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April 2024 Challenge

Mabel Adams

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Everything posted by Mabel Adams

  1. Mabel Adams
    For those that are borrowing a hematology tube: do you just spin it down and ruin it for the add-on retic or WSR, or do you pour part of it off into another tube to spin down?
  2. Mabel Adams
    We have only phlebs drawing which simplifies things. We recently instituted a Draw and Hold test in the computer. This test has to be ordered whenever extra samples are collected. That creates a track in the computer and a label for the specimen. BB has used a similar test called Band Only for many years.
  3. Mabel Adams
    How does surgery handle these when the wristband with the blood loc code is often under the sterile drapes? Do they have a formal policy to record the wristband number when the patient comes into the room and for the duration of the case they refer to what they copied down?
  4. Mabel Adams
    Wouldn't it be a slightly big deal if the D neg test happened to be the first one done on that donor--at least for the recipient of that supposedly Rh neg unit?
  5. Mabel Adams
    I have a feeling a lot of ORs would quietly exempt themselves with a pair of scissors!
  6. Mabel Adams
    The Tech Manual says to use saliva from known secretors and non-secretors as controls. It also lists under "Reagents", "Human (polyclonal) anti-A and anti-B. Note: some monoclonal reagents may not be appropriate for use, therefore, apprpriate controls are essential." Saline is also run. The anti-A used is diluted till it produces a 2+ agglutination. For testing the A substance only, I would have 4 tubes: 1) known secretor's saliva +Anti-A, 2) known non-secretor's saliva + anti-A, 3) saliva being tested + anti-A, & 4) saline + anti-A. After these incubate, A1 cells are added to each tube to see if the A substance in the saliva neutralized the diluted anti-A. Now that I have thought it through, only the non-secretors would produce agglutination so in a way that is actually the positive control--at least in my brain.
  7. Mabel Adams
    OK, I am reading the secretor procedure in the Tech Manual. I don't have anti-Lea nor anti-H lectin, but I suppose we don't really care about anything but A substance for this experiment. My only source of polyclonal anti-A would be a patient or volunteer. I can come up with a positive control secretor, but not sure I could come up with a negative control. The other problem I have is time. Does anyone have any of that to loan me?
  8. Mabel Adams
    Shily, your question about the A substance is interesting. Marilyn, is it possible that the A substance in the serum used to dilute the anti-A1 lectin could adsorb out the lectin in addition to the other cause of weakening that you mentioned? Maybe I could do some experimenting because I am married to one A2 that is Lea and Leb neg and I gave birth to another. I am A int and Leb pos so my daughter could be a secretor. I am not sure I have time or materials to do secretor studies on them, but I could probably provide someone some samples. I could do the A1 lectin dilution with my husband's A2 (possible non-secretor) serum/plasma and see if reactivity drops off like it does for everyone else.
  9. Mabel Adams
    "American Association of Blood Banks" lends some recognition or credibility to a regulation or other information for a layperson. "AABB" tells them absolutely nothing! There has got to be a better way to be global and inclusive than to make your name meaningless. How about "All-around Association of Blood Banks" or even "All-star" or "All-the-world" or "Amalgamated" or just about anything else. Or change the letters to GABB-Global Association...
  10. Mabel Adams
    Marilyn, I heard you had retired. Glad to see you aren't just tending roses or touring Europe but have stayed to keep all of us blood bankers educated.
  11. Mabel Adams
    Bob, this simply won't work. What are you going to do with your repeat patient who has had his forehead blown off? Where is your chip then, huh??? Name me a body part you can attach it to that will never be injured or surgically removed. You can't even imbed it in the brain, as we all know of some people that seem to lack that organ. Keep trying. I am sure you will think of a sure winner yet.
  12. Mabel Adams
    Almost all blood that leaves our lab goes via pneumatic tube in plain zip-locks (they are way cheaper than bio bags in addition to their not mistakenly labeling the blood as biohazardous). So far the few units still picked up go out "naked", and probably still will--until one breaks.
  13. Mabel Adams
    We haven't seen any software police yet.
  14. Mabel Adams
    OSHA actually lists tested blood products for transfusion as specifically exempt from the Biohazard designation...or did last time I checked. Bob, when was that we were looking that up? Last year sometime? I can't find it on the AABB site where I think I posted it.
