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There is going along to go along and then there is accepting ample amounts of data from extremely reliable sources. It's not about "sales" it's about trying to serve the population in general, based on the best knowledge we have currently and being willing to accept that. If what you are doing works for you in your little corner of the world, that's great but making light of advancements because it doesn't fit your paradigm and accusing some of the best professionals out there of being uncaring is.......... I'll stop now. I've been in this group for more years than I care to count and don't want Cliff to ban me.

I've seen anti-D come stronger or weaker in the same patient, and when we've sent them for molecular they come back as some form of weak D usually. We use Immucor reagent here, so tube typing, and it's the same reagents on the instrument as in our tube, but we do see some variability from the two methods, likely because of the RT incubation the instrument does on all blood types. The weaker D can "unbind" it seems, and the instrument will call something Rh negative when in tube we get weakly reactive or 1+.

Happy birthday

Happy birthday

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Happy birthday

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Welcome to this wonderful site nunu. ENJOY.

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I’m old enough to remember when both asbb and arc have been wrong and later changed their policy. Giving opos to all Du Pos is one. Plts don’t give anti d is another. And more. I do not agree that this is best way to manage. I’m not much for going along just because everyone does. There is No certain harm of others here. That is a sales topic. ALL is unknown. and every body is equally important or equally unimportant. “First do no harm” doesn’t say ‘except’ when it’s inconvenient. First massive policy is very dependent on drs using it properly and yet most do not. All blood taken but ffp returned? Only 2 units taken no other products used? No plts/ cro taken The point was to make whole blood The army proved best way to handle true massives sure gushing out: opos goes on floor immune system not kick in I get it BUT that is not how it’s usually being used in hospitals across the US. I think better policy would be give 2 units oneg in emergency with unknown and get a type complete within 30 min I have proven in my less than educated hospital (as far as following massive or emergency policies) that you can easily get a tube of blood in CLS hands in 10 min do quick front type and bam 15 min can give positive blood to positives. So complete aborh and screen in 45 min So full group/type within 30 min when spinning that tube down education phlebs respond to bedside etc 80% of our massive are not massive at all. Drs just want a quick response

Hello nunu, 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. nunu joined on the 05/18/2024. View Member

I'll add that this policy is in keeping with the guidelines of the AABB and Red Cross. If, in the US, we used O neg instead of O pos, we certainly would not have enough O neg left for known Rh neg patients or those with anti-D. We are on allotment for O neg and can't get more than our quota without the supplier's medical director approving a medical release. No change in sight. We can't trade the certain harm to those patients for the potential harm for the trauma patients who are 85% likely to be Rh pos, usually male, unlikely to make anti-D, and usually not likely to require emergency transfusion more than once in their lives. I'll admit that I am having some of the same qualms with the new policies to use O pos whole blood for traumas of any age and gender. Their arguments about the modern treatment of HDFN are probably right, but they are harder to accept for me. We had to start keeping O pos on our helicopters last year because we couldn't manage the O neg rotations anymore. Same risk as the whole blood argument. The only young female transported got the unit of liquid plasma and not O pos red cells.

It's pretty likely it's her blood because baby has a weak D Rh type but, yes, we thought of that.

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I'm sure I know the answer but I have to ask, did you test a second sample drawn at a different time? I'm sure the 1st thing you did was confirm right patient, right blood but had to ask.

I've said it before, inertia is the strongest force in the universe. From my 35+ years as a blood banker and supervisor of both donor services and transfusion services, I have come to the conclusion that, as a general rule, blood bankers are extremely slow to change when not resisting it completely. This appears to be especially true if they are not actively involved in the change or keeping up on the literature. I saw a great may changes during my tenure and not all of them were comfortable at first. Giving O Pos blood to massive bleeds was just one of them. The data supports it, no matter what our long held concerns and fears try to tell us. Many of those long held fears and concerns were primarily theoretical, especially in how prevalent and disastrous the outcomes would be. I have a number of stories to prove my point but I think I'll stop now and step off my soapbox.

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PathLabTalk would like to wish all members celebrating their birthday today a happy birthday. mlt(ascp) (57)sheweathers (64)Janis (72)dchow77 (47)apple1 (71)mona (61)Geertje (38)A.Treweek (48)

O negs are still used in excess of their numbers in the general population. I've worked on both the donor side and the transfusion side. The pressure on O neg donors is huge. They are asked to donate as often as possible. We owe it to these donors to be good stewards of their donation.