David Saikin

If that's the way you want it done, write it into a procedure. 40 yrs ago I learned that Kell did not exhibit dosage and could be ruled out with a heterozygous cell. My experience has taught me otherwise. Still, I try to r/o w a homozygous cell but it does not bother me to r/o using a heterozygous one.

Take your fibrinogen result and multiply it by the volume of the bag. x mg/dL x dL/100 mL x vol (in mL) of your cryo = total mg of product Someone should correct this if in error, but it seems logical to me. the dLs and mLs cross each other off leaving only mg/product. This is pretty basic stoichemistry. Wouldn't hurt to get a chem book or the AABB Technical Manual.

I don't think there are calculations for what you want. You have to do the actual counts of cells if you want that data. I don't know how you would calculate the hgb in a unit of blood other than testing. YOu can calculate how much plasma you want to give; platelets are known to give an "increment" based on the count in the bag - as long as the patient is not actively using/destroying them. As I said previously, there are standards that blood components need to meet when they are QC'd. Units need to be tested - rbcs for hct, plts for count, plasma/cryo for fibrinogen. Every component is not tested, the vast majority are not. I think you are seeking info that is not pertinent.

Mollison. All that info is general. If you get apheresis plts, they usually have the plt count attached. I don't know of anyplace that will give you numbers for fibrinogen in each individual unit. There are standards which the components need to meet (usually 75% of units tested must meet the std criteria).

We review the time from release to transfusion end for all transfusions.

the FDA only requires this data also - on a compatibility label. A transfusion tag is a different animal.

For WAA pts I try to give Rh phenotype matched. Haven't had a sickle patient here in over 20 yrs (that I am aware of - so policy on phenotyping except that they need sickle neg rbcs). They'd be transferred before I could get such a product.

We use the BloodLoc system. Anyone admitted as a patient gets one. In a pinch we will transfuse based on the bloodloc code. It only exists on the patient's arm band and blood bank tube. When they can't wait, they a unit labeled as uncrossmatched - group O (Rh depends on gender and age). As Cliff has reported out, if you are giving group O . . . Sometimes we never get a specimen. In these cases, the BB Medical Director signs off on the request sheet from the ordering MD. During out trauma certification the inspector had no problem that there wasn't a patient designated label on the product. When someone is bleeding out the paperwork has to become a secondary issue. I tell my staff - "give them the blood, bring the paperwork when it calms down (including the MD request for unxm rbcs.

Read/study the stuff you don't know or understand. A lot of the material on the SBB exam in 1985 is now used in the BB exam. Today's exam has a lot more management-type questions and is not just blood bank trivial pursuits exercise.

I too challenged the exam long ago; they sent a practical after you passed the written. I studies Mollison, Technical Manual, Harmening-Pittiglia, and the Garrity and Petz book about autoabs, made file cards of the blood group systems with ags and their frequencies, did a week at NY Blood Center. Good luck.

I would tend to disagree - you don't know how the product is handled after it gets where it is going (OR, ER, wherever). I don't believe that the temperature monitoring tabs are approved for plasma. If they are, I think you'd have to use them to document that the product was stored appropriately while out of the BB. I'd cite you otherwise.

I use Immucor's CorQc kit for my positive controls. anti-D,-c and the cells are AB Pos. dilute the ab 1:10.

Isn't that what the training environment is for? You are not going to take your upgrade and make it live before validating the changes (which you must do prior to implementation). And you have to train your staff on the upgrade.

It is 2 different systems. they both need to be QC'd. Had this problem at a recent client's facility. Talked to the regulatory folks (JCAHO in this case). Both systems need to be QC'd for the testing performed using them.

Ideally I would use a DVI+ rbc however, I cannot find a vendor who would sell me a DVI+ rbc. I run a D+ and D= rbc with each Weak D test performed. I think that DVI is the only mosaic that does not react in gel (made that way on purpose). I actually have a DVI patient but she is needle shy so . . . i'm out of luck there.