Everything posted by sbraden
I am going to make an assumption, (which I hate doing) and assume the part you saw shaken was the actual collection bag, which is surprisingly small. Shaped like a long rectangle? If it was an amicus system the manual actually calls for 2 re-suspensions before mixing into the plasma collected. The phleb will hold the bag firmly, with no slack between their hands and shake it lengthwise rather vigorously. The first time I saw this I curiously asked about it since I knew we usually treated them gently. Once it is suspended in plasma it sits "x" amount of time then is sent down to process lab. If
I work at a blood center and I can tell you that though super rare, mislabeling does happen. Not sub-groups, or variants, but actual wrong blood in the wrong bag situations. I have only seen a very small number of these and they always involve the most unbelievable, bizarre, "were they TRYING to mess up" situations. These situations usually result in 2 first time donors having their blood drawn into a bag labeled with one number and the tubes labeled another number, now both bags have the wrong blood/label. First time donors do not have history to catch these discrepancies. I would never sug
We frequently get samples on recently transfused patients that the hospital says have a negative DAT. Our DAT in Gel will be +/= and maybe a few +/= reactions in the neat plasma. The eluates often have easily identified antibodies with strengths up to 3+ in Gel. When we call the hospital to give report, we have been told several times that they gave crossmatch compatible blood before our work was complete. We sometimes perform eluates on negative DAT samples if it "makes sense" to us. Usually it's when we say to ourselves, "This might be a weak warm-auto if the DAT were +".
The original question was for all DATs, and this is from a reference lab perspective. We us Quotient for all three reagents. We use CAP. No we only VERY rarely use the scope, and it's at 10x rolling a tube and it's just for informational purposes. We also perform our DATs in Gel, with a significant difference between reaction strengths. Many times the tube is negative and the Gel is 1+ or 2+, so weak reactions should be caught there. Many identified Abs in eluates from tube negative, Gel 1+ samples. We HERE define optical aid to be a lighted mirror for tubes or laying the gel cards on an old s
As someone that works in a small blood collection facility, my first thought was how did this get through testing. Then I realized the problem is probably related to the antigens, not an antibody. First thing we check is DAT of the unit, which is negative. Then we would test against a couple of random samples from each compatible blood type, which you did. Then I would do a more elaborate ABO, which if there was a problem should have (in theory) been caught during testing. Then I thought about your reactions, 4+ tube, 2+ Gel, that's backwards from "normal" reactivity. Here we see a difference