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sbraden

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    sbraden got a reaction from donellda in Agglutination when testing with Ortho screen cells in gel testing not present when testing with 3% screen cells converted to 0.8%   
    We see this fairly often from our hospitals. Often the reactions have an abnormal appearance, as in they have mixed field or uniform haze through entire column, but the auto-control is negative. Usually we run a converted panel from another manufacturer and 4-6 random units. All of this testing is usually negative. 
  2. Like
    sbraden reacted to David Saikin in Final Labeling- Segment Testing   
    I disagree with the statement that if the donor center retypes that the receiving transfusion service does not need to.  I think the transfusion service must retype red cell products received into their inventory from an outside source.
  3. Like
    sbraden reacted to John C. Staley in Thermometers for taking temp of returned blood products   
    Just a thought.  With an issue like this you have to come to a point of realizing that you can only do so much especially when much of the process is out of your control.  You can drive yourself crazy playing the "what if " game!  Once you've done the best you can for your situation then accept that there will probably be a fallible human somewhere in the process who will come up with a creative work around.  A nurse will put a unit in the medication refrigerator until she's ready for it or they will put it back in the cooler in OR after it's been setting next to the patient during the procedure, just in case!  Accept that you don't have complete control and never will, you'll live longer!  

  4. Like
    sbraden got a reaction from Ensis01 in Platelet donation   
    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 you do not shake it enough, the platelets will not release from the small bag and you will have clumping and even low-yield products. I had the exact same "What are you doing!?!" response. Some machines, like the Trima I think, will do the agitation internally.  Hope this helps.
  5. Like
    sbraden got a reaction from zafer in Blood unit incompatible with many patients   
    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 in reactions of at least one, usually two levels higher in Gel than tube. Unless whatever is happening is more IgM than IgG....... Then I think, do we all have Nabs that would react to some super low-incidence antigen? That was literally my thought process in 2 minutes, with no logical brakes. LOL. I'm not knowledgeable enough with this off the top of my head, so now it's time to read. Please post what the supplier says.  
  6. Like
    sbraden got a reaction from AMcCord in Donor re-typing   
    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 suggest the confirmation step at the hospital be removed, especially with electronic XM so prevalent now.  I guess it's been at least 6 or 7 years since we had one of these. 
  7. Like
    sbraden got a reaction from Baby Banker in Donor re-typing   
    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 suggest the confirmation step at the hospital be removed, especially with electronic XM so prevalent now.  I guess it's been at least 6 or 7 years since we had one of these. 
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