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We use clear zip lock bags and we fold the product ID tag around the unit so that none of the information on the tag is visible. We used to use Biohazard bags, but someone pointed out that the patient or patient's family might think that we are giving them units with positive viral markers. When we release multiple units at one time, they go in a validated thermal container. Either way the unit and patient information are out of sight during transport.

In the US, all accrediting agencies must satisfy CLIA, and Blood Bank regs are based on AABB standards. So AABB standards are already in use by JCAHO, CAP, etc. Scott

No guidelines, just clinical common sense. There are absolutely no data to support the need for excluding heterozygous donors, nor the need for heterozygous recipients to receive only AA blood. Heterozygous patients are physiologically normal except for some data to suggest that under extreme conditions of dehydration, altitude they are slightly more susceptible to complications that occur even among hemoglobin AA patients.

I take the opposite view as I feel that AABB still adds that higher level of quality and safety needed for Blood Banks and Transfusion Services. I agree that CAP has changed over the last couple years and is more in alignment with the AABB standards, but the emphasis on Quality and tying that all together is not the same. The other points to mention are the training requirement differences and the depth of the inspection. CAP recommends their on-line training be taken prior to inspecting, but does not mandate or have CE requirements included for inspectors. AABB does have a monitored assessor program with mandated CE hours in specific categories as well as required training sessions. The CAP team will be in your facility for just about a half day. AABB/CAP combined inspection will be mostly likely a day and a half to thoroughly go through all 4 checklists. Do you view an inspection as a necessary pita, "just something to get through....." and want the inspector in and out as quickly as possible, or do you really wish to have outside eyes perform a in depth look at your processes to ensure that you are providing the highest level of patient care and service? My whole career has been in BBTS and I never forget that what we do has the potential to be quickly fatal more so than any other section of the lab and therefore I feel needs that '"extra" review.

Based on an observational study of ABO grouping in Gel I reported at the 1997 AABB Annual Meeting, ABO Plasma Grouping discrepancies occurred in 0.8% (26/3183) adult ABO grouping tests in Gel. Anti-B was not detected in 24/26 patients, anti-A was not detected in 2/26 patients, and anti-A1 was not detected in 3183 patients. In comparison, anti-A and anti-B was detected in 19/26 patients by the immediate-spin tube test, and was detected in 7/26 patients after 10 minute incubation room temperature incubation and centrifugation. Based on this study and 20 years of gel testing since that time have shown me the anti-A1 is rarely detected in Gel and that 70-80% of ABO plasma grouping discrepancies are resolved using the immediate-spin tube test. Centrifugation is used quite differently in gel versus tube testing. Centrifugation is used to separate agglutinated cells from un-agglutinated cells within the gel column, but is used to enhance agglutination in standard tube tests by forcing cells together at the bottom of the tube. This may contribute to the increased sensitivity of tube testing in ABO Plasma grouping tests.

Incubating patient plasma with patient red blood cells and then applying the antiglobulin test is no longer a Direct Antiglobulin Test but an Autocontrol test which is an Indirect Antiglobulin Test. Some may think an Autocontrol test gives the same results as a Direct Antiglobulin Test, but that is not always true.