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Stop blaming the Canadian Smoke. We in Canada, do result as No Antibodies detected. If the patient had an antibody in the past, that is maybe below detectable limits, but was previously identified, those are also in report as historical and as such the patient would have a full crossmatch in gel as well as phenotypically matched for previously discovered antibodies. -
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Cerner allows us to extend the date of the Preassess sample. If no pregnancy or transfusions, and a prior history or second sample drawn for confirmation of ABO/Rh, sample good for 4 days with OR day being day one. Not to surpass 30 days sample date. EXM still applies when sample date is extended.
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We don't recheck antigen typings here in our hospital in Canada. The typings that have been performed at Canadian Blood Services, are embedded in the barcode on the bag, with all negatives printed on the End User Label. Every unit is antigen typed for K so if it isn't printed on the bag the unit is K Pos. Antigen typings we do are all linked to the unit through barcode. The reason of, "We were typing a lot of units and may have mixed them up", is not acceptable in a blood bank setting. Go work in a different department if you can't organize yourself. Anyway, there is also a full gel or whatever you use crossmatch at the end of that phenotyping, as long as the antibody is reacting, an anomaly could be discovered there. You have to have a little faith that people before you are doing their job properly, or you can cause yourself a lot of undue stress.
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We do the same, but we run them on vision. The IgG pos is 300uL of coombs control cells and 900ul of MTS diluent 2. The C3D is the same with complement control cells. For our negative control we use on the Panel A cells that aren't included in our mini panel. We use Bio Rad Diff Dat cards if the Poly is Positive. Those we pipette manually on the bench. Just waiting for Ortho to get a differential DAT gel card that runs on the vision. Then it will be great.
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Ortho wants their money, get those machines delivered. I need a plan. Can anybody help me? Who knows if IT can make it communicate with Cerner. Help please.
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My favourite John Judd quote from a University of Michigan Symposium I heard him at. "Phenotypically matched RBC units for a corpse is not a medical breakthrough." If the patient needs blood get them blood, worry about the rest later. RIP John Judd
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Does anyone have a good procedure for exchange transfusions? Ours is ok but does not take into account hematocrit and potassium levels. How do I test this after I have manufactured the product? Thanks.
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I don't disagree Cliff. In Canada, it is a little different and it totally comes down to initial cost.
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Thank you all for your responses. We will be sticking with the Gel Methodology. Nothing in my being wants to switch to solid phase. Just waiting for RFP, because at the end of the day, it doesn't really matter which one I want, but which one is the cheapest.
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Sending out a question to all my blood bank peeps. Who has what? Likes, Dislikes? We currently have a Provue. A very reliable machine for 13 years, with outstanding service. It is almost time to replace. I need your expertise and opinions on what you use. Thanks in advance.
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I meant a Canadian thing to not do it.
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@AuntiS Must be a Canadian thing.
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We stopped doing LUI freeze eluates a very long time ago. If Mom has no clinically significant antibodies and there is an ABO incompatibility between Mom and infant, it is pretty clear the cause of the Positive DAT on the baby. There will be no difference in the treatment of the baby if we did the LUI freeze. Our report goes out as Possible ABO incompatibility, no further testing indicated. Regardless, in Canada we don't bill anything, it is covered by our healthcare benefits. My point is that other than a way to bill the patient, it isn't a clinically significant test.
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Our DTT procedure is send it to a reference lab. I can't help out with this one. Sorry.
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