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Showing content with the highest reputation on 12/11/2019 in all areas

  1. In a grammatical sense, and from one who has studied Latin, isn't the usage dictated by the indirect object of the sentence? You're adsorbing bound antibodies to phenotypically known cell lines, and therefore interpreting the product that had antibodies pulled towards it. The whole point is to take off the antibodies (direct object) in a way you could identify them to selected RBCs (indirect object). Up for debate
    3 points
  2. Ael? Or am I dating myself? I agree with Malcolm, for transfusion purposes, it doesn't matter what you call it. And ADsorption vs ABsorbtion ... I always looked at it this way: It depends on whether you are looking at the cell or the plasma. Antibodies are Absorbed from Plasma and Adsorbed onto RBCs.
    2 points
  3. A long time ago now, I was working in a very large London teaching hospital, when we received a patient who was a group B police officer (this was about the time when the IRA were active in London, but this case, as far as is known, ha nothing whatsoever to do with them). He had received multiple stab wounds. We soon went through our stock of group B, and eventually got through out stock of group O. Although we had ordered more stock to be delivered by "Blues and twos", at this stage we had a choice. We either transfused him with group A, or we let him die. The doctors in charge decided to give him group A. He survived, and when the emergency order of stocks has arrived, we switched back to group B, and then group O. Yes, his renal function was shot to pieces for a while, but, to be honest, that was probably the least of his worries at the time. I'm not saying that this would work every time, because it won't, but you can treat a haemolytic transfusion reaction, even an acute haemolytic transfusion reaction; death is difficult to treat. As Prof Brian McClelland MB ChB ND Linden FRCP(E) FRCPath (former Director of the Scottish National Blood Transfusion Service) once wrote in Thomas D, Thompson J, Ridler B. A Manual for Blood Conservation. 1st edition. 2005. tfm Publishing Ltd, "Transfusion has risks, but bleeding to death is fatal."! To my own shame, I once did a book review of this for the BBTS, and misquoted the title as, "A Manual for Blood Conversation."! The embarrassment!
    2 points
  4. I would say that she is a subgroup of A, but would quite definitely transfuse her (if necessary - you may not have to) with group A blood (straightforward group A, not subtyped group A). She will not suddenly produce an anti-A and, even if she produces an anti-A1, so what? It is sufficiently rare for an anti-A1 to be clinically significant in terms of a transfusion reaction, that such circumstances are still reported and published (since 1911, when it was first reported that there was an A2, as well as an A1), but, in all that time, there has NEVER been a report of anti-A1 causing haemolytic disease of the foetus and newborn. Giving her group A will not harm her in any way. Giving her group O will possibly deprive a person who is genuinely group O, blood, which will no longer be available.
    2 points
  5. Yes, I'm sorry, I didn't realise that the hospital literally only had six units.
    1 point
  6. Although I agree that treating a transfusion reaction is a lot easier than treating exsanguination, in this small hospital setting where they have only 6 units of blood to begin with, I don't think it would go so well to switch to incompatible after only 4u transfused. I'm with the group suggesting the hospital switch to stocking 4 O Pos + 2 O Neg RBCs. It is possible, don't let your provider tell you otherwise.
    1 point
  7. If the total inventory is only 6 units at a rural hospital, I would stock 4 O Pos and 2 O Neg. I'm not suggesting every hospital should stock only 'O'!
    1 point
  8. AMcCord

    Deviation Reporting

    When the reason for a deviation is determined we can decide how it needs to be addressed. In some cases, the deviation was an acceptable response to a given situation. No follow up required. If education or training is required, that is provided and documented on the same form. If the deviation is the result of continued 'bad behavior', training/education issues, or egregious disregard for policy, then our next step is an 'Opportunity for Improvement'. This is something we use throughout our lab. The tech and a lead sit down together to discuss the deviations and the problems identified to determine what the tech needs to do to remedy the problem. The tech is also asked what he/she feels is needed to help him/her resolve the problem. Once the lead and the tech have come to an agreement, the resolution to the problem is spelled out, including any education/training the lead will provide and the expectations for the tech's future performance. An end date for the required improvement is also determined. When that date is reached, the lead evaluates the tech's progress. If all is well, that is documented. The End. If there are still issues, the lead can re-evalute the situation. Additional training or education can be provided, with another periord of evaluation. If need be, the problem can be referred to the lab manager for possible disciplinary action.
    1 point
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