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Having worked in both (Ref. Lab & Transfusion Service), some of the antigen negative red cells provided by the ref lab are based on historical data. Also, we did not return any adsorbed sera to the requesting hospital. The hospital should confirm antigen neg. status (just as with ABO and Rh negative requirements) and if necessary when adsorbed isn't available, transfuse "least incompatible". Document the reference lab results in the patient record.
We require a second tech to repeat ABO/Rh in tube (our initial testing is in gel). Lacking the availability of a second tech, we IS or IgG XM group O RBCs.
I find it difficult to comprehend you actually "hide evidence". Ideally, we must document all mistakes and errors...how else do we learn and, thereby improve our services?
It is important to remember if identifying anti-M in a patient undergoing open heart surgery to perform thermal amplitude studies to determine at what temperature IgM anti-M reacts. This is due to the patient being "cooled down" for the surgery and prevents problems with performing the surgery. With prior knowledge of the thermal amplitude, the surgeon can either alter his/her approach, or not cool down the patient as much.
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