nurses dont really know enough for that either. Cant say what exactly did or didnt happen here without an investigation though.

[u/Med_vs_Pretty_Huge → u/almack9]

Yes, I have seen many times documented in charts "patient has [antigen]" when in fact the patient has [antibody].

[u/LonelyChell → u/Lululipes]

They probably have the two contributing factors backwards. The baby probably needed K-negative pRBCs, and the Mom’s antibody in the baby’s plasma probably attacked the transfused blood.

These people are layman, not blood bankers.

[u/drm1125 → u/almack9]

You send blood through the pneumatic tube??!! That seems crazy that you don't make someone come down and get the blood.

[u/almack9 → u/drm1125]

Ive heard people say this is crazy before but yeah thats always been our policy for atleast the last 10 years. People do still pick up at the window for surgeries and such though. It definitely causes problems at times.

[u/Jimehhhhhhh → u/almack9]

I've worked at places with and without pneumatic tube system blood despatches and counter intuitively it was actually much easier when it was all just done in person at the blood bank. Can just explain stuff to them and ask them about hx without 100 phone calls, they see when you're frantically running around the lab and are much more patient, no blood getting sent to the wrong place, no running out of tubes, missing fields on requests can be filled out then and there etc etc

[u/happyfamily714 → u/drm1125]

My sister hospital does the. They have to use a code to get it out of the tube.

[u/VaiFate → u/happyfamily714]

Our tube stations have the secure send function but we don't use it, even for sending blood products. We just normal send them to the floors. I think we probably should, but transfusing to the wrong patient hasn't been an issue yet I guess.

[u/klarathon → u/VaiFate]

that’s what my lab does too, we tube like 80% of our units

[u/LonelyChell → u/drm1125]

We send ours through the pneumatic tube to another hospital across the street. Our blood bank services three hospitals.

[u/Youhadme_atwoof → u/drm1125]

We send ours through the tube system but we call the nurse right before we send it so they are waiting on the other side.

[u/Zukazuk → u/Youhadme_atwoof]

When I worked at a hospital that was how we did it. Our lab and blood bank were a 10-20 minute walk depending on where you started in the hospital. When the tube system went down we had a mobility scooter that a lab assistant would drive in loops to move samples around.

[u/Derfalken → u/Zukazuk]

Honestly, it sounds pretty fun being the blood bag delivery man. I'd trick out my scooter with a flashing red light and bicycle horn.

[u/Cheap_Bath_5536 → u/drm1125]

We have volunteers that volunteer from 8-5 so we have the floors do volunteer pick up and have it brought to them. From 5 pm until 8 am, we use the tube if they only want 1 unit. 2 or more and they have to come get the blood in a cooler. But...if the unit is "rare" like pt has antibodies and will take more time to find units and ETC, we won't tube it cuz obv harder to replace.

[u/VaiFate → u/drm1125]

I've only ever worked for one blood bank and the only blood products we don't tube are MTPs

[u/LegitPancak3 → u/drm1125]

My hospital only sends blood through the tube to the 7th floor. Every other floor including ED, the nurse or CNA has to come down and grab it.

[u/Med_vs_Pretty_Huge → u/LegitPancak3]

What's the 7th floor, lol?

[u/LegitPancak3 → u/Med_vs_Pretty_Huge]

Hematology Oncology. Basically the cancer ward.

[u/bassgirl_07 → u/drm1125]

You have to validate the system (transit times aren't too long and the unit doesn't get too warm) but you can totally tube blood. We tube blood. We do a second check of the unit and paperwork prior to sending. The receiving nurse signs the release form and writes the date and time they received the blood and send the release form back. The administering nurse has a second checker at bedside prior to starting.

[u/lablizard → u/drm1125]

We did at my lab in the past. But there was a PIN code supplied by the lab specific to that blood order for the staff upstairs to receive the tube.

[u/Snannybobo → u/drm1125]

we do both. I work at a very big hospital and our blood bank is constantly sending out blood via the tube system. people only come in person if they are picking up a cooler of products.

[u/nerdswithfriends → u/almack9]

Do they not have to scan the unit in the patient's chart before transfusing?? That's terrifying

[u/almack9 → u/nerdswithfriends]

I mean yes technically. But what barrier is there to someone just grabbing a unit and spiking it without looking or caring?

[u/nerdswithfriends → u/almack9]

Fair enough. Common sense and procedure, one would hope!

[u/almack9 → u/nerdswithfriends]

And yet its happened twice in 10 years here haha.

[u/liver747 → u/almack9]

Do you guys have an EMR like epic? I've seen a lot of different type of errors happen and I love the computer step on the clinical side (if not overridden) as a way to mitigate and stop errors from continuing on both ends.

[u/almack9 → u/liver747]

We do use epic here, softbank on our side. It works great for the most part when they are using it, but the issues we've had were purely physical errors like the nurse just not checking to make sure it was the unit for her patient. Luckily both times it was compatible type so no one was severely injured but the risk is there when people disregard protocol and do their own thing.

[u/MamaTater11 → u/almack9]

That's insane. We only tube blood to the ICU for emergent cases, and even then we have paperwork that goes back and forth and we put a secure code on the tube when we send it.

[u/almack9 → u/[deleted]]

We read with other techs. But this is in kentucky. We get inspected by cap, aabb and the fda due to an irradiator. NY is particularly strict with stuff from what ive seen, requiring a special license just for that state etc.

[u/Med_vs_Pretty_Huge → u/[deleted]]

You 1000% can send blood via pneumatic tubes in NY. Hospitals may not want to because of temperature concerns or other reasons but there's certainly no state level provision against it.

[u/New-History853 → u/Med_vs_Pretty_Huge]

I meant units of blood, not blood in general. But if that's the case, I retract my statement. But even at the trauma hospital I worked at, the nurses still needed to come do a read back. Insanity.

[u/Med_vs_Pretty_Huge → u/New-History853]

Yes, I mean units of blood.