Baby Banker

Never mind. I just read it again.

Unless I'm missing something, the first case could be caused by maternal anti-B.

I think Johns Hopkins does titres in gel. We looked at it a few years ago for our isohemagglutinin titres, but decided to stay with tubes.

We don't titre because we don't have anything to do with the mother's care, but I know the hospital down the street tracks the titre. As for the panel/screen, I take the antigen profile and circle all the required antigens. Then I select a cell that is homozygous for each one. I sometimes have to use cells from other panels or screens. I know the rule is that you can substitute two heterozygous cells for one homozygous cell, but I never do that if I can help it.

If you know she has anti-E, you can probably put together a custom screen of E negative cells. That screen would only be positive if she developed another antibody. Be careful that you cover all the antigens that the FDA requires. That list used to be in the Technical Manual. I think it is D, C, E, c, e, M, N, S, s, P1, Lea, Leb, K, k, Fya, Fyb, Jka, Jkb.

I should have mentioned that we have X-ray irradiators.

We have used both. They both perform well. We are currently using Rad-Sure.

The Blood Bank Manager and someone from Biomed have trained to be able to do some repairs. There is not a recurring cause of downtime.

We have one of each. The Rad Source is much more reliable. Also, it has it's own water supply which is recycled, so you don't need a water hook up, and it requires only a 220 power connection. Another plus is that it can irradiate 60 mL syringes. We're a pediatric hospital, so that is important for us. The company has been very responsive to the few issues that have come up. Having said that, no x-ray irradiator is as reliable as a cesium irradiator. They have a lot more working parts, so there is a lot more that can go wrong with them. Even though we have two x-ray irradiators, we have had them both down at one time.

positive: small dead space, very little wastage negative: can cause hemolysis if used with red cells

Thawing in cold water would probably cause the cryo to precipitate.

Who titres and who washes out of group platelets?

They will need a sterile connection device. We have two. We filter the platelets when we draw them up. A tube sealer would be handy too.

We used to reduce volume platelets here, but haven't done in years. It produced a substandard product. We use aliquots of apheresis platelets. They are usually in syringes. We have a neonatal ICU that stays full.

We tube units of blood only to our CV Lab, and we transfer them in the computer, so our documentation is the packing slip generated by the computer. It includes a statement: 'Acceptability confirmed and packed by: tech's user id.'