donellda

We don't do special antigen typing of our units unless we do it specifically for a patient who has the corresponding antibody. Do they do this because the Kell antigen is very antigenic? It would seem to me, that it would be costly to type units for Kell to avoid using Kell positive units, unless of course the units are for a patient with anti-Kell.

For massive transfusion for patients with alloantibodies are you referring to an emergency release situation?

Hi David! Thanks for the introduction! I have read several of your posts and have found them very helpful. I worked in a small hospital in a town called Leamington several years ago and had a very enjoyable experience there. I have always been from the "big city" though if you call Windsor "big". I work in Detroit and it definately is the "big city". It's great to hear more about you:D

Hi and welcome to Bloodbanktalk! We look forward to exchanging notes and ideas with you!

I talked to the donor center who supplies us with most of our FFP. They said that the procedure that they use for plasma pheresis is a closed system. Is it possible that AABB gave the 24 hour expiration for all plasma pheresis because some methods for collection are open and others are closed making it too hard to determine which system different donor centers use? (It's a long sentence, I know:)).

The beat goes on. :cool: Hopefully, when we use our jumbos they will be used within 24 hours. The Technical Manual gave no explanation. Maybe I'll do a search to see if I can find anything else out. Thanks.

I guess that makes sense. Thanks.

Our trauma physicians developed a policy for massive transfusion that we call the "Red Chest Policy". When a trauma comes to our ER where the patient is to be massively transfused, in our case it's usually a multiple gunshot, the ER calls and alerts us they are coming for the red chest. We always have 6 pretagged O negative packed cells ready for emergency release. When they come for the red chest, it is part of the policy for us to thaw 4 units of AB FFP. If we have a specimen for the patient, we do a quick blood type and thaw type specific. The problem is, I have concerns that we may start to waste FFP because it is not always used after it is thawed. We have a real problem keeping an inventory of AB FFP due to lack of availabity and cost. We do convert our thawed FFPs to thawed plasma after 24 hours. I had decided to keep a small inventory of AB jumbo FFPs which are pheresis units for trauma use. We can sometimes get a few more jumbos from our supplier. I noticed the other day in the AABB Technical Manual that plasma pheresis units cannot be converted to thawed plasma. It says the outdate must be 24 hours. This breaks my heart:heartbreabecause I really don't want to waste jumbos. What is the difference between a thawed plasma pheresis and a thawed FFP? The only thing I can think of is the pheresis process itself that may affect some of the factors. Does anyone know? Thanks.

We did the LUI eluate at my old hospital. It is a very easy procedure. We don't do heat or LUI eluates at my current facility. We do a homologous antibody screen with A1 and B cells on the cord blood serum. It seems to work just as well as an eluate and is a lot quicker.

We do not do our own adsorptions so we generally get our units from ARC reference in the case of a warm auto. They will send us AHG compatible with adsorbed plasma and antigen negative if there is a clinically significant antibody underlying the warm auto. At our facility, we do an AHG crossmatch and give least incompatible and again, antigen negative for an underlying antibody. I worked for a hospital that did their own reference work and often for warm autoantibodies we would do a 30 minute incubation with no LISS AHG technique. Often times the warm auto would not react because they are sometimes LISS sensitive. I have had favorable results using this technique.

Well, they obtained a new specimen yesterday and there was absolutely no discrepancy in the reverse type. So they got out the 2 specimens from the weekend and whatever was there probably adsorbed out in the cold. They just did an AHG crossmatch to be on the safe side and called it a non specific cold antibody for now and everyone is happy.

Thanks! I need the day off;)! I don't think it is anything clinically significant either. If I was there, I could probably play with it myself. It's something that I find fun (if you can call it fun:confused:). I'll post the final outcome when I find out what it is.

The screen cells I and II were negative at 37 and AHG so O cells at 37 give a negative reaction. Immediate spin crossmatches with O cells and B cells were incompatible. The patient has no record of being transfused. The reaction with the O cells at RT and the positive autocontrol (I'm not there until Tuesday but I think the auto was done at RT) leads me to believe it is most likely an anti-H although the fact that the B cell in the reverse group got a stronger reaction when she tried to prewarm it confuses me a little. As far as mixed field reactions, she didn't mention a mixed field with the B cell. Since it is the weekend and we only work with 2 people on the weekend, I told them to put it aside for now. Dialysis is aware of the situation and since his hemoglobin is 8.0, there really isn't a dire need for blood at this point. ARC reference will not go in on a weekend for a patient with a hemoglobin of 8.0 so we can probably wait it out until Monday until my senior tech goes in. I'm sort of curious and wish that I had not scheduled a vacation day for tomorrow but I'm pretty confident in my staff especially my 2 senior techs.

