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May 2024 Challenge

GilTphoto

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Everything posted by GilTphoto

  1. GilTphoto
    We do a Type & Screen on all Labor Room patients. If anti-D is detected it's titered IF it reacts in a phase other than IAT, or if the IAT phase reacts 3-4+, to distinguish an immune anti-D from passively acquired from RhIG. Identification of other significant antibodies that cause HDN alert us to phenotype the baby for the antigen. If the baby's DAT is positive and the baby is antigen positive, we will watch the bilirubin. If it goes >15 we will put in an order for the <5 day, CMV neg, irradiated, leukoreduced, sickle neg, antigen neg, O neg, collected in CPD blood quad pack. Sometimes it takes a full 24 hours to get this unit, so we like to stay ahead of the game.
  2. GilTphoto
    We started using a Phlebotomist Witness Statement, that 2 people have to sign that they checked that the right patient was drawn, and they reviewed the labelling of the specimen and Typenex armband. Could be 2 Phleb, or Phleb and nurse, or 2 nurses if drawn from CVP. 2 signatures is a lot easier than 2 samples drawn by diff phleb and 2 ABO + Rh, which is what CAP recommends. We were just inspected by CAP + AABB last month, and the inspector liked our procedure. We also have a history check in computer. The only thing we were cited for was not having a ISBT 128 plan.
  3. GilTphoto
    Most of the time, when you get an anti-D on an OB patient, it's passively acquired due to antepartum RhIG, BUT, if you get reactions in any other phase other than IAT, or get reactions stronger than 2+, you may be dealing with an active immune response, and a titer would be recommended. Passively acquired anti-D rarely has a titer > 1:4, or reacts in other phases other than IAT We have had two mothers recently, who received antepartum RhIG, but the anti-D was reacting at IS and 37. Both babies had a positive DAT with anti-D eluted. One mother had a titer of 64, the other had a titer of 256. Her baby's cells typed Rh neg, due to large amounts of anti-D coating the cells. Neither baby required transfusion. Bilirubin went from 3.2 at birth, 6.5 day 1, 14.9 day 2, then started dropping.
  4. GilTphoto
    We just issue the 2 bags as is.
  5. GilTphoto
    Only 1 minute to spin? must be a fast centrifuge!
  6. GilTphoto
    Our Jewitt does the same thing. Every few months it dies. Sounds like a lot of people have the same problem.
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