Ensis01

That seems wrong on several levels, or is it me?

So when you find the discrepancy, do you test for weak D and if that resolves the discrepancy add a comment and move on?

Get the lab director to talk to the pathologist to determine if the photos are to help techs identify a skiptocite or if the photos are for review.

Either CAP or AABB provide a Titer for intra (and inter) lab comparisons.

Do you get many inquirys about about discrepant results from hospitals/Dr offices that only do IS?

If your patient is negative at IS and positive using IAT what is recorded in the LIS and how do you deal with resulting questions?

You could try 56'C heat elution method. Though this is better for IgM antibodies it usually works with IgG, but does take longer. See AABB Technical Manual Method 4.3

At the risk of opening a can of worms; who does accredit the accrediting agencies WRT blood bank? It seems the higher up the government system you go the less serology they know (let alone the growing molecular implications) but they must ratify/audit each agency?! If the agencies are therefore effectively self regulatory how do they form agreements within itself, other agencies, define who the experts are, come to agreements and then implement the results? I am familiar with the AABB technical manual revisions but have never thought through the process let alone the ramifications of integration with all the different agencies. Is there a pecking order? The ISBT meetings must be a whole other level of frustration! From reading several threads it seems a hospital blood bank chooses (and pays for) the accrediting agency according to it’s requirements based on work volume and/or the complexity of testing done? Who within the hospital makes that decision? I am trying to get an overview so I understand the process by which the OPs question could be resolved by each agency and how inspectors will audit individual hospital policy. Thanks in advance for some enlightenment!

I liked the first vitals being taken just before the blood was picked up. This prevented many a wasted unit. Not sure if this policy was regulatory or if common sense had broken out.

Did you try saline replacement at IS and 37?

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My understanding is: If you are irradiating then Yes. It is a new product. there are also licensing requirements that may be relevant.

Centrifuge your final eluate for 60 seconds and pipette it to a new tube. Check the old tube for fine red particulate matter adhered to the tubes sides, and if present repeat the process.

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A policy of nurses doing an ABO test at the bedside prior to transfusion makes me uneasy and it has taken a while to figure out and try to articulate why. Fundamentally it seems to me that if this policy is needed then the hospitals system of blood collection needs a total overhaul. To put it another way having nurses do an ABO test at the bedside prior to transfusion creates an extra layer in the transfusion process that will inevitably (in my opinion) cause delays, create confusion and problems that will need to be resolved by the bloodbank. Plus there is the need for training, validating the kit, monitoring etc. There are several threads (and lots of discussion) on this site expanding on different and effective ways to implement the second ABO check. There are also several treads on efficiently, and safely getting blood to patients emergently in different and difficult situations. Designing a robust process from the ground up would, in my opinion, be more efficient, safer and easier to control, audit and hold those that make errors accountable. So am I being paranoid, short sighted or just do not like change. Thoughts anyone