Carrie Easley

We only perform an eluate if +DAT can't be explained by an ABO incompatibility, known maternal antibody, or circulating RhIg. We will perform at physician request. but I don't recall that ever happening.  We only routinely perform cord blood testing on Rh negative moms & those w/ clinically significant antibodies.  Occasionally a pediatrician will request a cord DAT if a mom had a previously affected infant.

We pull two segments upon delivery.  One for retype, one in the event of a delayed reaction.  We keep them for two months.  The only units that we get back are actual suspected transfusion reactions.

Exactly this. We own the blood, so we make the policy. We give them 15 minutes for returns with the proviso that the unit has not been spiked and the temp is less than 10C (which it usually isn't) or it is not returnable for restock/reissue. If the temp is too high, they are given the option of taking it back upstairs to try to give it within 4 hours of checkout. If the transfusion has been cancelled, we take it and discard it. If we discard it, it becomes an occurrence report that hospital quality and nursing management see.
In actuality, the temp should probably be less than 6C, since that is the required temp for storage. I've almost got my medical director convinced to make blood non-returnable - you've got 4 hours to give it once checked out...period. We do require them to have everything, and I do mean everything in place before they check out a unit, then they have 15 minutes to start infusion. That time is policed by nursing and they are all very aware of it. We waste very very few units of blood because of returns, usually because the patient suddenly decides to refuse or the patient's condition changes very unexpectedly. It's taken us quite a few years to get to this point, but it was worth the struggle. It's pretty well ingrained now.

We have done gel DAT's (anti-IgG) in both Ortho & Grifols systems.  They work on the analyzer or in the manual system.  It's in their IFU's.
 
 

We went LIVE with the Erytra just over a year ago.  Have had some "kinks" to work out, but as others have indicated, Grifols is GREAT at responding to fixes and corrections!  I am totally a GEL girl.....and the Vision has had some issues of it's own.  The Erytra and Grifols have a great future.....that I feel confident of.  It is a fun machine to operate and is definitely advantageous in many ways....especially for large Institutions.
Brenda Hutson, MT(ASCP)SBB

Hello again,
That was my mistake in reading the literature...I was reading the specs for the DG Therm (incubator) and not the DG Spin centrifuge.  Darn!  It would have been nice.

Here's the one our entire lab uses.
Validation Plan and Results Review.docm

Here's the one our entire lab uses.
Validation Plan and Results Review.docm

Here's the one our entire lab uses.
Validation Plan and Results Review.docm

I never have.  Don't know how I feel about it.  Have never used cord blood for transfusion purposes either.  Always have confirmed w a heel stick specimen.  If you have the mother available I would think you would use a specimen from her.  Or am I just an old timer?

Just one additional thought.....if you have the typing results in the computer; and if your computer system will not allow you to Test and/or Issue Products unless that confirmation testing has been done, you do not need to place stickers on the units indicating that they have been confirm typed (it is just an extra step....extra label supply...and more time).  And to eliminate finding out "later" in the process that a unit was not confirmed, would recommend you have a shelf where you place "Units in Progress" (or whatever title you want to put on the shelf; just so it is known to all what the status of those units are).  Should not be placed on an Available shelf unless they are truly "available."
 
Brenda Hutson

We switched f/ an in-house created/validated Igloo system to MaxQ.  We love them!  They are plastic, so we can decontaminate after each use.  When we did our validation, we maintained temp for > 24 hours in rooms @ 22, 65 (heart room), & 85 (trauma room) degrees.  The lid is hinged, so it swings closed if someone forgets.  We use a saline bag connected to a digital thermometer that sits in a pouch on the lid.  This allows someone to constantly see the internal temp.  We issue up to 6 PRBC/cooler, but it would probably hold more.  I do think that they mentioned an upcoming upgrade w/ remote temp monitoring, so you might wait for that... I attached a Word doc that we used for PCS education.  It shows pics of how the units are packed.

New Blood Coolers.docx

We do an Rh type on all OBs predelivery, so we know which babies should have cord blood testing performed and then, which mom's are candidates for Rho(D) immune globulin. The physician/nurse is responsible for ordering the workup, but we are the backup to make sure it happens.

Uk guidelines suugest, "Any senisitizing event before 20 weeks not required KB test however lady required Rhogam .  After 20 weeks, any senisitizing event required KB as well as anti-D depending on the bleed.

I do check new QC lots when they come in simply by using the part of my QC procedure that utilizes the reagents in the kit. The new kit is checked against daily use reagents that passed QC with the QC kit in current use. I don't really consider it lot to lot comparison, just making sure that the reagent is acceptable for use.

Great idea!

I sent you some info

We've been doing it for over 15 years (from the time we had Ortho's gel cards).  Whatever validation was recorded, it's from eons ago and I wasn't involved with that one.
I would imagine it was similar to the validation done with the DAT method in gel cards (from my other post in that section)

Tech repeated and got the correct result.  I do not know if maybe she picked the wrong thing on the sheet.  She can not remember and did not save the cards that she used.  I just want to make sure I have a corrective action in place for JC that is sufficient.  Any suggestions?

We've seen this problem in the past. It can easily happen if the tech uses the 'patient' bottle instead of the 'crossmatch' bottle. There is no barcoding to help 'catch' this as there would be if it was an actual crossmatch of the unit of blood in the computer.

I'm fairly certain the chat could last well into adult beverage time.  Once that started the stories will get even better!  

When I asked CAP about this they stated that for Blood Bank it only applied to kits that come with their own Pos and Neg QC. So Fetalscreen Kit Yes, Elution Kit No.

We include a step in our method corelation (twice a year) where we run Ortho gel panel (0.8%), Tube panel (immucor 3%) and Immucor gel panel(dilute immucor to 0.8%). Our method was correlated almost 20 years ago!

We've got a demo of the MaxQ on the way.  I'm kind of excited. 
I hate our cooler system now.

Which book are you using, and at what "stage" are you in your professional life?  The reason I ask is that I may be able to suggest an alternative (but do not want to advise you read the same one! - and I stress an alternative book, rather than a better book; each to their own), and I need to know where you are in your professional life, so that I do not suggest a book that is either too basic, or too advanced.