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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.

Blue is my favorite color. WHen I was young, I adored ther large blue glass globe that hung on our tree. When I graduated from school and moved in my own home, my parents gave that ornament to me for my first Christmas tree. It reminds me of the greatest gift of all.

From a Reference Laboratory point-of-view, Seraph44, I can assure you that we would rather have the sample to work on properly, in our own time, as it were. The next time the patient comes in could be a real emergency, and then the Reference Laboratory has to work under undue pressure, on a case that they should have known about before. It is under these circumstances that mistakes are made.

Mine is a small, plastic Nativity that has been in my family as long as I can remember. I have fixed it over time and even "re-glittered" it once and the original box is still hanging in there too. It goes up somewhere each year, helping me still feel close to my parents. Merry Christmas everyone and may you all have a healthy and prosperous New Year.

I wish I had a dime for everytime I wanted to transfuse a patient just so I could get their antibody levels up to a point I could easily identify them!!! Never did but sure thought about it.

We also use manual gel (assuming you're talking about the screen) and tube ABO, No second tech, and require a second sample to give type specific. Our LIS will catch any clerical input and prompt before verifying results. Most LIS are built like that, so I'm guessing the LIS you have might be a DOS based system or completely manual system that does not include that type of logic or they are being transcribed in the system incorrectly. Either problem, in my opinion, is solved with proper training. Sometimes people do not have the BB background and are put into working BB independently too soon. When dealing with multiple patients, I like to alphabetize them in my rack, my centrifuge, and my LIS. This helps with the mixing up of patients.

I agree with AMcCord, you have proven that there is no clinically significant antibodies and that rouleaux is the culprit in the gel reactions.

Merry Christmas to all! Wishing everyone a very prosperous wonderful New Year.

Or maybe you just like to 'think outside the box'.

A small facility doing a lot of blood banking by generalists should seriously consider an automated testing platform. Automated testing eliminates a wide range of errors associated with specimen identification, test tube labeling/handling, results entry, results interpretation and transcription. Our platform prints a report with results and results interpretation. We affix a barcoded sample label to the report (one patient per sheet of paper). The barcode on the report is scanned into the LIS result entry routine and results are transcribed. This system works 24/7/365 with a single individual wholly responsible for results entry. I have used this system successfully over the past 10 years, both in a 525 bed Level II trauma center (>10000 rbcs transfused annually) and a 100 bed (<50% occupancy) community hospital(<1100 rbcs transfused annually). I believe that any strategy that relies on double-checking a process by multiple individuals will fail. If an individual cannot accurately transcribe results in the system described above, they should not be working in a transfusion service. Blood bankers need to embrace automation in the 21st century and discard 20th century manual processes. Whew!!, I feel so much better now. Thanks.

The patient is a DIIIc D variant. The variant gene controlling this expression of the antigen has D gene exons 1, 2, 4-10, but has exon 3 of the CE gene. So it's a hybrid of the D and CE genes.

I have worked in 7 hospitals over my career (US) and only 1 of 7 hospitals ran a K+/K- panel cell (with anti-K antisera) upon receipt. We do not QC panel cells- here is my rationale: Antibody detection (screening cells) are QC'd daily. Antibody Identification (Panel cells) are essentially QC'd each time you perform a panel (your patient sera/plasma serves as your QC) as you typically have positive and negative cells for rule in/rule out. Any patients reacting with all panel cells we send to a reference laboratory for ID. If you truly QC'd panel cells you would have to do each antigen (pos and neg) to prove all panel cells are viable for any patient that may come along, with any antibody specificity, within that 4-6 week period that the cells are being used. We do not carry all the antisera in our inventory. Does anyone has the time (or resources) for this? An exception is if you use expired panel cells (for rule outs), pos and neg cells (again patient or antisera can be used) must be tested per CAP to prove panel cells are still working properly for that particular antibody. -Colleen Hinrichsen

Terri - I wonder at the wording in the CAP Standards esp the words reagent red cells. . . of course they go on and directly state antibody detection cells but it would be tough to argue out that abid cells are NOT reagent cells. Just a comment. I agree with you.

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!

Hello, Thank you all for your feedback! I will do some more investigating with the consultants on this case as I agree, if it is an immediate HTR due to the anti-Dia it should be accessible in a literature review should it ever happen again anywhere else in the world. My patient had 2 more units successfully transfused on the night without futher incident (in al llikelyhood they were cold) and more units transfused the next day without incident. She was transferred out of ICU to the ward then home the next day. She did not go into a sickle crisis and had no concomitant illness at time of transfusion to exacerbate the hemolysis. Interesting case indeed! Kelli Lab Down Under

Were these ABO reporting errors, transcription errors or testing errors? Are your current test results (anti-A, anti-B, anti-D, etc.) entered into a computer, written on a paper worksheet or both? Need more information from you to be helpful.

I did say it wasn't a serious question. I thought it looked like a cute little robin, wearing sunglasses, waving at me

This is the time of year when Blood Centers run low on blood! Everyone is too busy shopping and going to parties I guess. We should all think about donating if we have the time over the next few weeks! Scott

Most of our OB docs are doing OP T&S on early prenatal visits. This is a big help. We get Draw and Hold on normal deliveries and T&S on C-sections.