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My Chinese is a bit rusty, but if I am not mistaken, the underlined sentence states that we need to wash cord blood at least once before testing. Sorry, I am just kidding, I don't know any Chinese, I just read Yan's explanation.

I doubt it. We QC our saline in duplicate every day. Thank you for your input.

Yes, I was thinking wharton jelly too. This was a cord blood sample. Thank you

Will you be selling this book? Thank you

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I know this post is about 15 years old, but I recently came across a similar issue. I have always done DATs in tubes. But currently switched to gel. I am use to washing the cells when I do a DAT. I find it kind of odd that the package insert for the IgG cards doesn't include washing in it's procedure. Do anyone know exactly why? The insert said just to straight add 10uL of packed cells to 1.0 mL of your MTS diluent to get your 0.8% cell suspension. I got a weak positive reaction on a baby cord blood. I decided to wash the cells and the reaction came out stronger. Then I repeated this 2 more times and got similar results (see picture). All controls were negative. Has anyone experienced this ? And can I get your thoughts on this matter? Thank you so much, please have a nice day.

Not sure why is this very hard, maybe I am missing something. The patient is informed about the transfusion and all the risks involved and then they give or not give their consent. It is very hard in Ohio for the provider to get a consent form signed?

Several years ago, I met one patient with a card, She showed it to me when I drew her blood for a type and screen. I think she had Jka. She had no history and was visiting from out of town. Her physician recommended for her to keep her card on her person. First time I ever saw such a card.

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I know your post is 13 years old, but it got me thinking. Usually we QC out Anti-C3 reagent with the tube method, but I was curious to see what would happen if I used buffered gel card instead. This is what happened: 1) I converted my 3% C3 control cells to 0.8%. 2) I pipetted 50 uL this 0.8 cells into 2 wells of the buffered gel card, one labelled "pos" and the other "neg". 3) I pipetted 25 uL of Anti-C3 into the "pos" well. 4) I pipetted 25 uL of saline into the "neg" well. 5) I centrifuge the card for 10 minutes. The results are as expected. The "pos" was 4+ and the "neg" was 0. This was a stronger positive result compared to the tube method, in which we usually get is a 1+ to 3+ reaction. My conclusion is that maybe there was something wrong with your gel cards. Did you use MTS diluent or saline when you converted your cells to 0.8? I am not sure if that would matter, but considering your samples were weakly positive to begin with, maybe the conversion "diluted" the samples.

I found the really good video on CLIA competency assessment. Maybe it can help a little bit

For the manual isohemaglutinin(naturally occurring antibody) titration procedure, I attached the AABB method for it. Also the AABB method for early detection of hemolytic disease of the newburn. These procedures are from the current AABB methods manual. Method_3_15_manual_titer_procedure.docx Method 5_3_Titer_for_HDN.docx

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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/