Mabel Adams
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Everything posted by Mabel Adams
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Mom is not genetic mother of baby? Donor egg? One of mom's gene's is for a C deletion and baby inherited that one??? Or am I looking for zebras when hoofbeats only mean horses? (Sideline: I assume the A1 and B cells used were reagent reverse cells so they are both Rh neg--thus both c pos. So we don't know if the reactions to them are ABO or the anti-c, right? Don't know how much you would care either.)
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Platelet Utilization in Cardiac Surgery
Mabel Adams replied to sandy's topic in Transfusion Services
http://www.psbc.org/bcrm/index.htm Try this website for the Puget Sound Blood Center's online Blood Component Reference Manual. Maybe it will also give you ideas for your "Orange book". It looks like their site might have other useful info too. -
There is such a thing as DAT negative immune hemolytic anemia, isn't there? Occasionally an IgA or something??? Probably Issitt mentions it--maybe even Tech Manual.
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We use Gammaclone control. (Our typing reagents are all Gammaclone.) You can use 6% albumin and I think some use saline.
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Is this a bone marrow transplant using 2 units of cord blood as the source of bone marrow stem cells? If so, the patient's original immune system will not make any ABO antibodies and his new immune system, as it gets established, could eventually make both anti-A and Anti-B. He has tissue cells that will still express the AB antigens. I believe this sometimes absorbs out the antibodies made by the graft so he may not make much in the way of ABO antibodies. Still, I can't see where you could go wrong by transfusing O red cells and AB plasma. Platelets would be harder. It is customary to make sure the product is plasma compatible with the patient red cells before worrying about the ABO of the plts themselves, but you may have a hard time getting AB plts and will have to give whatever you have. Someone else can feel free to clarify if I have not got this right. I just can't stand an unanswered post for too long.
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We run a gel xm QC to test the diluent, testing a negative patient plasma sample and our reagent QC kit positive serum sample against a unit made up to 0.8% in the Diluent 2. We don't do gel DATs. They seemed to be almost too sensitive for general antibody ID workups. When working up transfusion reactions, that sensitivity might be more appreciated.
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Since units aren't really compatible in vivo in the presence of a warm auto, how do you all handle crossmatches? Assuming you found no underlying allos and no cold antibodies, do you: crossmatch the units by AHG with the absorbed sample but still turn it out as incompatible, IS crossmatch the units with unabsorbed sample to confirm the ABO type but still turn it out as incompatible, AHG crossmatch with unabsorbed sample and turn them out as incompatible, not crossmatch at all but call them incompatible, do some combination of the above or something else. My computer will insist I call them Least Incompatible because it won't keep the unit associated with the patient if it is entered as "incompatible." Or I could call them "compatible" and add some caveat to the results.
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I can't ever get the "Quote" button to work how I think it should--or at all for that matter. Maybe you could include that secret.
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Since this case was originally posted last July--maybe it's time to test the kid again! Of course most moms aren't excited to have their babies' blood drawn so it might be a tough sell.
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Could this be another subgroup of "A"?
Mabel Adams replied to lmeduran's topic in Transfusion Services
When was the platelet transfusion and was the donor type O? Do I understand correctly that the eluate did not react with any O reagent cells, but did react with A1 cells? if your sample was drawn soon after the transfusion of an O pheresis platelet, you may be finding passive anti-A in the eluate. It would be pretty much all stuck to the patient's A cells so it is not interfering with the back type. Was the crossmatch by an antiglobulin method or immediate spin? An antiglobulin method might be able to pick up a small amount of anti-A in the patient's plasma, but one would expect an IS xm to behave like the back type. Did you test the patient with anti-A1 lectin? ...Or is this what you meant by Anti-A1 positive? Then the question becomes, "Did you test the eluate against A cells?" -
Why is it coming out now that the FDA wants a variance when people have been using a 24 hr outdate for 10 years?
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blood storage refrigerator in operating room
Mabel Adams replied to ccmd's topic in Transfusion Services
JCAHO came out with a recommendation a few years back but it wasn't actually a regulation as far as I know. -
Spin Immediate Direct Antiglobulin Test??? Does that fit the context at all? Sounds like someone's computer acronym to me, but maybe I am out of this loop.
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Of course, the boss doesn't want us doing any work we don't get paid for. Charging for unordered work is fraud, I think. I appreciate your clarification. Thanks.
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I am confused. Why would the FDA require anything for outdating FFP in 6 hours instead of 24? I know there is a move to go to 5 days. Are we maybe not all talking about the same thing here?
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I'm guessing you are already automated, but, if not, be sure to plan space and work flow for that (and any other changes on the 5 year horizon). When we remodeled 10 years ago, we had a stand on wheels built for our plt incubator. It has file drawers underneath and a "bread board" that pulls out. It has often been near the plasma freezer and we greatly appreciated extra space on the bread board when logging in plasma etc. I am all for moveable furniture for future flexibility.
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My boss says we aren't supposed to do any tests that aren't ordered (although we don't offer the Rh alone) because it is fraud or something. It also has to do with being legally liable for having info about a patient that we need to provide to the doc. I am sure you could clarify some of this for us, Bob.
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If you strongly suspect a new antibody formed due to recent transfusion that might be mostly IgM (c3) but possibly starting to make IgG which would all be stuck to the transfused cells in circulation, then it might be worth doing an eluate, but otherwise, we wouldn't.
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For awhile CAP made it sound like they wanted us to keep it if we use a tube system to issue, but they reworded the standard so now it is covered by the nurse doing an ID check when hanging the unit. I haven't gone back to tossing mine again yet, but probably will.
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We don't offer Rh types alone. We have had no compliance issues.
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We will be going live with Meditech in the next few weeks. It took some building but we got it so it will warn when we crossmatch or issue Rh pos to a neg pt. Our old system, Hemocare, did this automatically. We aren't required to enter a reason. Hmm. Wonder if I could make it do that?
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Remember 9/11 when all shipping stopped? Anything could have been rare then.
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Ditto
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How expensive are these "buttons"?
