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Posts posted by NicolePCanada
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On 1/25/2023 at 11:48 AM, jayinsat said:
When you use extended sample expiration, how does this affect electronic crossmatch? The sample collection date would cause our LIS to reject the EXM rule. Do you just perform IS serological crossmatches?
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
- John C. Staley, exlimey, Ensis01 and 4 others
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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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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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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.
- John C. Staley and AuntiS
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On 11/12/2020 at 11:20 AM, cthherbal said:
Good day, all.
From our monthly LIS reports (we use Cerner), I have just been tallying the data manually.
# of O pos units transfused to non O pos patients (RBCs)/ total units transfused
# of O neg units to non O neg patients (RBCs)/ total units transfused
# of AB to non AB patients (plasma)/ total units transfused
Hello cthherbal,
We are about to Go Live with Cerner Millenium. So for the reports, to me, look like **** for what I need to report out monthly to Canadian Blood services. What reports are you running to manually extract this data?
Thanks, Nikki
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This doesn't necessarily speak to your topic of how to get them to order irradiated properly or how to make sure the techs notice it, but I attached the link to the National Advisory Committee Guidelines for when Irradiated blood is required. This is Canadian, but interesting information, none the less.
https://www.nacblood.ca/resources/guidelines/downloads/Recommendations_Irradiated_Blood_Components.pdf
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I'm signed up and I can't wait. We are implementing electronic issue in April of 2021. Malcolm you rock!
- AuntiS and Malcolm Needs
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Since we opened this topic back up........I was simply going to stop using LISS rather than validating a new type. We never use it anyway. If we can't solve it we send it to Canadian Blood Services. Is there a good reason why we should keep it? Malcolm?
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Malcolm Needs, You do not disappoint. As soon as I saw this post re-emerge, I was just going to log in and answer for you. I tell so many people there is no place in the Blood Bank for a microscope. I love Issit's comment that "it causes more problems than it solves". Thanks for your sharing of knowledge.
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If we only do D typing on babies from D negative mothers and a weak D or Du test needs to be performed, the results of the weak D is only valid if the DAT is negative, so a DAT would need to be performed. Therefore, an ABO and DAT would be a good place to start. Just my thought.
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We use Immucor for our reverse (back) type and the package insert indicates that we need to confirm the reactivity of the A1, A2, and B red blood cells, not the negative results. So, we only daily QC that they are reactive.
- jojo808 and Texas Lynn
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https://www.nacblood.ca/resources/guidelines/CMV.html
These are the Canadian National Advisory Committee Guidelines for use of CMV Negative Blood Products.
- AuntiS, Malcolm Needs and Baby Banker
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On 1/18/2019 at 7:00 PM, Ensis01 said:
So they don’t forget?!
No Ensis, I'm only asking if there is a specific time between the drawing of the sample and the date of injection mentioned in any standards anywhere. Historically, we have always said it had to be 14 days between sample draw and injection. I'm just wondering if there was a reason. Thanks for your response.
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On 1/17/2019 at 3:19 PM, Mabel Adams said:
I think the antibody screen done at 28 weeks is to make sure that the current pregnancy will not likely be affected by HDFN. A secondary effect is to know not to give RhIG if already clearly sensitized. The OB guidelines in the US don't require testing at 28 weeks; they can just give the RhIG. Based on those points, I would not see a need to have the injection time tied to the testing date. I guess I would want a screen after, say, 25 weeks if they are doing one at all if it is to serve to predict the likelihood of HDFN. We detected an anti-D in recent years on the 28 week sample of a first pregnancy and the baby was very affected by HDFN after born at 35 6/7 weeks.
Thank you Mabel. I understand the why of RhIg. I just wasn't sure if 30 days was an acceptable amount of time to have the sample for or if there was a worry of other antibody formation between the time of draw and the time of injection. Perhaps I am just not explaining myself well enough. Thanks for your response.
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Does anybody know if there is documentation or requirements anywhere indicating the length of time a sample is good for on an Rh Negative pregnant woman who requires her 28 week RHIG injection? We have always said the injection must be within 14 days, but as with many other things, I'm not sure if there is a scientific reason for this or if it is one of those "That's the way it's always been things" Thanks for your time
Antibody Testing Report Terminology
in Transfusion Services
Posted
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.