Leaderboard

Most of our antibodies to gel diluent react only with the pre-diluted reagent cells, but not in cells suspended in MTS diluent 2 (auto control, XMs). There are no antibiotics in the diluent 2 because those suspensions are discarded promptly whereas the reagent cells must remain stable for weeks. If there are antibiotics in the gel itself, we have not seen reactions to that, but it makes sense.

I never was any good at Haematology!!!!!!!!!!

We use the electronic crossmatch when the antibody screen is negative and there is no history of antibodies. We also use this in lieu of the IS phase when we perform an antiglobulin crossmatch. Our AHG XM's are performed on the Vision with the IgG card.

The best solution is to get a smart fridge. I worked at a busy hospital where they had one we used to store blood in it, daily. It looked a lot like the following picture. We used to put blue tags on O Positive and Pink tags on O negatives. The nurses did not have to think too much, just to grab the units with blue tags for boys and pink tags for girls.

I just answered this question. My Score PASS  

I just answered this question. My Score PASS  

I just answered this question. My Score PASS  

Women's Services has the patient sign a "Consent for the Administration of Blood Products" upon admission and this covers the RhoGAM as well.

Just wanted to follow up about this. I was put in a virtual meeting with the folks who actually create the BT10 indicators (and relabel them for fisher to sell). It was the most demeaning meeting I've been part of in a while. I was told that any or all of the following HAD to be true: -The refrigerator temps had to be at 8C or above -- I have 4 continuous monitor probes that have not been over 5.7C in years with an average of 3.4C -The blood must be over 8C when the indicators are placed -- I have tested this many times with a contact IR thermometer and units very from 5.6-6.7C out of the supplier transport box, they are then left in the fridge at least 30min to acclimate before attaching the indicator which puts them at 5C or less. I have even placed them on glycerol bags with a probe inside and there is no reason why these things should activate. -The indicators are not fully attached to the bag -- there is a ring on the indicator that has no adhesive, so getting a full adhesion is challenging but I have more that alert that are fully attached and more than do not alarm that are NOT fully attached. -I need to activate these, then freeze them until ready for use -- I have to follow manufacturer's written instruction so says the standards (which does not include this) and the product touts that it requires NO pre conditioning at all. This is crazy. They explained how these work to me about 10 times, when I have no issue understanding the physics. It just doesn't work like they claim. I tried an experiment by testing a unit at 5.7C straight out of the shipping box, placed an indicator at 0 min, 15min, 30min, 1hr, 2 hr,while placed in the fridge (3.8C). Only at day 3, did I get alerts on the 0, 15min and 2 hr indicator. Then at the 1 week mark, all indicators had alerted. I have yet to get further feedback from the manufacturer but at this point my experience with them is so poor that I'm going back to my old vendor. At no time is anything in the process >7C, much less the 10C at which these are supposed to alert. Nevertheless... we're doing something wrong. Feel free to poke holes in my experiments.

I attached a few SOPs and a flowchart. Please let me know if you need other items. E-1-5_Identifying Cold Antibodies.docxE-4-6_Cold Autoadsorption.docxE-4-5_Cold Absorption Using RESt®.docxE-10-3_Cold Antibody Workup Process Flow.docx

You can't use REST adsorbed plasma to XM. IT removes ABO iso hemoglutinins. But use your validated computer system if all else fails. If your computer is validated and will not let you select ABO incompatible units then it can be used for ABO compatibility.

You may not "mean to offend" but that does not make it any less offensive. If you have nothing helpful to contribute it's best not to. I have worked in level 2 trauma centers with 24 / 7 coverage in the blood bank. I have also worked in a rural clinic in a Wyoming county the size of most states east of the Mississippi and there was not hospital in the county. The closest hospital was 2 hours by ground and if we needed a trauma center it was at least 3 hours to get a helicopter or airplane in and out. You do the best you can with what you have. The people of the county realized that one of the prices they had to pay for living in one of the most beautiful areas in the world was limited access to health care. They understood, accepted it and were actually grateful for the level we could provide! They neither wanted nor needed .......... I best stop now.