donnawac

There are no paper records to retrieve. This information was only housed in the computer and unfortunately the old hospital IT folks only migrated the patient information into the new system.

Has anyone run into a situation where they receive a lookback notification but could not access the computer system from years ago to be able to find the product history? What did you do? It looks like the hospital migrated all of the patient information but neglected to migrate the product history when they went up on the new system.

Currently the procedure for our rosette testing requires using a coverslip on our slides. Does anyone else do this?

Currently hospital nursing policies do not allow for blood products to follow the patients when they are transferred from one floor to another or to OR from the floor unless the product is currently hanging. This was also true the last hospital that I worked at so I was assuming that there is a regulation of some kind stating this. It does not look like this has anything to do with AABB/CLIA/CAP regs. Does anyone know if there is a regulation against this?

DAT was negative. No elution was indicated.

We verified that all samples did come from the same patient. The patient was transfused with 2 units on each occasion. So 2 units on the 3rd, 2 on the 13th. I do not think this is enough to cause any kind of antibody dilution.

Patient had 2-3+ reactions in a very obvious Fyb pattern on both 11/3 and 11/13. Diagnosis is a tumor with cirrohsis of the liver, previous cervical cancer (resolved 2002). Kidney tumor (resolved 2008) - - - Updated - - - Oh and the anti-E reactions are 3+ also in a very obvious pattern.

Yesterday we worked up a patient that had a previous anti-Fyb demonstrating. The previous workups were done on 11/3 and 11/13. Yesterdays sample showed NO anti-Fyb and was demonstrating an anti-E. We had the RN redraw just to verify the patient identity and got the same result. We also pulled the sample from 11/13 and reran the sample and still see the Fyb. Any thoughts??????

We do not allow it. Once the unit leaves the blood bank window--if it comes back it is destroyed. The only units that we allow back are the ones that were issued to the surgery refrigerators that have temperature monitors (Safe T Vue) on them. If they have not turned completely red we accept them back.

We have a patient who was last transfused 9/2011. He was worked up a month later with a negative screen and again in Nov. 2011. In Dec. 2011 we did testing which revealed an anti-K and anti-E in the eluate and plasma. In May of this year another hospital called saying they identified an anti-K (no E), and reported his antigen type as E+. He is typing as K-, (E+ e+). Could it be a possible auto E? From what I understand E mosaic's are rare.

It is not a CLIA requirement to perform linearity every 6 months. Calibration yes but not linearity. Most manufacturers require linearity upon start up and thats it. Results can correlate but have a bias--which is probably what you are seeing between the analyzers. Every time we have changed analyzers we have seen a bias between machines. Most of the time it has to do with the threshold that the manufacturer has set to start counting platelets. The lower the threshold the more fragmented platelets get included in that platelet count. We use the Sysmex XE2100D and have not seen any appreciable difference in platelet counts when collected in EDTA or ACD-A. I know that Sysmex has done an extensive study and has submitted to the FDA to get approval for the different anticoagulants for this analyzer.

We have been having some discussion here regarding appropriate QC for the pH meter. Currently we are utilizing pH buffers of 6, 7 and 8 for QC. Another center I know uses buffer of 4 and 7. Can anyone let me know what they are currently doing?

CMS along with AABB have decided that since donors are notified of positive bacterial detection results that bacterial detection is now classified as a CLIA moderate complexity test. Has anyone else dealt with proficiency testing for their BacT ALERT system? If so, how are you handling this? We would really prefer to try to obtain something commercially if you know of anything that is available.