I got a call from one of my staff members. They have a patient who forwards as a group B and reverses as an O with a weak rx on the B cell. They prewarmed the reverse group and the B cell got stronger. The antibody screen was negative, autocontrol positive, DAT negative. The patients serum is incompatible with all group O cells and group B cells. I'm thinking possible anti-H. So I'm having them do a room temp screen (although the B cell was stronger at 37??). I also asked them to test the patient cells with the serum of a group A patient to check for acquired B. The patient is supposed to be transfused Monday in dialysis but if we don't resolve it by then we will send it to ARC reference lab. She got these reactions: 3+ reaction with group A serum and 4+ with Anti-AB so it's probably not aquired B or a subgroup of B. Screen cell I 3+ and II 2+ at room temp,so my guess is anti-H or HI. Maybe someone else can think of something. The patient's Hb is 8.0 so it's okay for now.

We try to give ABO compatible when possible. We do not have the capability of volume reduction at our facility so that is not a possibility.

Hi Joy:wave: and welcome! I'm glad you finally decided to join:D. I notice a lot of guests when I check into the forum and I often wonder why they don't join in. This is a great place to get information especially with all of the new ISBT 128 and labeling rules coming.

Welcome Urvashi! We're glad that you found us!

We convert our expired thawed FFPs to thawed plasma also. It does help with our expired products but we only use them for traumas and open hearts or if the physician agrees to use the product. If we have AB thawed plasma, we do throw them in the "red chest" with the uncrossed blood but we don't always have them available.

I received a letter from the trauma physicians at my hospital last week because a trauma patient did not get his FFP fast enough. We are technically supposed to thaw 4 AB FFP as soon as they come for "the red chest" which is a cooler with 6 O neg uncrossed RBCs. This plasma generally gets wasted so we often will thaw 2 to start and once we get a specimen, we thaw ABO compatible. I researched the trauma that they spoke of. It was on midnight shift with only one tech working. He gave out the first 6 O neg RBCs at 1130PM and received a specimen 15 minutes later. They came for a second chest at 1202 at which time the tech was able to give type specific. An order for 4 FFP and 10 platelets came at 1240AM and these were issued 30 minutes later along with more packed RBCs. In less than 2 hours, this one tech prepared and issued 39 units of blood, 4 units of FFP and 10 units of platelets, which he pH tested and did 2 pools of 5 platelets. I thought that was pretty good work. The trauma physicians asked if we needed to revise the policy because of the "delay". I told them everything I just wrote out here and I said "no". I then put up a help aid on the window where we keep our units pre-prepared for emergency release, reminding the techs to thaw 4 units of FFP as soon as the "red chest" issued. I made sure that they knew that the tech did an impressive job and being by himself was just trying to get all the work out for their patient.

They should be visible now John.

Hi Roxanne! I'm glad you found us!

Hi Ephraim! Welcome to BloodBankTalk. Our health system is currently viewing both Capture and Ortho Gel. We are not quite sure which way we will go. I was an Ortho Gel user for several years when I worked for another health system. We did try Capture for a time period and I remember that we were not as impressed at the time as we were with gel. I'm sure that there have some improvements to the system by now. The more you use it, the less aprehensive you will be. I'm sure that there is someone here on the forum that has had experience with it that can reassure you. Good luck!

Infusion pumps are not mentioned in our SOP. Maintenance is done by nursing and biomed.

I live in Canada but work in the US. I have been med tech for a long time but I have worked primarily in blood bank for the last eleven years. I currently work for the Detroit Medical Center University Labs as the Blood Bank Group Leader at one of the hospitals. We are a busy hospital with a very busy emergency room and we see most of traumas in Detroit. We do open surgeries. We have an active labor and delivery as well as a neonatal ICU. We also have medical technology students who do their blood bank rotation in our lab. I am married with 2 daughters. My oldest is married and has an eleven month old daughter. My youngest is finishing her journalism degree at Wayne State University and will be attending the University of Western Ontario in the Masters of Media Studies program starting in September. Besides being a med tech, I am also a personal trainer with a small fitness business. I am one of the forum moderators here at Bloodbanktalk which is something that I enjoy doing. I am also a forum administrator for a fitness forum which sometimes requires a lot of my time but I enjoy doing this also. I am in the process of learning how to design my own website for my fitness business. After having said all that sometimes I look like this:zombie:.

I'm not quite sure what you are asking but I think you want to know if the clotting factors in a unit of FFP are measured before it released from the donor center. The only real QC that I know of is that the FFP must be frozen within 6-8 hours of collection, depending on the anticoagulant used, in order for the plasma to retain the level of reactivity of the coagulation factors. The FFP contains 1U/ml of the clotting factors. I believe that the only testing done is the testing for all of the disease markers. Sorry I can't be more helpful.