David Saikin

Can't answer that one John. From the ER.

I can go for months without using plasma so I keep my bath empty until I have orders. I fill it w tap water

I use the smaller (4u) Helmer product. Works very well.

I understand but in a 20 bed hospital it works just fine. You also run into the issue which perplexed me for a while. Weak gel rxs are invariably negative in tubes no matter what enhancement you use.

Repeated DAT in Gel 1+w. Makes me feel better. Cannot resolve the reverse grouping results. I played with both specimens (as did the evening folks). The mf results in gel were pretty equal as to top and bottom. I only did prewarmed w PeG so no immediate spin. Elution is a 4+ panagglutinin in gel. Doesn't look like rouleaux. I think the Peg absorptions work nicely (have done many).

Gel mf is top and bottom. 1+ (in tubes) is always mf by definition. DAT negative. All testing is gel except for the PeG testing.

none that I am aware of. She is from across the state line (very close) but I can't even find her PCP.

Interesting study but I could use another brain. Last evening: Pt presents w a broken wrist. Looks like an A+ (R1R1) except the reverse A1 cells are mf (gel). Antibody screen all mf except auto. A2 cells and M= cells: all mf. Cold autoabsorption: results the same. Strict prewarmed using tubes/PeG/anti-IgG: all are 1+ except auto (neg). PeG Autoabsorption: all cells negative. I want to assume a cold etiology due to the reverse grouping discrepancy. Patient was discharged before additional samples could be obtained. No medication history and no PCP documented. Any thoughts out there please? I have about 4 drops of plasma remaining.

While I am not averse to transfusing plasma on a historical type, I prefer to have an ABORh from the current admission.

Thanks Cliff. I've worked in those very large institutions. Nice to be able to transfuse 400 O+ in night (of course I only had 3 left). Seems to me that ARC is biased towards the "big" users. Anyway, we'll survive, and hopefully our patients will too.

its actually getting worse here. Cannot get any group Os except for emergent use. No stock replacement. I am an overstock and I am at my critical low levels and still can not get a routine delivery (even though I am transfusing 2 O pts - one w an antibody. Was thinking about writing OpEd Editorial: Your Blood Supplier Says You're Going To Die. Here in Northern NH/Vt I have polled the 7 hospitals in this region. We have a total of 16 O Negs (and I have 6 of them). Didn't even ask about O+. My neighboring hosp called to ask if we had O+ to ship. They had a bleeder and were down to 2u. Blood supplier not sending them any. No emergent and no stock replacement.

don't you hate that. I remember transfusing about 400 O+ one night; had none left. Called for 30, they sent 3. Day shift was bonkers at blood center when they came in.

N-hance has been around for quite a while. I think it was a Gamma product before Immucor bought them. You should do some validation.

Especially if the pt is on I&O.

We tend to have spot shortages of O's in the Northeast. Plt inventories also tend to be sparse lately.