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PathLabTalk would like to wish all members celebrating their birthday today a happy birthday. jkroc (49)DYD (66)FEL (55)Jack J (67)valery21 (42)wilsedw (38)Paul Maddox (70)

Happy Birthday! (lots today!)

We send both syringes and bags through the tube system. We have a special cap that we use for syringes for which it is obvious if someone has taken it off. That is to prevent partially used syringes from being accepted back into stock. That was an issue for all syringes, not just the ones sent through the tube.

@Malcolm Needs......YAY! it always makes me feel a little "smarter" when my thoughts are consistent with your answers!!! PCH was my first thought!

First, blood given pre-hospital is quite routine these days. Both ambulances and helicopters are carrying Low Titer O Positive whole blood that they transfuse on scene in response to traumas and hemorrhagic shock. In South Texas, the ambulances and helicopters receive their blood directly from our blood supplier. Who will be stocking your helicopter? Will it be your facility? If so, you have a lot of work to do. If your supplier, you have nothing to fear. Second, when a unit is given pre-hospital, our EMS techs give the empty blood bag and a record of transfusion to the receiving nurse in the Emergency room, who then sends them to the blood bank (theoretically, practically we seldom get them right away). Our emergency room physician orders a type and screen upon arrival. Only if an antibody is detected (or we have a history of a clinically significant antibody) will we perform any crossmatching with the unit. I would suggest you google the topic Low Titer Whole Blood. It will help you answer your question.

We do perform both activities. Since we had already validated the system for transport of all other products, we validated syringes by ensuring that when they were sent they wouldn't leak or break. We also add a little additional padding to the tubes with syringes to guarantee they are held in place.

PathLabTalk would like to wish all members celebrating their birthday today a happy birthday. kirbysmom (53)bardebe (67)kk072 (64)Phoebe Chio (49)JSSTCB (37)ADawson (56)aninha (49)Arnold Buglione (74)ladybug9537 (69)sisve (58)juiwang (54)lmbgab (60)beyur (55)dupe (65)terry george (74)william williams (70)Eugenew (70)ckerr (61)eugenewcom (70)Cheryl Patrice (65)pinkgirl (64)Eva Szego (49)

For those at hospitals with children units, do send send blood products syringes and/or aliquot bags through the pneumatic tube system? If you do did you do a validation for tubing products in syringes? Do you return to inventory unused blood products issued in syringes or aliquot bags? If you do what is the acceptance requirement?

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PathLabTalk would like to wish all members celebrating their birthday today a happy birthday. Dickie (69)the kid (59)hmcmahon (62)wolfpack (37)EDAHLSTR (76)Cellano (71)avilale (44)smokey (63)Terry Schaack,MD (67)SBBSue (58)

Welcome mrosol.

Hello mrosol, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions, please don't hesitate to ask. mrosol joined on the 01/28/2023. View Member

Yes, cell saver.

Happy Birthday!

Sounds like a case I would have had at the IRL

PathLabTalk would like to wish all members celebrating their birthday today a happy birthday. Konecki (69)Barbara Barksdale (69)mbd_of_marbella (49)basak (43)n.peters (45)Kathy Garrett (75)ewemass (68)SRANA1989 (60)muzammils (46)wmc --

Man you got me good, started searching for anti-O and anti-Q and thought that I missed something big It's cool, no hard feelings! Anti-P sounds much more familiar. That's why we don't do DL test ourselves, we don't have time for it.

I apologize if this topic has already been asked, I searched and couldn't find it! I have a trauma helicopter that wants to start carrying red cells (United States). I am concerned about the possible regulatory issues surrounding this process. We discussed most of my concerns. However, when I asked about a patient specimen for crossmatching I was informed that no there hospitals that provides this service has ever requested a sample. I was always under the impression we had to perform crossmatches on blood we release in emergency situations, I consulted my medical director and he was on the same page. There is always the possibility that I am reading too much into the FDA CFR/AABB Standards and perhaps there is a more flexible interpretation. Would someone please let me know if you see this differently?

I was joking about the specificity being between "anti-O" and "anti-Q", in that anti-P, the specificity almost always involved in a case of PCH is a "cold-reacting" IgG anti-P that "fixes" complement (and P is between "O" and "Q" in the Western alphabet). A pretty poor attempt at a joke, I fully admit! While I am not saying definitely that it is a case of PCH, the fact that the patient has a suspected AIHA, that the auto-antibody appears to be "cold-reacting", that it is IgG and that it also involves activated complement, strongly suggests that this may be the line to go down as an investigation. We didn't perform a DL test routinely by any manner of means (despite being a London based Red Cell Immunohaematology Laboratory). It was always discussed between our own Consultant (or, at night, weekends or Bank Holidays) by the on-call Consultant, but all of the staff knew how to perform the test, even if they were a lone worker. We always used to dread being asked to perform such a test as a lone worker, as it took so long to do!

You are like an encyclopedia Should of course have included some information about the patient. 67 year old woman with anemia. Suspected AIHA, but no established diagnosis. The patient has been moved to a larger regional hospital, so it is not certain we will get the final diagnosis. So "anti-O" and "anti-Q"? I opened my trusty antigen factsbook, but nothing… do you mind telling me more? We only perform DL-tests at the request of the department/patient responsible doctor, as we do not perform them in house. Did you perform DL-test routinely?

I have an idea of what I think it might be, but I would hesitate to say without a bit more information concerning the condition and underlying pathology of the patient. How old is the patient? Have they recently had something like an atypical pneumonia? I think, without knowing the answer to the above questions, that the specificity of the antibody MAY be between "anti-O" and "anti-Q". I would suggest performing an indirect DL-test. I may well be wrong, OF COURSE, but the attached may help. Paroxysmal Cold Haemoglobinuria (PCH).pptx

For me a somewhat unusual example, I would appreciate your opinions on it. 4C 37C Prewarmed Screen H 1+ neg Ak panel H 1+ neg Auto H 1+ neg With routine screen on gelcard (anti-IgG) at 37C all cells became 1+, NaCl tube test at 4C gave lysis with all cells, prewarmed on gelcard (anti-IgG) neg on all cells. Room temp 37C Forward A neg B 4+ Ctr neg Reverse A1 2+ neg B 4+ 3+ Extra reaction in reverse grouping in room temperature DAT IgG 1+ C3d 2+ Sample stored at 4C overnight gave extensive lysis and an unusable sample So a cold antibody that activates compliment, our laboratory rarely see lysis like this. How do you guys routinely investigate this? Do you do anything more? Cold titer? Recommending a blood warmer?

Welcome!

Happy Birthday!