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We have a Neo and a Tango. We run all automated surveys on Neo, and run instrument/instrument/manual/ comparisons quarterly. This has been acceptable to CAP for 10 yrs.

Couldn't the argument be made, that performing panels and comparing to patients' history with the same antibody being identified, that the panel is being tested "periodically"?

For years we have been using our QC antisera and rotating one cell from the panel each day and testing it with our routine daily tube QC. It was not so overly burdensome( one additional cell) and even though we are testing only one cell each day we make it through the entire panel at least once during the month. This way we are testing the "panel" if not every cell each day of use and we have some quality control. Everyone is correct there is no way to check every antigen so we felt this was a good compromise.

Just off the top of my head, I can't think of much more, except for the obstetricians to make sure that any preexisting anaemia is corrected by iron therapy, or vitamin B12 and folate or, in extremis, erythropoietin, so that, if there is any blood lose, the Hb and Hct are as high as possible prior to the haemorrhage (without, of course, making her polycythemic!).

Nope, never did any QC on panels. Could not see the sense in it. How could you possibly test for all the antigens!! As Malcolm says above, "You have to stop somewhere!" I chose not to start.

If you are inspected by CAP you are required to have a protocol for providing blood in emergency situations. I would suspect that CLIA has a similar requirement and your lab would certainly fall under CLIA requirements. Your plan should be written according to the resources you have. It should also address what to do when your resources have been depleted or are about to be depleted and what to do if/when the patient is transferred (do you send blood with the patient and how would you do that). Spelling out how you would deal with replacing your depleted blood supply would be a good addition to the other information. Crazy stuff happens even at small hospitals - if somebody needs blood badly, not being prepared to deal with providing it rapidly could be a matter of life and death for the patient. I think too often we all fall into complacency and think that just because something occurs rarely, the associated policies aren't very important. In actual fact, the things that are seldom done are the things that are most likely to be screwed up. We've just spent several years making sure that our emergency release and mass transfusion protocols are up to date, realistic and (most importantly) making sure that all staff, not just lab, are aware of them. It's paid off in better performance by everyone during those uncommon events.

I understand that it is easier to draw the bloods when the patient comes in for pre-op, maybe many weeks before the actual op. Can I suggest that what would be sensible would be to bleed them then for a T&S - this way you will be prepared in case the patient turns out to have anti-nasties (this is a new scientific term coined by me as it's Friday afternoon); and then to bleed them again when they come in for the op - you will be then within the time delay as well as avoiding the patient having to come in three times (pre-op, 3 days before op, and for op); but still in time to react if there is a change between the two samples

I would say that the request for the titre is a conservative 100, 000%!!!!!!!!!!!!!!!!!!!!!!!! I agree - I've had OB docs ask of "I" negative blood !!!