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AB123

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  1. Like
    AB123 got a reaction from AMcCord in CAP Inspector Requesting Documents in Advance   
    They requested by e-mail and haven't sent any official sharing links so I guess there expecting them back by e-mail which from what I've found from the CAP website is not one of the acceptable ways of sharing documents in advance., and yes, the list is 3 sides of A4 paper long so its a pretty large list. 
     
    I did find the below on the CAP website, and it seems there is an option to "Opt" for advanced document review, however we have not, so I think we will be declining this. 
     
    Thanks 

  2. Like
    AB123 reacted to Malcolm Needs in Chido / Rodgers Identification   
    Be careful, because a very strong example of either anti-Ch or anti-Rg can, and will, react with enzyme-treated red cells, albeit that such examples are exceedingly rare.
  3. Like
    AB123 got a reaction from Malcolm Needs in Kleihauer sample timings   
    5.3 Timing of samples The maternal sample for FMH estimation should be taken when sufficient time has elapsed to allow fetal cells to be distributed within the maternal circulation following delivery, manual removal of placenta or sensitising event. A period of 30-45 minutes is considered adequate (BCSH 2006a).
    BCSH FMH Guidelines 2009
  4. Thanks
    AB123 got a reaction from mpmiola in Barrier method   
    We have a blood transfusion administration module in our HIS, on receipt on the ward they have to scan the unit against the patients electronic record, if it doesn't match the patient it was issued for, it will not allow them to proceed with the administration. I am working to further enhance this by incorporating patient wrist band scan at the same time at the patients bed side. 
  5. Like
    AB123 reacted to noelrbrown in Rosette Test Reagents   
    I suggest you try any high potency IgM anti D which these days is a monoclonal and thus not high protein. The anti D on your bench right now ( immediate spin) should work.
  6. Thanks
    AB123 got a reaction from Malcolm Needs in Retention of records for patients with passive Anti-D injection   
    The thirty year rule came from the European blood directive 2002/98/EC, the NHS is only UK based, this was a European wide requirement.  
    https://www.health-ni.gov.uk/articles/blood-safety-and-quality-regulations-2005-amended#:~:text=The Regulations,-The retention periods&text=Blood establishments and hospital blood,(regulations 8 and 9).
    Also there is no such 30 year limit on suing the NHS, its 3 years from the date of discovery, so if you didn't find out until 50 years later then it would be 53 years. 
    Applicable Time Limits To Sue The NHS
    Claimant immediately aware that negligence had caused avoidable harm 3 years from the date of the negligent act Claimant made aware later that negligence had caused avoidable harm 3 years from the date of the discovery Those without capacity No limit (There are some limits to those claiming on the injured party’s behalf – please see later sections or call our team for specific guidance)
  7. Like
    AB123 reacted to Malcolm Needs in High Frequency Antigens   
    When I got to bed last night, I suddenly realised that I may have missed out a fairly obvious cause, as I had not taken into account the fact that the patients were all pregnant.

    I just wonder if these patients have all made anti-Lea and anti-Leb, as it is not unusual for the Lewis antigens to "disappear" in pregnancy, and quite often they transiently make Lewis antibodies.  If none of the cells you are using are themselves Le(a-b-), then this antibody mixture (actually, it isn't a mixture, but anti-Lea+b) can look like an antibody directed against a high prevalence antigen.

    If you cannot obtain sufficient Le(a-b-) red cells to test this theory (and it is only a theory), you could try to inhibit the antibody with saliva from an Le(a-b+) individual (but don't forget to control this by diluting another aliquot of the plasma with saline).
    The attached may be of interest/use.
    The Lewis Blood Group System and Secretor Status.docx
  8. Like
    AB123 reacted to Malcolm Needs in High Frequency Antigens   
    Well, this is why I suggested the CR1 rBGP, as this will inhibit the antibodies directed against antigens within the Knops Blood Group System and, my other suggestion was the Chido/Rodgers Blood Group System; just as examples.

