
Posts posted by Jennifer Castle
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On Thursday, July 19, 2018 at 7:58 AM, tcoyle said:
Agreed! From the 31st Edition of the BBTS Standards:
Standard 5.14.5 Pretransfusion Testing requires two ABO group determinations and cites Standard 5.14.1 as the precursor. 5.14.1 states the ABO group shall be determined by testing the red cells with Anti-A and Anti-B reagents and by testing the serum or plasma for expected antibodies with A1 and B reagent red cells....
TRM.40550 Forward/Reverse Typing Phase II
For each patient, red blood cells are tested with anti-A, anti-B, anti-D, and serum/plasma is tested using A1 and B reagent red cells.
NOTE: The ABO/Rh type of the patient's red blood cells must be determined by an appropriate test procedure. Tests on each sample must include forward and reverse grouping.
CAP and AABB are in agreement.
I respectfully disagree. The CAP standard you cite is for the initial type. Any other time CAP mentions type confirmation (ie. TRM.30575, and TRM.4670) they state ABO only.
Jenny
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Edited by Jennifer Castle
We have a 19 yr. pregnant female, front type Apos, back type 1+ A1cells and 4+ Bcells. (in gel) No history available.
Tube test with A1 cellls=1+; A2 cells=0; two different O cells=0; and B cells=0.
Anti A1 Lectin = 1+
Antibody screen negative
Results the same with different lot A1 cells. Strength increases with cold incubation.
Crossmatch in IgG at 37 degrees with patient plasma and A1cells is 1+. (in gel)
We are having the patient re-drawn for confirmation, but do I call this weak A subgroup if all results confirm? Clinically significant? Transfuse O cells?
Or could this be pregnancy related?
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Agree with AMcCord, we recently had this occur and FDA stated that unless the death can be directly linked to the transfusion, we do not need to report. We did investigate as a potential reaction, and our Medical Director reviewed the chart and wrote up a conclusion that indicated that the transfusion reaction was not likely. In case it's reviewed, we did our homework.
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An MD at Trauma mtg stated that he understood that the anticoagulants used in Frozen Plasma collection were a reason that the INR reversal with FP is difficult to achieve. I had never heard this, just wondering if anyone else has?
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We require BB notification, and after prelim investigation, the Lab Medical Director makes the call whether it's ok to continue for hives/itching, and whether additional units may be given. Hives category gets a clerical check and all other "Transfusion Reaction Symptoms" (as defined by AABB) require disconnection of unit and are worked up as reactions. The patient's MD does not make the call. We have a separate transfusion reaction categories for: 1) hives, itching 2) potential bacterial contamination and 3) everything else.
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It's my understanding that the manufacturer of the unit must label the unit for Zika testing as long as it remains an investigational test. We collect donor units and must label each one with the Zika comment. If you are only the end user and the unit is already labeled with the Zika comment, I don't know that you have to log that comment into your system, unless you re-print the label. (as with thawed plasma).
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Currently we use the Nageotte Hemacytometer to screen donor units for WBC. I would like to switch over to running the samples on our Sysmex Hematology Analyzer, which is linear to zero in Body Fluid mode. Has anyone done a switch like this that would be willing to share information?
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Hi,
I have a question from our IT person:
What/how are people charging for Draw and Band's? Is there a CPT code? And how are you tracking volume for this test in the lab?Thanks,
Jenny -
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@amurphy We have the expanded field in test, we have entered the N0125 comment, have also entered this in our printer software. We can print a single label for a single unit, but do not know how to make this a permanent change.
Thanks, Jenny
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Our problem is that both Digi-Trax and Meditech are claiming to have solved the problem, but the "fixes" are not communicating. We have yet to see any solution that gets us to the final outcome, which is printing the read-only comment on our donor units entered into Meditech onto labels from the Hematrax printer. If someone has gotten that far, I'd love to hear from them.
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Has anyone been able to implement the required Zika comment on their donor unit labels with the combination of Hematrax and Meditech?
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2nd ABO
in Transfusion Services
We use a separate BB wristband, perform electronic crossmatch, and require a second draw on patients for whom we have no type history. (We may also use a separate draw, ie. CBC if available). Last year, a patient was registered incorrectly (same name, different date of birth - so all bands, charts and labels were incorrect). It was caught by the phlebotomist performing that second draw. If I had ever questioned our process, I certainly did not look back after that near miss. We have to remember that patient identification IS the number one safety goal, because everything stems from that.