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RichU

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    Isle Of Man

RichU last won the day on May 7 2020

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  • Gender
    Male
  • Biography
    Worked in RCI NHSBT for 20years. Took the opportunity to move to the Isle of Man Hospital Transfusion when it was confirmed that the centre I worked in was going to close and I didn't want to commute twice as far to the new Centre or go on to 24/7 shifts.
  • Location
    Isle of Man in the Irish Sea
  • Occupation
    BMS blood transfusion
  • Real Name
    Rich Ullyatt

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  1. RichU
    We use BioRad gelcards. There are different ABD-Confirmation cards for Donors and Patients. The Donor one detects DVI, the patient one does not. The D status of all donors found negative by the ABD conf card are confirmed using a monoclonal anti-D by IAT. Is re-grouping of units, sent from the blood bank, at the hospital a thing? Sorry for the late post
  2.    RichU reacted to a post in a topic: Kleihauer sample timings
  3. RichU
    What are the post delivery time constraints for a sample to screen for FMH? We require maternal sample taken at least 45 minutes post delivery, but is there a maximum limit and where are the regulations for this? I can't see anything in the BSH guidelines (for UK bods) We had a delivery sample which we had to reject (minimum data set not met), so we issued 500IU anti-D and requested a repeat sample which did not get taken until the day after. Would foetal cells (with prophylactic anti-D, already sensitising them) be being removed from circulation, would this affect the dosa
  4.    Malcolm Needs reacted to a post in a topic: Selection of M- red cells
  5. RichU
    Thanks Malcolm, I was hoping you would reply. I didn't fall asleep but had to reread a few times! I left their employ 4 years ago. I don't recall selecting M- units if the anti-M was not detected by IAT. I did wonder if the policy had changed since I left, but from what you say it was already in place. The unfortunate thing for us is that we produce our own red cells, which are compatible and (probably) safe for these patients, but we have to import M- units from the UK due to the RCI report. This means we have to pay for the units and the cost of air freight for blood which we
  6.    RichU reacted to a post in a topic: Selection of M- red cells
  7. RichU
    We have an antenatal patient with previously detected anti-M. We referred the booking sample to our RCI lab who did not titre the anti-M as it did not react by IAT. The report we got back recommended we select M- units for cross-matching by IAT. This is contrary to the British Society for Haematology guidelines which say M- must be selected only if detected at 37oC. When I queried the advice I was told this is their policy. Any thoughts?
  8.    Malcolm Needs reacted to a post in a topic: BloodBankTalk:Antibody/Antigen Reaction
  9. RichU
    Wow. I didn't realise how lucky we are at my hospital. We process around 7,000 samples a year, so not a large facility. It is not a lack of expertise that stops us doing elutions/titres/adsorptions rather that it would not make financial sense for us to. We have 4 full-time transfusion specialists for routine (9-5) hours. Outside of these times is covered by multidisciplinary on-call. Any biomedical scientist in the pathology department can join the rota. On call samples are processed in haematology, transfusion, biochemistry and a few micro tests by the lone worker. Traini
  10. RichU
    I just answered this question. My Score PASS  
  11.    RichU reacted to a post in a topic: Antibody stimulation by antigen negative blood?
  12. RichU
    We have a system called bloodtrack. Basically crossmatched units for named patients and 2 O neg units for emergency use (labelled with dire warning about uncrossmatched red cells) are kept in a locked fridge. To access this fridge the user who comes to collect units has to scan their barcode then the barcode on the blood pack(s). Bloodtrack saves the information regarding personnel, unit details and time removed from temp. controlled storage. There is an audit form with the emergency units which the medic has to fill in and return to the lab. so that we know which patient has received whi
  13.    Malcolm Needs reacted to a post in a topic: Brain Cramp
  14.    RichU reacted to a post in a topic: Confused about dosage
  15. RichU
    All paediatric units produced by NHSBT in the UK are HbS negative.
  16. RichU
    Sorry for the delayed reply mrmic. We received 3 requests for bilirubin level but 2 were insufficient. The first was within normal limits. We have had no follow up samples from baby and I do not expect one. I assume, due to our lack of knowledge regarding an ongoing situation, that the baby did not require any medical intervention. Thanks
  17.    RichU reacted to a post in a topic: Antibody stimulation by antigen negative blood?
  18.    RichU reacted to a post in a topic: Antibody stimulation by antigen negative blood?
  19. RichU
    Thanks for still cogitating on this. How strong would an antibody have to be to block antigen sites? ( Difficult to answer given the lack of cases, I assume) Also, given the presumed whoppingness(!) of the titre, wouldn't you expect at least some sign of HDFN? Cheers p.s. I have had to postpone the presentation due to circumstances beyond even World leaders.
  20.    RichU reacted to a post in a topic: Antibody stimulation by antigen negative blood?
  21.    Malcolm Needs reacted to a post in a topic: Antibody Titer After First Affected Pregnancy
  22. RichU
    There's always a caveat with serology! Sometimes when things are so ingrained it's easy to take them as read.
  23.    RichU reacted to a post in a topic: Antibody Titer After First Affected Pregnancy
  24.    Malcolm Needs reacted to a post in a topic: Antibody Titer After First Affected Pregnancy
  25. RichU
    Sorry, it's not that I don't recognise the significance of a titre of 32, just that I wished to illustrate that a rising titre is significant during any pregnancy but if you don't do any titrations, due to detecting an antibody in a previous pregnancy, how would you pick it up?
  26. RichU
    I always understood it was the change (especially upwards trend) in titre throughout pregnancy which indicated whether there might be a problem for the current fetus (and likely antigen status) rather than just a historic or latest result. A change of titre from 2 to 32 is more alarming than a titre which is 32 at booking but remains at 32.
  27. RichU
    Forgot to mention that all our transfusion lab samples must be handwritten at the bedside with no amendments or missing details and signed/dated/timed with matching printed form. As you can imagine we reject lots of samples.
  28.    Mabel Adams reacted to a post in a topic: Second blood type during surgery
  29. RichU
    We always require a second confirmatory sample before issuing group specific units if there is no historical group. We request this as soon as we know the patient has not been seen by us before. This doesn't impact on the speed of providing cross matched blood due to the shorter test time for a forward group compared to a full group, antibody screen and cross match. The units are selected based on a rapid tube spin group and set up with the first sample group and screen. We do not do electronic issue for any patients.
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