    I notice that you said that most of these patients are pregnant.  Please do not, under any circumstances, think along the lines of HLA antibodies (I am certain that you wouldn't), as these would not appear as antibodies to high prevalence antigens.  As I say, I'm sure you wouldn't, but others might.
  9. Like
    AB123 reacted to Malcolm Needs in High Frequency Antigens   
    Short of getting HFA negative cells, you may be able to get recombinant blood group proteins, such as CR1 (possibly from the International Blood Group Reference Laboratory in the UK, or from Professor Axel Seltsam's company, which, I believe, is called imusyn GmbH & Co. KG.
  10. Like
    AB123 reacted to David Saikin in High Frequency Antigens   
    cold agglutinins (you did say "a lot of antibody screens tend to be positive in all screening cells." 
     
  11. Like
    AB123 reacted to Malcolm Needs in High Frequency Antigens   
    It is probable that most are auto-antibodies, as David suggests, but it could also be things like antibodies within either the Chido/Rodgers, or the Knops Blood Group Systems (if the auto is negative).
  12. Like
    AB123 reacted to noelrbrown in Flying Squad Blood   
    I haven't heard it called Flying squad blood for Donkeys years, srichar3 are you from the UK?
  13. Like
    AB123 reacted to HN327 in Flying Squad Blood   
    Not sure what flying squad is but we have something similar at our hospital  We call them Emergency Uncrossmatched RBC and have it located in the ED Trauma Bay and a few Surgical area.  These units are stored in a constant temperature monitor system CimScan and also have a door alarm  function that alert Blood Bank whenever it is open.  RN are require to notified Blood Bank of any product usage and what blood type  (O+ vs O=) based on gender.  Like O= for female of child bearing age.  If we do not receive any call within a few minute, we are require to call the charge RN to check in on the situation.
    Each of these prepared units have an Emergency Uncrossmatch allocation label along with a transfusion report form to chart the vital and and 2 FDA ply sheet that require the Physician signature acknowledging the risk/need for transfuse outweigh the risk of waiting for a type&screen completion.  1 sheet for patient chart and other sheet send back to Blood Bank for crossmatch later when T&S receive before sending it to medical director review.    
  14. Haha
    AB123 got a reaction from John C. Staley in Flying Squad Blood   
    O Neg that is kept in a fridge that nurses/doctors can take in urgent situation without been crossmatched or issued to a patient. 
  15. Like
    AB123 reacted to NLiveris in ISBT 128 Product Modifications   
    I hope this information helps in regards to DIN on collected or pooled products. Per US Consensus Standard, 
    the DIN should remain that of the collection facility unless the product is pooled. 
    If the product is pooled, a unique new pool number shall be assigned by the pooling facility. This product shall 
    be given a new Donation Identification Number (DIN) and not use a DIN from one of the units in the pool. The new 
    DIN shall have the Facility Identification Number of the pooling facility.  

    And below DIN information is excerpted from the US Consensus Standard v3.0.0 - 7.8.2.2.
    Some computer systems treat reconstituted red cells as a pooled product; others do not. The Donation Identification Number (DIN) 
    can either be a newly assigned Pool Number (for those systems that treat the product as a pooled product) or that of the RBC 
    (for those systems that do not treat it as a pooled product). The text name and location of the facility that appears beneath the 
    DIN shall correspond to the Facility Identification Number within the DIN. That means, if the original DIN of the red blood cells 
    is used, the name beneath the DIN shall correspond to the collection facility. If a new pool number is assigned to the product, the DIN 
    shall have the Facility Identification Number of the pooling facility, and the name beneath the DIN shall be that of the 
    pooling facility. Regardless of which method is chosen, traceability of both the red blood cells and the plasma shall be assured. 
    The DIN of the plasma must be associated with the DIN of the final product in the facility records. 
  16. Like
    AB123 got a reaction from Malcolm Needs in Blood Group Discrepancy   
    Found an old Bio-Rad card that is still in date so decided to give it a try in that and its shows a plane old B Pos! But the Ortho gives a consistent 1 or 2 + A reaction in 3 different cassette types. 
    Awaiting an explanation from Ortho. 

