Jane

Our hospital prefers to use the term birth parent instead of mom/mother.
I've been making a conscious decision to try and use the more inclusive terminology

Can you convert the tube panel cells from 3% to 0.8% and test in gel?  We primarily do that to run selected cells that are not already diluted to 0/8%

We frequently did this in the Reference Laboratory where I was the Manager (but you have to include both a positive and a negative from the "gel" technique into the "tube" technique - or vice versa, to ensure that the "sensitivity" of both techniques, while not being necessarily identical, are reasonably close).

Column agglutination technology is an excellent technique, but does have a tendency to detect antibodies that react at temperatures well below 37oC, even after fairly prolonged incubation at 37oC.  However, the fact that the blood group, including the "reverse grouping" is clear of atypical agglutination suggests that this may not necessarily be the case for this patient.

Just to be on the safe side though, and if you can, I would either treat the plasma from the sample with rabbit erythrocyte stroma (which will adsorb out most "cold" agglutinins), treat the plasma with 0.01M dithiothreitol (which will denature the J-chains of IgM molecules, meaning that, although they can still sensitise the red cells, they are no longer able to agglutinate the red cells) or, and my personal favourite, is to pre-warm the plasma and red cells to 37oC before mixing, perform the IAT at strictly 37oC in glass tubes, wash with saline warmed to 37oC and use monospecific AHG.  If any, or all, of these techniques lead to negative results, the chances are that the antibody is a clinically insignificant "cold" IgM antibody, such as an auto-anti-HI (given that the patient is group A, and the test cells are all group O)..

Failing the above, send a sample to a red cell reference laboratory.

I hope that helps a little bit.

See the attached.
SCHS Initial Training Checklist 2023.doc

I'm retired, so no more policies for me. 
While what you say makes sense, and is logical to include in your training, I am not aware of a requirement for it.  It was always a balance between adding more elements to the training plans, and getting staff trained, competent, and working.
I ran a large facility, and we were always understaffed by about 8 people, that's a lot out of 42 FTEs.

Thanks y'all! I'm a previous member that lost access to the email I had signed up with. Excited to get back in 

Hi,
If you want to send me a personal message with your prior account info, and which account you'd like to keep, I can merge them for you.
You do not need to do this, but some people who have prior posts, like to have them all under one account.
Cliff

Hello Ncjane,
Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions, please don't hesitate to ask.
Ncjane joined on the 01/07/2025.
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Welcome to this FANTASTIC site Ncjane.  Educating others is such a noble calling, and I hope we can all help you with your own calling to education.  ENJOY!!!!!!!!!!

I used Sunquest (a few years ago) and I thought for all discrepancies you could set what level of user could override it or maybe if it can be overridden. This may require a maintenance change that you or someone at your facility should be able to make.

Sounds like you have some co-workers who are having trouble thinking outside of the box. It's hard to change if you can't see beyond what you've always done. One of our retired employees was fond of saying....."So, what are you going to tell the lawyer when you are in court?" every time a patient safety issue came up. In this case, a patient dies or suffers a severe transfusion reaction and the reply would be..."We've sorry a bad thing happened to your loved one but we've never misidentified a patient before." Stick to your guns. It may take awhile but persist.

You know how it is John, you mention the word blood transfusion and it automatically becomes our responsibility.  

I joke that I do this correlation to prove that the methods don't always correlate.
I don't hand pick strong ones, I just randomly pick some positives and run them on Tango (solid phase), gel, PEG, and LISS. If they don't all agree, I explain why...the apples and oranges thing. In BB, if there was a perfect method that detects everything, we would all be using it, wouldn't we?