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Just wanted to comment that starting 6/27/2016 I will become the interim Blood Bank Manager for the Cottage Hospital system in Santa Barbara, California. Looking forward to the challenges and opportunities this will bring my way.

I never had any nurses complain/question us about milky plasma. We did however, have a nurse complain and refuse to transfuse a unit of blood because the color of the unit was a slightly darker red then the first unit they transfused the patient with.........

Last Saturday I ran up the Mt Washington auto road. In July I will do a cycling century riding around it, then in August I will ride my bike up the auto road. Here are a few details of the run. ---------------------------------------------------- So, admittedly I was getting a little freaked out about the weather. The week up to the run temps were I the 20s and 30s, several inches of snow, freezing rain and winds averaging 50 mph with gusts in the 90s. Those are far past the conditions for which they would simply cancel the race. If it were in the 20s or 30s alone the race would go on. I was not prepared for those temps. The day before the run was beautiful. The forecast for Saturday was also perfect, I started to relax a little. Dawn and I went to pick up my number the night before, I also wanted to check the place out. I’ve driven up Mt Washington many times, but this was my first race of any kind ever. It was a pretty big deal. The starting banner was set up the night before. I got my number, not sure how I scored such a low number, but I was happy to have an actual race number. The morning of the race I was again concerned about the weather. Predicted 40s at the top, while not cold, it’s colder than I would run in just shorts and a shirt. I had on a compression shirt (love that thing) a cycling jersey (for those that run and don’t cycle, these are cool as they have pockets), tights and shorts. I was also planning on carrying a sweatshirt tied around my waist. I changed my mind an took off the tights and left the sweatshirt behind. Once Dawn headed up the mountain, no turning back. I walked around for almost 2 hours (cars had to head up very early) and started to get a little chilled. Clearly I need to HTFU. While I was waiting I met George Etzweiler. Really cool guy, his 11th time running it. He’s 96! They are pretty good about giving him a bib with his age. Finally the race was about to start. Again, I’ve never been in anything like this, so it was all really pretty cool to me. They had us all line up at the banner, the people that were expected to win / place well were in the front. A few minutes of talking, some words from our sponsor, a singing of the national anthem, sounding of the cannon and off we went. All 1140 of us. The first mile we all stayed together. Some of the fast people obviously went ahead, but the rest of us lumbered along. By mile 2 I was happy with my decision to leave the clothes, I was soaked with sweat. At this point I was still running. By mile 3 it was a mix of walking running. I took off the compression shirt and stuffed it in one of my jersey pockets. It was soaked. I was trying really hard to drink as much as I could. My breathing and heartrate were too high to sustain. This is when the walking started. It was mostly running until mile 5, then it switched to mostly walking, running when I could. I am also doing the bike ride in August, that is going to be a lot harder. At least with the run I can stop, or walk. There is no comparable option with the bike, it’s go or stop. On a hill like that there is no starting again once you’ve stopped. So the whole run I was saying, this section will be hard, but not too bad. This section will be really hard and about all that I can manage. Uh oh, this section is probably harder than I can handle, what will I do? I had to stop doing that and focus on the run. By mile 6 I knew I still had a long way to go, but I was convinced I’d make it. By mile 7 you could see the top, then you turn a corner and you can see the observatory. I knew I was close, and I knew I had someone who loved me and was cheering me on waiting. I am very lucky. The end is a brutal 22%. I was mostly walking at this point but needed to make a good show of it and tried my best to run that hard part. The crowds cheering you on really helped, but it was more than I could do. I ran most of the 22% hill, walked for a little, than ran across the finish line. 2 hours 17 minutes. 910 out of 1140, clearly no record, but I wasn’t last. Actually the guy in last was pretty special, it was George, he finished! He’s 96. His son and grandson started with him, not sure if they finished. At the top they packed the cars in like sardines, Dawn said it looked like a scene from the Walking Dead. I got my participant trophy. The blanket was nice, I was pretty overheated and the air was cool. Then the best part. I haven’t had a soda in almost a year. I love soda. So there it is, the hardest physical event I have done (to date). Will I do it again? Possibly. At lunch with Dawn yesterday I suggested she do it next year. She didn’t say I was nuts. She’s thinking about it. If she decides to do it I will start training this fall for a run that is next summer. I want to run the whole distance next time. As far as winning, I feel like I won. I have a lot of respect for Mt Washington. I’m saying Man 1: Mountain 0, but suspect it’s more of a draw at this point. Next up is the century around it next month, then the ride up it in August.

