Ensis01

One reason (maybe) is that if you are AABB accredited the Reference lab you use MAY change what they are required to reprove from the results you provide, which would reduce cost.

I wholeheartedly agree with all the above comments for you to determine the surgeons expectations. One other thing we found VERY useful was asking if the patient has had prior heart surgeries, i.e. how much scar tissue was on/around the heart. We found that the more scar tissue the patient had the more products, especially RBC, would be needed.

I can just imagine the conversations you may have if a patient comes to you after being titered at a different hospital and an 8 fold increase is the result

I was told, by a very senior tech, that this convention began pre-automation when instances where an anti-E was identified but occasionally weakly reacting anti-c was missed. This resulted in a change in hospital policy so when the patient has an anti-E and is c= give E=,C= units. I then assume this practice spread as techs gained seniority and moved to different hospitals. The improved reagents, panel cells and especially automated methods over the last few decades, plus increased pressure with time and costs may either make this policy redundant or (remain) implemented based on your patient population and experience. Thoughts anyone

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My understanding and experience of thermal amplitude testing is to identify a cold autoantibody and determine if it is clinically significant or primarily just a nuisance. I have never been involved in cold autoantibody titers; can someone explain its purpose please.

The LIS has to have all the different product codes you may use entered so it can log and track them in your inventory. Discuss with your supplier as you will probably never see most potential products (it is a REALLY long list). The Dr however should only be able to see the basics RBC, platelet, plasma, cryo and be able to add extra requirements like LR, irradiated, washed etc. I suggest having special products like washed, platelet crossmatchs in a sub menu (or at least harder to get at).

Considering how often inpatients get stuck I am not sure they would notice the 2nd check especially if appropriate CBC tubes are looked for and used.

Upright: so you can read the unit number plus the segments can be kept tidy to avoid getting tangled with each other, and observe hemolysis.

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Did you test the eluate against DAT negative patient cells?

They should have, or create a policy to replace/reattach the armband. Get your pathologist and QA involved.

My main concern would be the cold ambient temp in the OR.

I would say it depends; if you need to do extra testing to resolve a discrepancy that is billable. if the instrument did not give a result due to QC failure (due to a hemolized sample for example) and you used tube then not billable. It should however be noted that I do not do billing.

My experience is that When a patient is being transferred from another facility with cross matched RBC or other products; infusion should have started by the time they leave the ambulance. Products not being infused are discarded unless they have correct transfer paperwork, I.e. for antigen neg units. Crossmatching process begins again. To put it another way if you know the patient is coming; the other facility Dr. Orders enough products to cover the journey. If the patient is a hard work-up get all information and transfer antigen negative units. If worked up at a reference lab: Reference labs have a form that will allow transfer of results though receiving facility do not always accept these results.