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I will start the ball rolling with how we handle some of the issues you have addressed: 1. Antibody is present, but not ID'ed yet, and crossmatch is compatible: We have a form that states that the antibody has not been identified, and although the crossmatch is compatible transfusing it does carry some increased risk because it has not been screened for the corresponding antigen. Ordering physician has to sign the form. (Pathologist is not usually notified.) 2. Patient has a history of a clinically significant antibody and the crossmatch is compatible: We have a form that states that, plus the comment that transfusing it does carry some increase risk because it has not been screened for the corresponding antigen. Ordering physician has to sign the form. (Pathologist is not usually notified.) 3. Antibody is present, but not ID'ed yet, and crossmatch is incompatible: We have a form that states that the antibody has not been identified and the crossmatch is incompatible and carries an significant risk of a possible hemolytic transfusion reaction. Ordering physician has to sign the form. Pathologist is notified that we are issuing incompatible blood. The above situations are spelled out in our policies/procedure manual. In any of the above situations, if the supervisor or assistant supervisor is present they are consulted and get involved in the situation (to make sure we are doing the best/safest thing for the patient.) If supervisor or assistant supervisor are not present, whether they are consulted/notified depends on the expertise/experience of the tech involved. All staff are certainly welcomed to call us at any time, but a few of our experienced techs are comfortable handling the situation. Donna

Growing up, I was fascinated by one tarnished old blue ornament that was always placed with due ceremony deep in the center of the tree, where it was as safe as could be from accident. It was from my grandparents’ first Christmas, which dates it back to 1912 or so. My dad gave it to me years later with the understanding that it would eventually be passed down to my oldest daughter. When we took out the Christmas paraphernalia last year, though, I was horrified to find the carefully packed ornament shattered! It was no doubt the work of malicious Christmas elves who, bored with their year-long internment in the ornament box, broke it during a night of drunken revelry. I was crestfallen, until a work friend suggested I go to a craft store and get an empty plastic ornament and put the pieces inside. Which I did, and retrieved the broken pieces from the trash, and the ornament, over a century old, hangs today in our tree and will end up with my daughter one of these days. Every culture, religion, nation and ethnicity has its holidays, whether spiritual or secular, seasons of joy, thankfulness and redemption, when we gather together to celebrate and enjoy the fellowship of our families and friends. So I’m happy to be able to share a bit of mine, and I wish for good health, peace, prosperity and happiness for all in our BBT family.

How wonderful, I bet your daughter will appreciate this. I have a hard cardboard little house, painted green with little shutters that my grandfather made maybe 70 or more years ago. You put an electric candle inside and when its lit up, you can swear that the elves are in there (when I was 5-6 years old, I was completely convinced of that). I hope that one of my two kids will want this little house someday as its just not Christmas for us until that house is lit up. Blessings all!

Thanks for sharing, Dr. Pepper & Karrieb61. Beautiful memories. Wishing everyone a Merry Christmas and a wonderful New Year. Donna

We had to recently update and revamp our too - same reason. Hope this helps. Our procedure is specific for Meditech, but most of it is usable. 61-Newborn Exchange Transfusion - 2.doc 67-Transfusion of the Neonatal Recipient (under 4 months) (2).doc Exchange Transfusions RBC Unit Worksheet.doc