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As expected, I was recently cited by AABB/CAP for not being able to change the alarm activation setting on my 20 year old BB Refrigerator to 2.5C (from 1.5C) because of the storage of RhIG. The alarm temperatures are factory set and cannot be changed. Does anyone know where I can I can purchase a separate alarm system, to augment what I currently have, that will satisfy the citation??? thanks, Susan

OK - I'm going to be controversial. The baby is RhD negative using several reliable anti-D reagents that are known to pick up all but the weakest Weak D antigens, and the baby has a positive DAT. Why are you even considering giving RhoGam? The baby is RhDnegative. No need to do a Kleihauer (unless the Doc wants to check for fetal bleed, but nothing to do with the Rh group) So the financial equation is not between how much does RhoGam cost compared to EGA (and what about the technician's time) or Kleihauer but the cost of RhoGam and/or EGA and/or Kleihauer against having a good system in the first place. And are you going to do an adsorption/elution on each one as well just to make sure it's not a Del? Why not a genotype? It would be more accurate? (Although soon, that probably WILL be the case in Europe - pre-natally - using fetal DNA extracted from maternal plasma. Some countries already doing that)

This is definitely an AABB citing because RhIG is a derivative (manufactured product). It does not matter if you have never had temperature go below 2C and have statements on the refrig....The alarm settings do not "match" the recommendations of the products. I understand what the citation is about.... I am looking into a NIST certified small and inexpensive min/max digital thermometer with an alarm. This is generally used in micro labs. The probe can be placed in a small bottle of liquid (approximately the amount of volume in an RhIG syringe). There is a wire attached to the probe that can fit "between" the door jamb (without compromising anything) and the thermometer can "stick" on the side of the refrigerator. Should be able to write protocols and also alarm testing procedures for this.

John V, AABB Standard 3.7 for Alarm Systems reads "Storage devices for blood, blood components, tissue, and derivatives shall have alarms...". RhIG is a derivative, so this is a valid finding.

Bga and Bgb are horrible. There is so much cell to cell variation and so much difference between one anti-Bga and another that the normal 'rule-out' rules just don't apply.

I was taught a bit ago (well, in 1972) to touch the top of the heat block as you put your tubes in. Not quite a thermometer, but at least you know it's plugged in.

We actually got rid of the micro-dose because first it was ordered for patients that were not candidates for a mini dose. Second the price was almost the same as a full dose and why worry about the having two to stock. It is always better to give more than not enough, many OB patients due dates may be changed after the first trimester to an earlier date. Look at Ramsey et al in Arch of Pathology Lab Med, March 2009 regards to underdosing, I'd rather be safe than sorry.

I'm opposed to it. A few Joint Commission inspectors have mentioned to me over the years that they have removed many from ORs and they were glad to hear we didn't have one. I agree that if this is a done deal, to try to have continuous monitoring on the equipment with temp indicators on the units. Having an electronic method to monitor the temp of that equipment would be preferable to taking manual temps every day.