SbbPerson

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Under the AABB Standards for Blood banks and Transfusion services(1st. ed. 04/2021), the recipients' red cells must phenotypically match the donor cells, i.e. it does not contain the corresponding antigen(s) to the recipient's antibody(ies). I think the main idea is that the best blood to give to a patient is "type specific" blood. So that include the ABO/Rh antigens and all other clinically significant antigens that may trigger an immune response. 5.14.3 When clinically significant red cell antibodies are detected or the recipient has a history of such antibodies, Whole Blood or Red Blood Cell components shall be prepared for transfusion that do not contain the corresponding antigen and/or are serologically crossmatch-compatible to include anti-globulin testing.

I am sorry, but I think that is a poor excuse. "I am sorry, your son died because we are under staffed." If a service is not available, do not offer it. Personally I think if a facility is not equipped to take care of a bleeding patient, they should not accept that patient in the first place. Especially for an ED that can't wait 20 minutes for blood. They do more harm than good. This just has lawsuit written all over it. I don't mean to offend anyone, this is just my opinion. Thank you

It looks like Sandra has the antibody answer key for each case. There are more questions than that, because it is over 500 pages. The book is "only" $80 on the website. But I bought it several years ago, so the price might have gone up by now

All of them? The book is over 500 pages, sorry, there are too many.

Why not just put a lab tech on night shift? That solves all your problems. You got to weigh your options and what do your prefer, a patient having life saving blood, or going over budget on salary/employee expenses. Good luck

I have it, I bought it years ago from the AABB website. I may have to search for it a little. Do you have a particular question or section in mind? There are a lot of questions.

Yes, it is. It is actually because the transport temperature for whole blood, RBCs, and plasma is 1 to 10 degrees celsius. After 30 minutes, the internal temperature of the units go above 10 degrees which may promote bacterial growth. Basic 30 minute rule is that if the unit is outside of a controlled temperature for 30 minutes or more, it must be discarded.

Do you have an on-call lab person? Most hospitals with an emergency room have a lab person on-call when the lab is closed. They can come in and issue the blood. If not, call the lab manager/supervisor and make them come in and issue you the blood. There is the HaemoBank that is fairly easy to use and perhaps can be used to store just uncrossmatched emergency blood. Maybe you can get one of those. I know some smaller hospitals that use it. It's like a small refrigerator/vending machine for blood products. Good luck

There are hospitals now that has switched their verbiage from "least incompatible" to "most compatible". Which is true! This blood is the BEST blood possible considering the patient's situation. There is nothing you can do about the patient's auto, but you can make sure to provide the "best" compatible unit to the patient. Of course you do this by making sure there are no underlying clinically significant alloantibodies in the patient's plasma. Some places just straight out say "incompatible" on the transfusion report/tag. The physician is then notified and made aware of this. Some places make the doctor sign a form acknowledging the "incompatible" units and the risks involved, but where I work, a verbal "ok" would suffice. We are all on the same team, working towards the same goal, the welfare of the patient. We are not trying to "pin the blame" on anyone for possible hemolytic transfusion reactions. We all want the same thing. Here is a really good podcast on the subject from the Blood Bank guy. It is really interesting and goes deeper into the subject and "what to do when everything is incompatible". Good day. https://www.bbguy.org/2020/06/17/085/

At my hospital we don't use bands. I think this is great, because our rejection rate is pretty low. There are too many travelling nurses we need to train if we were to use the bands. And even when trained, nurses still get them wrong. Now all they need to do if to make sure the specimen has at least 2 unque identifiers , along with collectors's info, date, and time. Simple. Also for each type and screen, a testing request form is filled out. All patient information must match between the form and the specimen. That's it. Nice and simple. The band is great, but not everyone knows how to use it, and training takes up alot of time, especially with all the travelling nurses we have.

We just indicate in the test result , that the patient has history of of transfusion reaction. We are don't alert anyone because of course we are not physically present with the patient during transfusion. All our providers are very well versed on what to look out for during a transfusion, i.e. hives, chills, rash, fever, etc..