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I see your point, but if this was to happen I could put in a separate thermometer to trouble shoot it, right? If the continuous probe is out for what ever reason it should alert me, and then I could put an internal therm in the device. And if it doesn't alert me, then having the internal probe is only useful when I look at it. If there is no regulation that requires the internal therm then, I do not see its purpose except to trouble shoot, and it that case I would only use it when I need it.

I somewhat remember that early on with the LUI freeze elution there were some attempts to elute non-ABO antibody specificities. At that time some suggested an additional source of protein and/or a minimal "LISS" environment might help with detecting these other antibody specificities. I'm not sure it worked out too well and other elution methods were much better. We just used for ABO elutes.

We have a monitored and locked refrigerator between the two trauma OR's , adjacent to the ED. It has 6 O pos red cells and 6 A liquid plasma and access is made by RN's trained to use it and they have to scan in their ID(linked to some training module) and the Patient's MR#. Blood bank and has a computer screen on the wall that shows that the refrigerator is being opened and you can see t he patient's information, what is being taken out and who is taking it out. Problem with this has been: 1. nurses trying to access it who haven't been trained to use it and they can't get in so they call the BB and complain and want help. We then send a trauma pack from the refrigerators in the BB 2. The trauma nurses are the only ones trained and sometimes they say they are too busy to access it so ask the BB to send a pack but they really want what's in the refrigerator. The powers to be are discussing the possibility of have the OR runner access it. Which works for me as they are the ones that pick up the blood in the BB anyway and really have a better concept of storage and handling of these products than some of the RN's. Note: yes it is O pos red cells so if the patient is of child bearing age it is up to the provider to make the decision to use the blood in the refrigerator if get O= from the BB

Wow this is a late post. I just can't find the time to keep up sometimes. I certainly was not implying that either Duffy antibody would not be able to cause HDN but rather theoretically speaking given the circumstances it didn't quite give the picture of HDN. Again, even that is not a absolute. Looking back at all the comments and possible causes, which all had merit, I failed to see any reference to the possibility of an autoimmune issue and that there may be a possibility that the specificities are part of an newly development of autoantibody complex forming, i.e. mimicking specificities. Although these are normally seen within the Rh-Hr specificities, other specificities are not unheard of. Follow-up testing for cases like this rarely pan-out, if the infant clinically unaffected, the parents get their baby and disappear (sometimes and at least may not show up again until the next pregnancy). Too bad, would make a good abstract.... "My" thoughts or opinions for this site are based on previous experiences or readings (actual book in hand journals) and etc. Immunohematology Reference Laboratories see a variety of cases sent for consultations and that is what makes it so intriguing and challenging for us to give the clinician the information he/she needs to take care of their patient and that we are right there with him to help. We may not always have a specific answer but we can look for histories of similar cases and what the outcomes have been and give it our best educated interpretation of what might be happening and what transfusion recommendations we might propose. I'm about to retire and my ramblings will decrease (Yea goes the crowd). As far a the gel system, again my own thoughts/experiences we had in our Immunohematology Reference Lab, starting back even before Ortho commercially prepared system was as follows: Basically it is a micro-LISS-system with an optimized serum to cell ratio. Although we could not find a niche for using it on our investigations, we did start keeping it around to reproduce issues our hospitals were seeing with its use their routine transfusion service and to help provide educational information on what was happening and whether it had any clinical relevance. There was a lot of weak reactivity of various strengths referred to us by a variety of hospitals. Many these were related to the problems seen with the LISS tube system. Maybe even a little more since it much more sensitive based on how the method is set up commercially to work. Lastly, I believe that Malcolm Needs is truly an asset to this site and provides excellent information to all regarding such a variety of topics and also provides excellent references to support the information he provides. Thank you Mr. Needs! I hope you continue to provide your insight in this forum for many more years. mic

NicolePCanada, I agree entirely with Ward_X, but with the caveat that workers must remain competent in the method.

Protein problem patients, especially a cancer population, maybe?

The "Swiss Army Knife" approach to serological problem solving used to be fun. Having the ability to tinker with a variety of test methods and come up with your own conclusions was one of the addictive parts of immunohematology. Alas, that is no longer viable in today's era of validate everything and demonstrate competency several times a year. I used a lot of words to say: "If you don't use it, get rid of it".