#crossmatching

Overwatch Hero Reveal

First Week as a Medical Technologist!

I remember writing on my last post that “I don’t have the spirit to find a job yet” but two days after that very post, I landed a job... in a freaking public hospital!!! Yep, can’t believe it myself either.

It honestly still hasn’t sank in because it all happened too fast??!!! I’M NOT EVEN EMOTIONALLY PREPARED TO WORK YET!!!! I’m not even 100% sure that I’m going to practice the profession but surprise surprise! I remember only getting up in the morning (which I usually don’t because I always wake up at lunch unless my niece has school affair) to submit my PDS in a local hospital then the next thing I knew, I was already signing a contract and getting my biometrics!!! I thought there’s still a long process and all that but it all happened in a flash!?

I was assigned in the Blood Station Facility of our Provincial Hospital. So far, I’m getting the hang of our work flow. My seniors were nice enough to teach me everything I need to know and actually left every crossmatching during my shifts to me for almost a week which I am thankful and afraid of at the same time. I am a self-proclaimed loser in phlebotomy due to my infamous phobia in needles (yup, ironically) and I was never even able to develop the "skills" during internship since I had it in two private hospitals that’s why I’m really scared and nervous whenever I was told to ward and extract. So far, I only had 2 failed extractions (endorsement) because the first patient’s vein collapsed, ‘di ko na nahabol which I thought was QNS (which later on I learned that okay lang pala huhu sayang) while the other one was a diabetic whose veins I couldn’t palpate #defensive. But I was also shocked and glad to have heard/ been told as a “sharp shooter” by a patient and her relative. Me??? A sharp shooter??? Over my shaking hands looooooool nope. It’s so funny that I developed the habit of praying “sana madali lang ang vein” whenever I receive blood requests. It’s still a looooooooong way to go for me in phlebotomy and I’m praying I’ll get over my fear of needles soon and extract like a pro.

I’m still as anxious as I am the first day because I am very aware of the fact that just one wrong drop of mine, I can kill a patient... and automatically lose my license. I always make sure to ask for guidance whenever my shift starts because that’s the only protection that I can get against all possible mishaps and my innate stupidity. I’m still really slow whenever I do crossmatching. I only do it per patient because I can’t risk doing it simultaneously with other patients because I may or may not confuse one from another. I tried once to do three crossmatching all at the same time and copy the way my senior labels and I seriously (lowkey) got confused that’s why from then on, I decided to stick with the way staff from St. Luke’s label as I’ve seen during my internship. I also developed a habit of checking the units I crossmatched for the day in the Crossmatching Logbook as well as the Completed Transfusion Logbook the moment I enter the lab in my next shift to see if any transfusion reactions or problems had occurred in the units I’ve crossmatched lol.

Every day is a new learning experience for me! Really looking forward to learn more and hopefully fulfill my dream of being a person for others as Medical Technologist. I’m still not sure if this really is what’s meant for me but I’m really leaving everything to Him for his plans will always be the best.

on my way home I suddenly had the idea to match characters from FT and DGM together. Here is so far what I came up with:

Natsu Dragneel x Lenalee Lee

Arystar Krory x Lucy Heartfilia

Allen Walker x Minerva Orland

Kanda Yuu x Yukino Aguria

Alma Karma x Meredy

my tubes..

That's me.. doing compatibility testing..

A blood transfusion is the introduction of whole blood or blood components into the venous circulation.

Human blood is commonly classified into 4 groups: O, A, B and AB.

Antigens, or agglutinogens promote agglutination, or clumping of the blood.

Antibodies, or agglutinins are preformed and react to certain RBCs.

The reason why the blood type O is a universal donor, is because it does not have any antigens.It is compatible with any blood type. The blood type AB is considered the universal recipient because a person who has it can receive blood of any type. It does not have any antibodies.

Blood typing is done to determine the ABO blood group and the Rh factor status. This test is also performed on pregnant women and neonates to assess for possible intrauterine exposure to either to an incompatible blood (particularly Rh incompatibilities)

Crossmatching is also necessary to identify possible interactions of minor antigens with their corresponding antibodies. RBCs from the donor blood are mixed with serum from the recipient; a reagent (Coombs' serum) is added, and the mixture is examined for visual agglutination. If no antibodies to the donated RBCs are present in the recipient's serum, agglutination does not occur and the risk for blood transfusion reaction is small.

Potential donors are eliminated by:

History of hepatitis

Tattoos

HIV infections (Promiscuity, or homosexual men practicing anal sex)

Heart disease

IV drug users

Cancers

Severe Asthma

Bleeding disorders

Convulsions

Blood infections (Dengue, Malaria)

Pregnancy

Anemia

Menstruation

Low or High blood pressure

Hemolytic transfusion reactions can destroy transfused RBCs and predispose client to subsequent kidney damage or failure. Other forms of tranfusion reactions may also occur, including febrile, allergic, circulatory overload and sepsis. Symptoms include chills, fever, headache, backache, dyspnea, cyanosis, chest pain, tachycardia and hypotension.

NURSING INTERVENTIONS FOR TRANSFUSION REACTIONS:

1. Discontinue the transfusion immediately.

2. Maintain vascular access with normal saline solution. *Normal saline must always be used when giving a blood transfusion. If the client has an infusion of dextrose, stop that infusion and flush the line with saline prior to initiating the transfusion. Solutions other than saline can cause damage to the blood components.

3. Notify the physician.

4. Monitor vital signs.

5. Administer any analgesic, antihistamine, etc. as ordered.

6. Monitor fluid intake and output.

7. Send the remaining blood, bag, filter, tubing, a sample of the client's blood, and a urine sample to the laboratory.

GUIDELINES:

#18-20 gauge intravenous needle; using a smaller needle may slow the infusion and damage blood cells, although int might be necessary to use in infants and children who have smaller and more fragile veins.

Obtain blood from the blood bank just before starting the infusion,

Do not store the blood in the refrigerator of the nursing unit; lack of temperature control may damage the blood.

Once blood or a blood product is removed from the refrigerator, there is a limited amount of time to administer it. Make sure it is not left at room temperature for more than 30 minutes before starting the infusion. (LESS THAN 4 HOURS, or blood components might be damaged if left in room temperature for too long. It can also encourage bacterial growth in blood, hence, sepsis might occur. RBCs deteriorate and lose their effectiveness after two hours at room temperature. Lysis of red blood cells releases potassium in the bloodstream, causing hyperkalemia.)

Compare lab blood records with another nurse: Client's name and identification number, number of the blood bag label and ABO blood group and Rh type on the blood bag label.

If there are any discrepancies, notify the CHARGE NURSE and the BLOOD BANK.

OBSERVE THE CLIENT CLOSELY FOR THE FIRST 5 TO 10 MINUTES.

RUN THE BLOOD SLOWLY FOR THE FIRST FIFTEEN MINUTES AT 20 gtts per minute.

Fifteen minutes after initiating the transfusion, check the vital signs of the client. Most adults can tolerate receiving one unit of blood in one and a half to two hours. 

Assess and monitor the client every 15 to 30 minutes, or more often, if necessary, until 1 hour post-transfusion.

Blood administration sets are changed within 24 hours or after 4 to 6 units of blood per agency protocol.