SbbPerson

Did the 4 collections use a cell saver? If not, what process or instrument was used for collection? Thank you

Our cell saver machines are in the OR. Only surgery techs/personnel are allowed to use it. I never seen one in action but I hear good things. Attached are some guidelines, best practices, and indications for use. Good luck. cell_saver1.pdf cell_saver2.pdf Guideline_IntraoperativeCellSalvage.pdf Poster_Abstract_Fatreduction.pdf US-Cell-Saver-Elite-Owner's-Manual-120859-AC.pdf

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Attached is the website and customer service number if you haven’t tried those. Good luck Credo Operating Room Container Product Sheet.pdf

We use the credo operating room containers. The container should be able to sustain 1 to 6 degrees celsius for 10 hours with the plates in them. We use this for surgeries when they need 1-6 units of blood or plasma , and it is not optimal for them to keep running back and forth to the blood bank. 1) We store the plates in a sub zero freezer. 2) We keep about 2 sets of the plates in a 1-6 degrees fridge. They are good in the fridge for about 40 hours. After the 40 hours, we put them back in the freezer. 3) They need to be in the freezer for about 12 hours before they can be used or be placed in the fridge. 4) You need to wait about half an hour or so before you can use them after you take them out of the freezer. Because obviously it will be too cold if you use it right away. So yeah, to validate that it is working, measure the temperature inside the container for 10 hours. I attached the product sheet. Good luck. Credo Operating Room Container Product Sheet.pdf

Also this test should only be performed on Rh negative moms. And do not use any other Anti-D reagent, use only the one included in the kit. Anyways, I attached the AABB procedure to this test. I hope this helps a little. Good luck. AABB_FBS.docx

Does your sister hospital uses the same Lot numbers of Immucor FBS kit? If yes, then you guys must be doing something wrong. When was the last time your cell washer/centrifuge was calibrated? RPMs? Amount of saline dispensed? If they are not using the same Lot #'s, perhaps give them one of your kits and see if they get the same result. If the kit's QC passes for them, then there is something wrong with either your procedure or maybe equipment. This is really strange. Good luck.

I couldn't find a regulation that says that per se, but according to the AABB Standards for BBTS (33rd) edition; 5.11.2.4 : The transfusion service shall have a policy to reduce the risk of misidentification of patient pretransfusion samples. Also according to the recent AABB technical manual; page 504; In our facility, the phlebotomist and a 2nd person verifies the patient's ID at the time of the pretransfusion specimen is drawn. They both sign their names on the request for blood bank testing form. After the blood bank receives the specimen, me make sure the information matches between the form and the specimen. If the patient doesn't have ABO/Rh history, confirmatory ABO/Rh testing needs to be done before blood products can be issued. Sources: Cohn, Claudia S., Delaney, Meghan, Johnson, Susan T. and Katz, Louis M.. <em>Technical Manual, 20th edition</em>. https://ebooks.aabb.org/pdfreader/technical-manual-20th-edition50155278 PPID_pearls.pdf

Strange , we have never had that problem. We use immucor too. I agree with AMcCord, washing is critical for this test. Also, how are you counting the agglutinates? By tube or slide? If you see agglutinates by tube, you should do it also on slide so you can count the number of agglutinates per LPF. If you get less than 5 agglutinates in 5 fields, it is negative.

I got the chloroquine method from the most recent AABB Technical manual. Maybe it can help you. Good luck. METHOD 2-20. DISSOCIATING IgG BY CHLOROQUINE FOR ANTIGEN TESTING OF RED CELLS WITH A POSITIVE DAT RESULT Principle Red cells giving a positive direct antiglobulin test (DAT) result cannot be tested accurately with blood typing reagents that require an indirect antiglobulin technique. Under controlled conditions, chloroquine diphosphate dissociates IgG from the red cell membrane with little or no damage to its integrity. Use of this procedure permits complete phenotyping of red cells coated with warm-reactive autoantibody, including tests with reagents solely reactive by indirect antiglobulin techniques. Specimen Red cells with a positive DAT resulting from IgG coating. Reagents 1. Chloroquine diphosphate solution prepared by dissolving 20 g of chloroquine diphosphate in 100 mL of saline. Adjust to pH 5.1 with 1 N NaOH, and store at 2 to 8 C. 2. Control red cells carrying a single-dose expression of antigens for which the test samples are to be phenotyped. 3. Anti-IgG antiglobulin reagent. Procedure Step Action 1 To 0.2 mL of washed IgG-coated cells, add 0.8 mL of chloroquine diphosphate solution. Similarly treat the control sample. 2 Mix and incubate at room temperature for 30 minutes. 3 Remove a small aliquot (eg, 1 drop) of the treated test cells and wash them four times with saline. 4 Test the washed cells with anti-IgG. 5 If this treatment has rendered the cells nonreactive with anti-IgG, wash the total volume of treated test cells and control cells three times in saline and make a 2% to 5% suspension in saline to use in subsequent blood typing tests. 6 If the treated red cells are reactive with anti-IgG after 30 minutes of incubation with chloroquine diphosphate, Steps 3 and 4 should be repeated at 30-minute intervals (for a maximum incubation period of 2 hours), until the sample tested is nonreactive with anti-IgG. Then proceed as described in Step 5. Notes 1. Chloroquine diphosphate does not dissociate complement proteins from the cell membrane. If red cells are coated with both IgG and C3, only anti-IgG should be used in tests performed after chloroquine treatment. 2. Incubation with chloroquine diphosphate should not extend beyond 2 hours. Prolonged incubation at room temperature or incubation at 37 C may cause hemolysis and loss of red cell antigens. 3. Some denaturation of Rh antigens may occur. 4. Many serologists test chloroquine-treated control cells for each antigen of interest. Select control cells that are positive for the antigen corresponding to the antisera that will be used to type the patient’s cells. 5. Chloroquine diphosphate may not completely remove antibody from sensitized red cells. DAT results on red cells from some persons, particularly those with a strongly positive initial test result, may only be diminished in strength. 6. In addition to its use for removal of autoantibodies, this method can be used for removal of Bg (HLA)-related antigens from red cells. Appropriate Bg controls should be used. 7. If a commercial kit is used, manufacturer’s instructions should be followed for testing and controls.

Hello, can I ask if the patient's DAT was positive for IgG?

Please let me know if you can see these pages okay. Good luck!

Compared to the previous model , the ULtra CW , it is indicated that the variation of fill is just a bit higher. We use this model. In our QC/maintenance book, it indicates: For the Ultra CW (12 tubes) , the expected fill volume is 37-40 mL. For the Ultra CWII, expected fill volume is 34-38 mL. Notice there is a higher fill variation for the CWII.

I was an MLT student at Walter Reed Army Hospital. At that time, there were lab techs there that were enrolled in the George Washington University SBB program. They did their blood banking clinicals at Walter Reed. I heard the whole class passed the SBB(ASCP) exam after the course was over. There were only 4 or 5 of them, and they were all Officers in the Army. Every time I see them, they would be studying. The military put extra pressure on them passing the SBB exam because they are paying for their school, salary, and room & board.

It's a lot cheaper than most blood bank books you see these days. Most of its reviews I have seen are positive. It appears that the first and only edition of this book was published in 2014. I think it is great that it also includes an instructor's manual, lesson slides, and test bank questions.