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I don't think you are violating any regulatory requirement to return blood within 30 minutes if they can't start the unit and they still want to transfuse. I think you are correct in encouraging them to complete within 4 hours instead of returning to BB and almost certain discard by BB.

We store our reagents in a blood bank refrigerator and I keep the range 2-6°C so it meets the needs for both blood products and reagents. It's been handy when one of the refrigerators has an issue-there's no questioning if items were stored at the appropriate range. When we have needed a back up refrigertor, not all of our reagents and products fit in one fridge and we move some of the reagents to heme and take temps every 4 hours.

@John C. Staley, this may be true, but the FDA does actually review each file. They notify us a couple fo times a year that an event is not reportable.

We have the same BUT we decided to use production as what if!... It is very easy to block billing by just creating a code at interface level. We also use teo patient to stock in ER and OR and again we hav eit blocked at interface so it does not generate any transactions.

Thanks so much Eman that is just what I needed. I just couldn't find it.

We have done gel DAT's (anti-IgG) in both Ortho & Grifols systems. They work on the analyzer or in the manual system. It's in their IFU's.

The NHSBT Reference Laboratories use a similar technique to an IAT. The red cells are packed, and then diluted to the appropriate percentage, depending upon whether you are using BioRad (DiaMed) or Ortho (BioVue), and then just add the appropriate volume to the cassette and away you go. It works a treat.

If they had ordered the workup, and the DAT was positive, would you have assumed that the reason was because of the anti-K? Supposing the eluate had been negative with K+ red cells? What would you have done? Chances would be, in such a case, that the mother had made an antibody directed against a low prevalence antigen passed on by a paternal gene. Next time it could be that this antibody is a lot stronger, and may cause HDFN (with the emphasis on HDF). It may be that this "unknown antibody specificity" could be a "real nasty", causing severe HDF, but you wouldn't be able to advise the obstetricians to be on high alert during the pregnancy. Admittedly, if the DAT had been positive, and anti-K had been eluted, this would have masked any antibody directed against a low prevalence antigen, but hey!

we do not do eluate for the positive DAT on cord if it is due to ABO incompatibility and mother's antibody screen is negative. We do an eluate if CORD DAT is positive and mother has positive screen. We also do an eluate when CORD DAT is positive & there is no ABO incompatibility & mother has negative antibody screen and mother doesn't have history of antibody........We had a case like that almost 10 years ago where I was new tech and the DAT was very weak positive, I repeated it for my supervisor and my supervisor also repeated it before sending out to reference lab.........The ID was anti-Goa. Subsequently father was tested and father tested Goa+.

For those who routinely do eluates, what evidence/data have you to support such a policy? Whether an eluate is positive or negative, when have eluate results changed the physician's decision to do or not to do?

At this point in time we perform an eluate if the physician requests it once they are notified that the DAT is positive. I can't remember the last time we did one.