  15. Mabel Adams
    Did the audioconference touch on any ways to meet this requirement without doing 2 blood types on separate specimens or adding a high tech or barrier system? In other words if you have a good system--even if that is only that your phlebs do a consistently good job--so that you can give some evidence of a sufficiently low error rate will they accept that?
  16. Mabel Adams
    Also, do you use monoclonal anti-A reagent? How strongly does it react with A3 cells? Is it as weak as with human source anti-A?
  17. Mabel Adams
    Shily, you do great with English! It seems like the only things we have trouble understanding are things that are done differently in your country--not your English. Even if some syntax isn't perfect, you get the main ideas through clearly. I am impressed by your willingness to join this forum as a non-native speaker. You are educating us about ways things are done in other countries' blood banks. Thanks.
  18. Mabel Adams
    We treat the cells with EGA to remove the antibody, then proceed with the weak D test. We haven't had to do one for a long time.
  19. Mabel Adams
    If we only have to do this in "non-emergent" cases how are we defiining this? Are all stats emergent? I believe from the debate about computer crossmatches, it was established that we can charge for the second blood type, right? Seems like it will be time-consuming to verify that the techs are actually doing the second type on all patients without historic types and non-emergencies (and AB Pos ladies over 104 years old with red hair...or whatever else CAP dreams up).
  20. Mabel Adams
    Except for the new CAP item (50575 or something) that seems to strongly suggest reyping patients. On the AABB site I asked if anyone was planning to meet this requirement by doing anything other than retype the patient and no one answered. This CAP requirement is the one I have to meet. I may choose a method that also meets the electronic xm requirements because we may want to go to it anyway if we have to do all the work. As for other techs doing the blood type--they already have full-time jobs and we are understaffed as it is. It isn't whether they are capable opf learning, but whether we can further disrupt the workflow of the whole lab to pull them into BB. Not that this is impossible, but we will be begging if management and the other depts don't buy into the necessity.
  21. Mabel Adams
    Bob, whose CCC do you use? Mine are apparently at least partly Rh pos so don't work well in your recipe--it comes up weak pos to 1+ at IS with anti-D. The other recipe is, as we would expect, rather more mixed field, but workable. Thanks. My supplier sends out their donor testing so doesn't have many weak D samples either.
  22. Mabel Adams
    I am trying to figure out a way that a small place can do anything meaningful with the new retyping rules. We seldom have more than one tech working BB and on nights have at least some time when there might be only one tech in the whole lab. Weekends occasionally have only one tech trained to do BB on duty for at least a few hours. Do I try to have the second type done by another tech maybe hours later--maybe flag the units that they can't be issued till the repeat is done??? Or do I just meet the letter of the law and have my same tech toss the cell suspension and repeat the type himself? I don't really want to have separate rules for different shifts, but I also want extra work to provide some meaningful benefit.
  23. Mabel Adams
    I inspected a hospital lab for CAP last Friday. They only store and issue blood that is crossmatched remotely. All the crossmatch questions were in their checklist, yet it said it was a customized checklist. They were missing the donor and tissue and parentage sections as I recall. (Or maybe parentage is separate now anyway.) BTW, we inspected on Friday and the end of their 6 mo. inspection period would have been this Mon or Tues.
  24. Mabel Adams
    I am so glad to see that St. Baldrick's is a legitimate charity (over 88% of funds go to programs per Give.org). I was afraid it was someone's spoof on Cliff's appeal for the heart association. The internet seems to have fostered a culture of mean-spiritednes--often hidden by anonymity, but there is no call to decrease civility and plenty of reason to increase it! Even if we disagree we can be kind and civil about it, no? OK, off my soap-box.
  25. Mabel Adams
    What system are you on? We did manual BB billing, first entered straight from a free-standing BBIS billing print-out to the billing computer--then manual entry into Meditech. Now we have the BBK module of Meditech so I have built it that way too. It was pretty labor-intensive to do manually and required someone that understood the system.
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