MaryPDX

Another reason why our computers are better at selecting ABO compatible units than serological testing is.

So, you are ancient Cliff, according to David!!!!!!!!!!!!  

We were discussing this recently, wondering what we would need to do if mom was drawn on admission for induction but didn't deliver for 2 days and then baby needed an exchange transfusion on day 3 of life (5 days after Mom's specimen collected).  My argument was that the baby couldn't be affected by any antibody mom made after delivery so we mostly care that the mom was drawn in the 3 days before delivery (and screen done then).  Then, if we need to use mom's sample for an IgG XM (Ab to a low inc antibody maybe) then we want mom's specimen to be fresh enough for the antibody to still react in the crossmatch.  I think it depends on whether her anti-Jsa (or whatever) was 4+ or 1+ when the sample was fresh plus some other variables that I think we would consider on a case by case basis.  Any common antibodies, we would be able to get antigen negative units and aren't even required to do an IgG XM on them for neonates (although it makes everyone squeamish--maybe we would have 2 people do the antigen type).

If the patient is AB, and the anti-A1 does not react at 37oC, I cannot see for a moment why you don't give the patient cross-match compatible AB.

We went with the second blood type but only on patients we are not giving group O blood to. Between that policy removing about half of the need, allowing use of another lab specimen from Hem or Coag and a lot of historical types on record, it hasn't been too bad.  We are AABB and TJC but not CAP inspected.  We made the change for patient safety at the time.  Now I think AABB is requiring something similar to CAP.

I agree MaryPDX, but, unless the Reference Laboratory is made aware that the patient has been on Dara, time and reagents can be wasted by trying to sort out the problem by more "traditional" means.

The only way I'm aware of is DTT treating the screening cells used.  

In my opinion, "unique" does not equal "independent".  We used to require handwritten blood bank tubes but switched to allow computer generated specimen labels.  The impetus for this change was the acquisition of hand-held phlebotomy scanners which printed the labels at the bedside after scanning the patient's wristband, however we had surgery personnel begging us to allow pre-printed labels for years because they cannot generally access the patient's wristband once the procedure has started and they often misspelled, copied, and omitted information.  Additionally, some people's handwriting is atrocious!  We have so many fewer headaches now that we made this change!

We do 4 hours after it leaves the Blood Bank.

Our rule is 4 hours after it leaves the fridge or cooler.

Hi Cliff 
We count 4 hours from the time it's out of controlled temperature. If you pack your unit in controlled transport box than time start from it opened the box.
It's worth looking JPAC guidelines 
 

Hi Cliff.  We do 4 hours from the time the unit leaves the blood bank.   We use a electronic time stamp to document this time on the blood administration tag that is attached to the unit.  We teach the nurses that they have 4 hours from this time to complete the transfusion.   This does not apply if we send products in a cooler.   

https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM425952.pdf
This is in Draft status, but should be finalized this year.  Once finalized, FDA will give 2 years for implementation.  Transfusion services should not be mandated to make changes until some time in 2019 or later.  There are some misstatements in some previous posts that should be clarified.
PAS apheresis platelets can be stored up to 5 days and must have a "safety measure" test within 24 hours of transfusion if transfused on Day 4 or 5.  The use of platelet additive solution does not confer any protection against bacterial proliferation. Plasma-stored apheresis platelets can be stored up to 7 days and must have a "safety measure" test within 24 hours of transfusion if transfused on Day 4, 5, 6, or 7. Pathogen reduced apheresis platelets can be stored up to 5 days and can be transfused up until expiration without additional testing.  

Most of our reconstituted whole blood is made using washed RBCs (to remove the residual anti-A/anti-B/anti-A,B), which necessitates the 24 hour outdate.

Hear, hear Scott.
How can an algorithm tell the difference between an anti-D+C and either an anti-C+G or anti-G, anti-hrB, rather than anti-C+e or anti-hrS, rather than anti-ce (anti-f), to name but a few?  The answer is that it cannot, and these specificities are much more common than a lot of people think.

Minimum requirement is to present the patients name and MR# in writing. This ensures there is no confusion as to who the blood is for as there could be other emergent situations occurring. In this type of situation written can be on the RN's hand, glove, post-it note etc. If patients name and MR# not brought with them in a written form they call for the info, write it down and present to tech.

Thanks guys,
I let this thought go... we wont dont it.
Instead we'll warm up a bottle for use in prewarm procedure then toss it after.

Is your printer only 203 dpi. Ours are 300 dpi.  I  am looking at the manual. It says accepted value for  ZT410 Print Width 203 dpi = 0002 to 832. I don't see anything about max for label length.

The meeting was just fabulous (as were my hosts), and it was simply fantastic to meet so many people from this wonderful site.
It was be invidious of me to mention the names of the individual lecturers, as they were all excellent, but I have to say, nevertheless, that there were five people who stood out for me; namely Ed Synder, Melanie Champion, Ghislain Noumsi, Kathy Rafferty and Anne Eder (which rather makes my earlier comment about being invidious redundant, but this is not so say that the other speakers were not anything less than superb).
I tried to upload a couple of photographs (and failed miserably!), but, as promised, I have sent my two lectures to Cliff Reeves for uploading onto the site (couldn't do it myself- they were either too big, or it was beyond my IT ability - or both!).

I quite fancy an expedition to Loch Ness - with or without the monster......

I concur. A good writer should be able to finagle that logic into a validation plan. Getting hold of said cells may still be problematic, but at least it might be simpler than an expedition to catch the Loch Ness Monster.

I don't know of ANY "serological" laboratory that has the ability (or the necessity) to test the whole gamut of Weak D types (and I don't think anyone could - as many of them are unique to the proband), but, I would have thought, as long as you know you can detect a Weak D Type 2 (which is the "weakest" of the normal "Weak D" types, you should be covered) -  you should be okay.

What Malcolm?  No anti-weak D antisera available in the U.K.?
(There is such a thing as an auntie weak D, however.)  My father's sister was a terrible center-back when playing for Suffolk.
Scott

I don't know for sure but there was nothing on her referral suggesting she had received treatment for any medical conditions. 

Deionized water is not recommended because it is potentially corrosive to the chamber and baskets. Distilled or tap water is OK. We have very 'hard' water in our area, so we use distilled in ours with CleanBath. We drain weekly and have never had to clean up mineral stains.
The manual suggests using "stain, scale, or rust remover suitable for stainless steel" to remove stains and discoloration - can't recommend a specific product since I haven't needed one. As Scott says, CLR is good stuff - I use it at home. Just make sure you get the chamber well rinsed to remove chemical traces before you put your thawer back into service.