NicolePCanada

I'm very glad you shared this wonderful news with us. We may have never met but you have helped countless people including me in my short time as a member of this forum. I am very excited for you and hope to one day be able to meet you in person. Congratulations! Please don't ever leave this forum, it wouldn't be the same without you. Nikki

　This is the Canadian Standard: A little vague....... 　 10.6.1.3 To provide ABO- group-compatible red blood cells, there shall be at least two determinations of the recipient’s blood group on record: one from a current sample and the second from the recipient’s previous records; 　 testing of a separate sample collection; or retesting of the same sample where positive patient identification technology was used at the time of sample collection. Note: Positive patient identification technology refers to a computerized system that uses a barcode, radio- frequency identification (RFID), or another electronically readable element on a patient’s identification band to confirm identity.

Poly Specific AHG is less expensive.

I eat cookies as much as possible AuntiS. Wish I could have been at ISBT.

And if you were going to be there Malcolm, I would have changed my plans around and driven 4 hrs to Toronto, just for the opportunity to shake your hand and the ability to say, "I met Malcolm Needs"

Always the BIG question. Was it drawn properly? I think you answered your own question there.

To further confuse the issue the National Advisory Committee in Canada has now said that as long as the unit of blood is returned within 60 minutes, temperature doesn't matter. This is from the Canadian Society of Transfusion Medicine Standards 5.8.7 Return of Blood Components and Blood Products 5.8.7.1 Blood components may be returned to the TS inventory if the following conditions have been met and documented: a. visual inspection of the blood component is acceptable b. the bag is intact, including ports c. at least one sealed segment of integral donor tubing is attached on red cell components. Alternately, an identified segment must be available to the transfusing site. d. the temperature of the blood component is acceptable or the blood component has not been out of the controlled environment for more than 60 minutes from the time of issue (per occurrence, not cumulative).10.10.2/10.10.5/11.4.7 We find this standard rather vague. What is the acceptable temperature and what would standards for our Quality Audit (like your AABB audits) consider a controlled environment? From what I have learned this was a very rigorous testing process at extreme high and extreme low temperatures and there was never any bacterial issues if the unit was returned to the refrigerator within 60 minutes regardless of the temperature of the unit upon 'return'.

I'm so glad I live in Canada. We don't bill for anything, we just do it.

Thank you Malcolm. I knew you would come through on this one. I am going to find that book straightaway.

I have to ask because we are getting pushback from our Pathologist about the clinical relevance of this very outdated test. Does anyone still perform Cold Panels to identify and determine the difference between Anti-H, -IH, -I, or do you just call it a cold antibody, warm the plasma and call it a day? Does anyone know anything about a hemolytic cold antibody? Thanks in advance.

We have a helmer freezer and the suggestions in the manual for maintenance is to test high and low temperature alarms quarterly. Our low limit is -35 Celsius and our high is -20 Celsius. The alarm limits can be set at the facility.

We do a rosette test that screens for Fetal Maternal Hemorrhage and if that is positive send it for a Kleihauer. That cuts down on the amount of Kleihauers you would do. The test takes 15 minutes to perform, you just have to draw a new sample from the Rh Negative mother one hour post delivery of all products of conception.

We do the screen and the panel right away if there is enough eluate to go around, however our policy also states that if the DAT results have not changed from previous time and no new antibodies have formed, an eluate does not need to be performed. We have a lot of cancer patients on weird meds that mess with the DAT so it would be a supreme waste of reagent to do it over and over to achieve the same "All cells reacting, no specificity" results.

Sorry I see you did the Room temp screen and it was negative. Forget my previous comment.

What about a room temp Anti-M, have you tried your reverse with M Neg, A1 cells?

Our policy states that as long as no transfusions or pregnancy in past 3 months the pre-assess sample is good for 30 days. If there are antibodies present we automatically xmatch antigen negative units, in case. The 96 hour window begins on the day of OR. We only separate the plasma if the surgery is >14 days from date of original type and screen so there is no hemolysis in plasma if they need blood day of OR.