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There was a period of time it was so hot in our lab due to construction issues that a door to the main hallway had to be open or our chemistry analyzers wouldn't work. It was still tropical with the door open. We threatened to work naked, in view of everyone that passed by. We did get a couple of big fans after that until the problem could be resolved. As for monitoring temps, we do pretty much what Scott does.

I sometimes think that management monitor the temperature in many of the laboratories where I have worked by seeing how many of the staff faint. If it is more than 50%, it is regarded as too hot. Anything less than 50% and it is okay!!!!!!!!!

Another good source is towards the back of the Blood Group Antigen FactsBook.

The reverse grouping red cells in the UK often react with an anti-c. I would be happy (on the evidence you give) to transfuse c-, E-, K- cross-match compatible blood. As you KNOW that the patient is group A, I would ignore the bit about giving group O blood, which is totally over the top.

It is important to remember that there is a sort of continuum between the various A types (including A1 and A2) in terms of the number of A antigen sites expressed per red cell, and that there is no such thing as an absolute A1, absolute A2, absolute A3 and so on and so forth. In addition, of course, the lectin Dolichos biflorus is NOT an anti-A1, but is a lectin that "recognises" the A antigen, the Tn antigen and Cad antigen, as well as the A1 antigen. It will not recognise the A antigen if it is diluted correctly, but every now and again, there will be an "overlap" between a "strong A2", and a stronger than normal Dol. b. reagent. In addition, there are people who are Aint, or A intermediate, who are somewhere between an A1 and an A2. SUch people usually hail from the south of the African continent, but not always. As we are looking at ABO, I am not for one minute surprised that the reaction strength increases with cold incubation. The next thing to remember is that, with gel, it is all but impossible to add the reagents to the reaction chamber so that they remain exactly at 37oC, which means that IgM antibodies, such as anti-A1, which it looks like this pregnant lady has in her circulation, will sensitise A1 red cells prior to true incubation at 37oC, but will not elute quickly enough to give negative reactions after 37oC incubation, particularly after centrifugation. Anti-A1 is NOT clinically significant, unless it reacts STRICTLY at 37oC, and this can really only be shown by a pre-warming tube technique, in which case A2 blood (or other A subtypes, such as A3, Ax and Am) can safely be transfused, keeping your precious group O units for group O recipients. Anti-A1 has NEVER been implicated in clinically significant HDFN. None of this is pregnancy related.