EdSandlin

I work in a level one trauma center and MTP is a pretty big deal for us. We do ordered "shipments" of products and these can go on for hours. We're also a teaching hospital and frankly I don't think these docs would have a clue how to proportion product orders in a stressful situation like that. We recently started electronic crossmatching as well so we can get those shipments ready and out the door pretty quickly too. MTP can be a hassle but I think it's effective.

How on earth can you trust a statement from a patient about when or if they have been transfused or pregnant? I've had nurses tell me that their patients "can't remember" if they have even been in a hospital in the last three months.

There are two layers to the ansewr to this question: 1) Weak D positive mothers will cause fetal screen tests to be unreadable. The indicator cells attach to mom's cells instead of to fetal cells causing large, visible clumps rather than microscopic rosettes. 2) This doesn't matter because it is really obvious and you just have to cancel the test for that mother. Once in a blue moon you may waste time on an invalid test but this is far outweighed by weak D testing for ALL your D "neg" moms, which is shamefully wasteful of time and resources.

Our facility requires an antibody screen to be drawn prior to admistration of Rho-Gam (i.e. the same day). That way we have explicit record of the antibody status of the patient and can subsequently just run the "mini rule-out" panel that others have mentioned. Our computer system then will accept an electronic crossmatch after the "Anti-D probably due to RhIg" answer is entered. I'm ignorant of a screening method that would exclude Rho-Gam, and frankly skeptical that it would be trustworthy not to exclude significant antibodies.