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Well deserved Malcolm sorry I cannot be there: other engagements in Germany and Russia papapablo

WOW; a real can of worms! Just for fun and off the top of my head here is my opinion. PPE is by definition to protect the techs. The lab lay out should allow a transition location to don lab coat. When entering lab proper; add gloves and safety glasses (ask anyone who has had their head in the eyewash for 15min). Gloves should be changed when visibly soiled and periodically as they loose their impermeability over time (I remember reading either vinyl or latex in ~20min). Wash hands when changing gloves. Put face shields in key locations. Small reagent/blood smudges on paperwork are taped over, if larger spill occurs put in plastic folder and photocopy. If this is followed the tech is protected and contamination throughout the lab minimized/contained. Gloves are prohibited but lab coats required in labeled "Clean" areas of the lab that are used for issuing blood products and manager/Sr. tech paperwork. Blood products worked on in the lab are handled with gloves but products are issued without gloves and placed in Ziploc bags so that if dropped leaks are contained. The RBC will be taken out of the bag and hung by an RN wearing gloves. Yes I know that it is purely semantically that if working on a RBC I wear gloves but when issuing the same unit I do not. It does however provide a clear distinction as far as writing and interpreting policy. The last thought is that whatever you decide is your policy; it must be practical and enforceable or will not be followed by the techs and therefore only an academic exercise.

Congratulations Malcolm!!!!

We would report them as "maternal", on the grounds that babies with even the most "mature" immune system at birth will only produce IgM immunoglobulins (and these do not "fit" the cognate antigens very well), but would not,under any normal circumstances produce IgG blood group specific immunoglobulins, and so these would disappear from the foetal circulation pretty quickly.

We have Cerner and our test for neonates is called "Baby Type and Screen" and includes 2 orderables: "Baby ABORh," and "Mom ABSC" (mom antibody screen). Our workflow: Transfuse order for RBCs is received in blood bank We go find the pedi lavender from hemo and add-on a Baby Type and Screen and a Crossmatch. The Baby T&S consists of a blood type on the baby-"Baby ABORh" (just a forward type, of course) and the Mom's antibody screen-"Mom ABSC." Usually we have already performed cord blood testing so we have a blood bank comment which shows the mom's name and medical record number (our cords have both mom's and baby's label on the sample and we add the comment to the baby's profile while doing the cord blood workup) We look up the mom's record to see her antibody status If no antibodies, we result the "mom absc" as negative. We select a neonate crossmatch and it is "compatible" once we scan the unit number for the aliquot. No serological crossmatching is done. We only transfuse O pos and O neg to babies. If mom has an antibody, we use antigen negative blood for the baby. Again no serological crossmatch required. We use the "neonate protocol" to override the sample expiration so our neonate samples are good for 4 months (Cerner actually calculates it as 120 days from the date of birth.) I hope this is helpful.

It's not just you, this is a standard of practice at most places including my own that I personally have issues with but have been unable to get much attention for. The numbers are small and no one seems concerned. It's just an argument in logic I like to raise every chance I get. It makes people think and that is a good thing.

The lab I did a CAP inspection for last year had their blood bank on the second floor of the lab and right next door to the O.R. There was a window connecting the two departments and when the O.R. needed blood, they would go to the blood bank window, check it out, and take it away just like they were at the McDonald's drive thru ordering a happy meal. I would prefer to have my blood bank in a separate room with the following: - a window with a nice view - a phone to connect me with the outside world - plenty of padding to protect myself against myself when dealing with personnel and warm autoantibodies - a valium salt lick to take the edge off I don't think that's too much to ask, is it?:cool:

At our facility, We only perform a DAT on the pre-Transfusion sample if the Post transfusion DAT is Positive (+). IS your facility CAP Accredited?

We don't even perform a Pre-DAT, if the post-DAT is negative. How much you do with a positive DAT depends on the comfort level of the pathologist and the patient population you have. AABB is an outstanding organization -- one that deserves support and membership! No one has done more over the years for the blood banking community (from donor to recipient to Techologists to technology) than they have, and other agencies look to them for guidance in the Transfusion Medicine arena, including the FDA. Many times, though, it short-sightedly comes down to dollars in the budget ... One other thing to remember about the AABB is their 20+ year focus on systems, something that other agencies have only recently (and begrudgingly) adopted. They are a progressive voice in the very conservative lab field, and way ahead of everyone else in their view of quality -- indeed, others are following their lead and playing catch-up! Larry Smrz, MBA, MT(ASCP)SBB, CQA(ASQ) Indianapolis, IN AABB Assessor