  17. Like
    AB123 reacted to DebbieL in ISBT 128 Product Modifications   
    My hospital is not AABB but I will put in my 2 cents for what it is worth. The way I read this:
    The collecting/pooling facility will put a DIN on the product. The receiving facility will not change, alter, or remove the number (on that bag). Reading between the lines if you take those units and combine them in a different way with a NEW number, in a new bag, you are not altering the numbers on the original bags. You have a new bag with a new number and the next facility (should there be one) should not change your new number. Your computer system should be able to retain the original product numbers under the new facility number for posterity. You can locate who received either original number in the pool should there be a lookback in the future.
    It might depend on your computer system. Can you print a ISBT label with the new facility number? I would think that is the only number you would need on the new created unit. If you have several numbers on the bag it is going to confuse the nurses at the bedside and we don't need to confuse them. I do remember back in the olden days before computers when we made exchange blood, the bag and paperwork had both the plasma and RBC numbers on it because that was the only way we could do it and keep up with the DIN.
    We pool large quantities of plasma for Therapeutic Plasma Exchange. We just use the newly created ISBT facility number on our bag and paperwork. We have never been dinged for this.
  18. Thanks
    AB123 got a reaction from Malcolm Needs in Blood Group Discrepancy   
    I meant it in the sense that it's an antibody reacting with the A antigen rather than another cold reacting antibody reacting with another antigen on the Acells been the cause. 
    However as per my original post it did react with A2 cells this along with the strength of the back group was why I was questioning and AsubB.
  19. Like
    AB123 reacted to Yanxia in Blood Group Discrepancy   
    I totally agree with all those briliant ideas, and there are  some A subgroup have anti-A and anti-A1, such as Ax and Ael .
  20. Like
    AB123 reacted to Oniononorion in Blood Group Discrepancy   
    srichar3, do let us know results of other tests and if the patient was treated as AsubB for transfusion. I’m curious as to why the patient would have such a strong reaction with A reverse cells if they are a subgroup (I have only seen 1+ in reverse with A cells in subtypes but of course YMMV) and wonder if perhaps there is some pertinent clinical information causing false positive results with anti-A in gel, such as pH- or reagent- dependent reactivity. Especially since it was just BPos in tube method.
  21. Like
    AB123 reacted to David Saikin in Blood Group Discrepancy   
    Does look like a AsubB w anti-A1.
    I'd test pt cells w A1 lectin.  Also run a small IS/rt panel of screening cells, A1, A2, auto cells and see what it looks like.  By running the screening cells along with A1/A2 cells I can get an idea if it is a cold specificity or anti-A1.
     
     
     
    a
  22. Like
    AB123 reacted to Malcolm Needs in Blood Group Discrepancy   
    Looks like an AsubgroupB to me, but, these days, with monoclonal antibodies, which type of A subgroup can only be accurately sorted by molecular techniques.
    The reverse group needs more investigation.  It could be anti-A1, it could be another "cold" antibody specificity (such as anti-M or anti-P1), or it could be a combination of the two.  If there is no reaction at 30oC and above, it doesn't really matter, but, to be on the safe side, if blood is required, I would give group B packed red cells, or group B red cells resuspended in AB plasma.
  23. Like
    AB123 reacted to AMcCord in Disconnecting and Reconnecting Transfusions   
    The manufacturer's instructions for use on the infusion set packaging says: "Consult facility protocols and current standards for guidance on changing sets. It is recommended to change sets within 4 hours after initiating infusion of blood or blood products."
    So that's what our SOPs state - 4 hours. Nursing service agrees.
  24. Like
    AB123 reacted to mcgouc in AABB Transition To New Standards   
    I had in my policy that we would review the Changes to Standards document published by the AABB and document on each change whether it affected us or not.  (We did not draw donors so we just reviewed and put those changes as not applicable.). If we were already in compliance with the change, we would document no change in policy required with the policy number. If a policy had to be updated, we documented when the updates, training, etc were completed.  The Medical Director signed this review and we kept it with our policies. 
  25. Like
    AB123 reacted to Eman in AABB Transition To New Standards   
    I think we would refer to this statement in our "Organization" Quality Program document: 
    The Quality Unit responsibilities are defined and include: active and prospective participation in quality planning; oversight of all activities relating to quality; ensuring that policies and procedures are properly maintained and executed; ensuring that the quality of products, tests, and services provided conform to regulatory/accreditation, customer, and company standards; and maintenance of the facility quality manual
     
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