You are such a bad ass!

Very cool! Scott

Cliff, seeing the Pink Floyd running shirt makes me have even greater respect for you. Bravo!

Respect!!!!!

Nurses - don't you just love them! The vast majority are very good, but a substantial minority have got a medical degree from a cereal box!

Oh Dear!

#6 is incorporated into the approved DHQ and is required. We had the other 5 that you do. We did get rid of the "any Medications" as we ended up documenting tons of non-value information. Took up tech time and memory in our app. People take too many vitamins, supplements etc these days that have no impact on donation.

Just one problem there Malcolm. You've forgotten the most important reason. You aren't a woman!!

Actually, this has been done. It was a poster presented at BBTS ASM some years ago now at, I think, but don't quote me on this, Bournemouth. I can't remember who were the authors, although one of them was certainly Dr Fiona Regan, and it won a prize (sorry to be so woolly about the details, but I am working from home today, and so don't have access to all my books, reprints, etc). Anyway, the bottom line was that the equation used for the Kleihauer test result relies on the woman being a Standard British Issue in terms of weight, height, etc, and, of course, all women average out under a bell-shaped curve (meaning some will fall outside the Standard British Issue woman, but still be within the "normal range", and some humans (including me) will fall well outside the average (in my case, not because I am exceptionally tall or short, or because I am under weight - which leaves one alternative!!!!!!!!!!!!!!!).

Have seen this many times with cancer patients. They are probably immunosuppressed and not making a lot of antibodies including isoagglutinins. I would try room temp incubation first. Make sure you run an autocontrol.

Is your patient male or female - not that it matters that much, to be honest???!!!!!!! IgM antibodies, which include ABO and H isoagglutinins, react optimally at 4oC, and so, if you are storing the patient's sample for 15 minutes in a refrigerator, you will be bringing down the temperature of the plasma in the sample, perhaps not to 4oC, but certainly closer to 4oC. In addition, IgG ABO and H isoagglutinins also react at 4oC, with no need for any potentiators, such as enzyme-treatment of the red cells, and cause direct agglutination (just see an EDTA sample of a cord blood from a baby suffering from even mild HDFN due to ABO, that has been left in a fridge over night. The baby cannot have made an IgM auto-antibody at this stage, the maternal IgM antibodies cannot have passed through the placenta, and so the agglutination seen in the sample must be down to the maternal IgG ABO and H isoantibodies). So, to cut a long story short, The patient's condition can account for the reverse group at initial testing, but the temperature can certainly account for the "appearance" of the reaction after time in the fridge.

In the past 12 months have you seen a doctor for evaluation or treatment for an illness or injury? . In the past 72 hours have you taken any medications including over the counter medications? In the past 48 hours have you been to a dentist or do you currently have any incomplete dental work? In the past 4 weeks, have you been in any of the areas listed on Form #16-04 “Donor Self-Deferral Information Sheet to Reduce the Risk of Transfusion-Transmitted Zika”?

1. We will perform an elution with a positive DAT within 3 months of a transfusion, BUT, will also perform elutions on other cases (even if the DAT is negative) if the clinical symptoms give us reasons to suspect that an elution may be of help. Nothing in the world of blood transfusion is pure black or white. 2. Normally, we use the acid elution technique, but will, occasionally use the Lui technique. 3. Usually, but not exclusively, gel IAT. 4. Full panel, as a minimum, but may include A1 and/or B cells, and others as required partner's red cells in the case of a suspected case of HDFN due to an antibody directed against a low prevalence antigen). 5. I can't think of any - YET!!!!!!!!!!!!!!!!