CarolS

Jessica A, we are much like you. Haven't transfused a newborn in 10 years or so. Our policy is to issue the freshest O negative unit on the shelf and they would let us know the volume used. By that time, the baby would be long gone from here.

Hello... looking for some advice about records of antibody workups. We currently keep a folder for every patient with clinically significant antibodies. In this folder, we keep the antigrams , antigen typings, etc of each time we work up that patient. These are then stored indefinitely in a large file cabinet.. Every few years, I pull out the expired patients. Searching for expired patients used to be fairly easy.... I could pull them up using their SS# on Ancestry.com but that is no longer an option. How do you store these types of records and how do you eventually weed them out? I should say that we are a small rural hospital and we are only talking about 4 large file cabinet drawers. Thank you in advance for your advice.

Hello, We are a small rural hospital looking to update our massive transfusion protocol. Our current protocol utilizes a 1:1:1 ratio but there is some confusion about the platelet portion of that ratio. We use all apheresis platelets so have been issuing one apheresis pack for every 8-10 RBC/FFP units. Most of the literature that I have read refers to the 1:1:1 ratio, but not much is said about the use of apheresis platelets and how that affects the ratio. After how many RBC/FFP units do you give one platelet pack?

We have always done eluates on newborns with positive DATs.... a freeze-thaw when we suspect an ABO antibody, and an acid eluate when we suspect anything else. We are also looking to discontinue them. Thoughts??

Thank you to everyone who responded. This confirms what I was thinking and I don't know why it took me so long to ask. Old habits do die hard! Ok.... so then we only really need to do the auto with an antibody ID, then the DAT if the auto is positive. Are there some rules about when it is absolutely necessary to do an elution, or is it done with every positive DAT when the patient has been recently transfused? Another elution question.... when is it necessary on a cord blood? Currently we do an ABO/Rh and DAT on all newborns from Rh negative moms. Then we do an eluate on all positive DATs... a freeze thaw when we suspect an ABO incompatability, and an acid when we suspect anything other. Is this necessary, or could we only do one if specifically requested by the physician? Thanks again for all of your help!

I have a question for all of you blood bank gurus out there and I apologize if this topic has already been discussed..... we currently do auto controls on all patients who have been recently transfused (within the past 30 days), then DAT and elution if positive. Many of our patients are regularly transfused, so therefore have autos done with each screen. Many of them have positive DATs, so we are ending up doing many, many elutions. I can't remember how long it's been since we eluted a clinically significant antibody..... maybe 3 years. What are the recommendations for when auto controls, DATs, and elutions be done? I feel like we are just spinning our wheels! Thank you in advance!

Lara, I would be interested in that also please. My email is csmith@ovrh.org Thank you so much

Hello, Our emergency room has complained about the time involved in getting multiple units of FFP thawed in a trauma situation. They are actually willing to share the cost with us for a new thawing system. We currently have a Cyto-Therm III which is probably 15 years old. It takes every bit of 20 minutes to thaw 2 FFP, longer than that if there are more than 2 units to thaw. Could anyone recommend a unit which would thaw 6-8 units in minimal time? Thank you very much.