Eoin

In the absence of donor screening and if you are transfusing whole blood, you may well have to continue with the minor - or batch antibody screen your donor blood when recieved. You probably do not have another option as you will surely one day find the patients own cells haemolysing when he gets an antibody to an antigen on his own red cells. Sounds like you need some pressure on your blood suppliers. Good Luck Eoin

Wow, now here is a thread that has stayed the distance!!! I have been using Gel cards since first released many many years ago. That was in a hospital in Oz with large trauma and maternity centres. I have looked at this question a number of times (at others requests)> NOWWHERE in the literature does it say re-spin. Initial inspection of cards on receipt will show bubbles, or cards that have been shipped on their side. It is permissable to spin these to re-settle the gel. BUT it will not get rid of all nuisance reactions. Colloids and other plasma expanders would be one of my chief suspects (along with other s&%$) they pump in for ER or obstetric emergencies. The others like fibrin etc can be dealt with easily, but does mean a repeat. The others - Good Luck with all that. Experience is essential!! Remember, you can treat a patient with a reaction, but cannot help one who is exanguinated! Eoin

Ah, I think I am on to your wave length. I presume you mean donor plasma against recipient's red cells. This was dropped in the mid 1970's by most blood banks. The benefit is small. Donors are well screened for allo-antibodies at the time of donation. However we only transfused plasma depleted red cells - Packed red cells or PRBC. You will encounter HLA related antibodies and Anti-IgG if your are using a lot of products (Plasma, FFP, Platelets etc) but there are ways of dealing with them. A good reference for approach to any Transfusion Reactions you may encounter can be found on the web at www.BBguy.org Good luck with all. Eoin

Look up bbguy.org . Very good from a medical point of view. We follow his lead, but with a staged approach. Eoin

Welcome 30492. HAve only been aboard a short time myself, but the forums are great. Some great ideas come along. I have been a BB since 1968 (time I retired I think), but you never stop learning. regards Eoin

Welcome Paulis - are you referring to computer matching? Eion

I have seen this a number of times. I agree. Further full investigation needed. Mostly they have had Anti-D gammaglob somewhere else. I have seen what we considered at the time to be a true auto - anti-D, but that was back in the late 70's, so typing sera for D was still fairly crap then. Would love to have the patient again (was male incidentally). Experience showed if given D Pos blood, he haemolysed it but did significantly better when given D Neg blood. Can not remember his underlying condition (come on guys, it was 38-40 years ago). Quick investigation engeekay2003. Good luck Eoin. PS do tell us the outcome.

Opened fine Cliff. I have Office 2003, but have conversion apps for later versions. Regards Eoin

Hi Fellow slaves. We use clear plastic bags (overwraps) which the Irish Blood Transfusion Service (suppliers of blood / products / components) require to be left on till the unit is hung for T/X. This is audited by regulators. We also use RTBB0006 Labcold Blood Box a small red bx for transport to ward / theatre etc. to avoid bag being dropped and kept from public view. The company can be found at www.labcold.com. Cheers Eoin

Liz, Send me your email and I will send you our checklists. They specifically address ISO15189, and EU Drective on traceability and haemovigilance but I am sure you would find useful stuff in it. I use a vertical units audit and a specimen trace audit, but could send both if you are interested. Regards, W Eoin

Hi John, We use Mysis( or more correctly Sunquest as it went Sunquest - Mysis - Sunquest). They have been promoting a wireless PDA with scanner to us. It is due for release in the fall. I think they are calling it Transfusion Manager and it looks like it would close a lot of Traceabiliy and Haemovigilance gaps for us so we will be looking at it. It is due for release in the Fall (Going through FDA at the moment I believe). It is probably just for use with Sunquest though. Regards Eoin

We can pick stats on indivual medicos. We look at triggers, compliance with MSBOS, and C/T ratios for them. They know we are looking at these and compliance thus lower blood outdating has occurred.

Same sample, but back to the primary tube by a different Scientist. On call - back to the primary sample, using a different technique AND separated in space and time.

Ortho BioVue have it in their blurb supplied with Gel cards. email me if you would like a copy. Your manufacturer should advise on this. Cheers, eoin

Risk Assessment and management. We use pre-admission assessment Group, Screen and Save extensively for our Ortopaedic patients. We say 28 days, but if within 5 days over, the Q Manager will personally ( or medical scientist if out of hours) check that patient has not been transfused two months prior to or since Save sample drawn and authorise on individual basis. Plasma held frozen for 5 weeks + 1 if subsequently transfused (to cover Tx reaction workup in case of DHTR). Cheers, Eoin

Hello Marilisa, Welcome. Like me, I am sure you will find the forums in particular very interesting. You get a great feel for what is going on in the BB world. I have been in BB for some 38 years, but believe you learn something new every day. A quick scan every morning is almost always rewarding. Cheers, Eoin

Hi mrstymt I have recetly joined in to the BloodBank Talk Forum. I have 40 years bloodbanking experience, but still learn from the forum. Welcome and good luck with your career. Eoin

Ortho BioVue do have Anti-IgG/Anti-C3b, C3d/Control cards (at least in Europe). We routinely use them.

John Just FYI. I know this is not your law or requirement, but stemming from an EU Directive here in Europe, the issuing laboratory must fate the blood, and requires us to store Traceability Labels, which are returned at completion of crossmatch. This directive is enforced in European Member States by statutes from the contry in which you operate. Eoin

I worked with Prof Jim Isbister in OZ. He is a very dedicated transfusionist, and understands all angles of the business, so for him to come out with this, I feel we shoould take notice. However, it will cause a supply problem if we go off half cocked, so will wait and see for the moment.

I would hope the answer would be a universal YES. Eoin

We routinely double type patients, regardless of whether they have a previous record or not (records have known to be wrong - (e.g. older records may have incorrect RhD type for instance - before current generation of monoclonals). This is performed by a second scientist wherever possible. It is always done from the primary sample tube. It is done by an alternate technique (tube if original was in gel cards). On call, the scientist must perform a second type themselves, again sampling from the primary tube and using a second technique. This must be separated "in space and time".

Bloodbanking now comes under an EU Directive in Ireland. The authorised body to oversee this and licence bloodbanks is the Irish Medicine Board. ISO15189 accreditation is also required as part of this process. This has made us look at all our processes in some detail, and I have come to the conclusion that Lean will be the way of the future. If anyone has gone through this process I would also be interested in their thoughts. Has it had a great impact? Also what are the most beneficial aspects of the process. Many Thanks Eoin:confused: