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The difference between listening and hearing.

It's one thing for us here at MLO to identify the dangers inherent to the job of a clinical laboratorian, but it's another for the laboratorian to actually heed sound advice and sidestep problems before they happen.

In this month's cover story, "Risk management in transfusion medicine" (which start on p. 28), laboratory consultant Lucia M. Bette, M.A., MT(ASCP) SBB, DLM, and Phillip J. DeChristopher, M.D., Ph.D, director of Blood Bank/Transfusion Medicine at the University of Illinois at Chicago Medical Center, remind us no endeavor is without risk. For that reason, they identify five areas of hazard in transfusion medicine and outline strategies for managing those risks.

The AIDS pandemic, they explain, has reemphasized the need for a unified comprehensive risk management program for all aspects of transfusion.

But it's not like any of this is news.

Are Berte and DeChristopher guilty of merely stating the obvious? Sure, the time of procuring the blood is the first major area of transfusion risk. After all, first there's avoiding needlestick. Then there's providing an irrefutable link between the donor and the blood unit. An international uniform blood labeling effort provides one level of safety. Similarly, the ability of a supplier to identify via computer which facilities received any components from a donor who now demonstrates evidence of specific infectious diseases is vital.

First and foremost, however, Berte and DeChristopher point out, good technical training and astute attention to donors' well-being are quantifiable preventive measures.

All of the blood-labeling efforts and computer-stored, algorithm-tested results don't mean a thing without the most important tool: human intellect.

Can that be taught? Can that be shared from mentor to student? While Berte and DeChristopher's article is jam-packed full of information, one of its real benefits is its ability to rekindle a fire under a reader's sixth sense ... that is, his common sense.

As you saw in last month's cover story on new and emerging pathogens (Part 2 of which continues in this issue, starting on p. 44), infectious diseases and their growing resistance to antibiotics are renewing the need for the most basic of health practices ... like washing your hands. Interestingly enough, hand washing only recently became a tradition in Western medicine, having been introduced only 150 years ago by Dr. Ignaz Semmelweis, who shocked Viennese doctors when he advised them to scrub between patients. He was mocked for his theory until the practice proved to end an epidemic of childbed fever and maternal deaths.

Hmmph. Hand washing. Who'da thunk it? And yet, a century and a half later there are still some accounts that after touching a patient, medical professionals may wash their hands only half of the time. "It's not a knowledge problem," Elaine Larson, dean of the School of Nursing at Georgetown University, was recently quoted as saying in a Wall Street Journal article, "but rather a behavioral one."

It would seem of all the tools and products modern medicine yields, the single most important one is still the most mercurial. And today, more than ever, we can afford fewer and fewer mistakes.
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Copyright 1996 Gale, Cengage Learning. All rights reserved.

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Title Annotation:precautions to take in transfusion medicine
Author:Zacharia, Mark
Publication:Medical Laboratory Observer
Article Type:Editorial
Date:Mar 1, 1996
Previous Article:Is the door half open or half closed on the laboratory's future.
Next Article:Switching needles saves money on blood culture contamination, but risks transmitting HIV.

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