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Except that the QC manufacturer's diluent used to make a control antibody solutions is not used in any phase of patient testing--it does not need the be QC'd--it is QC. I would think the point is that the gel diluent is being controlled (which it should be), by showing it does not produce a positive reaction as a negative control. When patient or unit cells are being tested in gel, you use that gel diluent to create an 0.8% suspension--so for a positive gel control, if you are creating your own 0.8% suspension, again you want to use the manufacturer's diluent. Scott

Happy to join a professional team like pathlabtalk. I read lots of interesting topics

I once had a patient who did not show the same blood type as his historical record. We had to redraw him and repeat all testing which matched what we had on the sample from earlier that day. As Scott said, we could at least safely transfuse him but later we learned that he was registered under the record of a prior patient with the same name (different DOB) so then we had to separate all of the testing records from the prior patient and clean up the records. Much better than a mistransfusion but still not optimum. Nowadays the habit of asking the patient to verify ID verbally should have caught that before he even got his blood drawn but this was eons ago.

As Malcolm said, it is unfortunate that you were frightened. Because your anti-Coa will react with most of our test cells, you could be subject to panicky medical providers in the future too. (Sorry I implied above that being negative for the Coa antigen is common; Malcolm has stated that much more accurately.) If you are in the US, I would suggest that you contact the lab at any hospital you would likely use and ask to speak with the blood bank section. Provide them with information about your antibodies and ask them to formulate a plan for managing your anti-Coa should you need a transfusion, especially in an emergency. This will save time when they have to repeat your antibody identification workup. If they formulate a plan in advance they can probably keep it in your record in the blood bank so that it will be available when needed. If they are a small hospital, they should be able to discuss the plan with their reference lab or the medical director of their blood supplier to come up with something that works in your locale. These things always work best when blood bankers speak to blood bankers because, frankly, no other medical practitioner is taught all of this information in the detail that we are. My goal for you would be that a plan be created that provides you with the safest transfusion possible when transfusion is life-saving but that you avoid transfusion if possible to prevent you from making any more antibodies to other antigens that you lack. You are welcome to answer this post or message me on this group if you need help with talking to your local blood bankers or understanding what I am suggesting. Best plan of all will be to be too health to ever need a blood transfusion!

We've caught misdraws twice the last month from samples that required a 2ABORh/didn't abide by proper electronic collection... it's safe to say the hassle is beneficial!

Our organization fought us on this but it has been so beneficial for patient safety. Once you implement and get use to it it’s hard to imagine going back to the old way of not confirming the blood type. It is a struggle to get everyone on board. We still have doctors fight us.

Although this mainly covered the preparation/reasoning and less so the conceptual basis, the latter slides from 60 on were quite helpful. Thanks!

This goes back to some comments made earlier in this thread. It is impractical to screen for all antigens for a particular patient that may induce an antibody response. However, for a patient that is actively producing (or is known to have produced) an antibody for a particular antigen, transfusing known antigen positive blood would clearly not be indicated if it can be avoided. Scott

I'm sorry, but I find this appalling. Fancy worrying you like that. I know that I said only 5 people per 1, 000 are Co(a-), but in 2014 (the last year to which I have access, as I am retired) NHSBT had 38 such units frozen down in the National Frozen Blood Bank, and well over 100 "walking donors", who we could call upon at any time, to provide "fresh, liquid" blood. If you compare the number of people living in the UK (and the size of the UK come to that) to the number of people living in the USA (and the size of the USA, where many of the individual states on their own are larger than the UK), you can see that the USA would also have had numerous compatible units frozen down, and would also have had many, many "walking donors". It is totally unacceptable that the medical staff should have frightened you like that, with comments that are patently untrue.

Testing the same specimen twice may detect some internal testing errors, but will not detect WBIT (Wrong Blood In Tube). You need to gather some data to show how many patients would be impacted by collecting a second blood sample. Ask these questions, "How many patient admits annually?", "How many patient admits required blood bank testing?" (at my facility the calculated percentage was 11%), "How many patient samples type as Group O?" (at my facility the calculated percentage was 55% and we don't draw a second blood sample on these patients), "Of the non-Group O patients, how many had an independently collected blood sample in Hematology that could be used for the second ABO blood sample" (in our facility that was calculated to be 16%). So for every 1000 patients admitted annually, 100 (I'm using 10% for sake of simple calculations) would require blood bank testing of whom 45 (100-55) would be non-group O, 7 (45 x 0.16) would have a blood sample in hematology, leaving 38 (45 - 7) or 3.8% (38/1000) patients requiring a second sample to be collected. Using this kind of data will give you a much better grasp of the impact of routine performance of a second ABO determination on all patients for whom a Type and Screen or a Type and Crossmatch is ordered.