huntilla

A problem I foresee with testing of platelets for bacteria using the eBDS is that those of us that lack a sterile docker or heat sealer are going to have a problem. Following is from the Pall website: Sterile connect the Pall eBDS Sample Set to the platelet product. Refer to Performance Data for optimal sampling time. It is much easier to have your blood center test the platelets (all apheresis are tested prior to release) but even here in North Texas with a large donor base we still transfuse about eighty units of random platelets a month. Up to twenty of those units require pH and glucose testing, now we are looking at not receiving products in a timely fashion for those patients with pooled platelet orders. Our local blood center performs testing on their own collections but not on units imported from the Metro blood supplier. So in the event that our local supplier has depleted all random platelet stock we will have to make arrangements to change the order to apheresis or wait until random platelets with testing performed are available. Yet another layer of complexity to add to the heap.

We were just inspected by the CAP last month and I have run two to three samples every six months for method comparison and the inspector was satisfied by our process. We only compare the type and screen resultsfrom our Echo to the tube method. Anytime we have a murky antibody ID we are confirming results in the tube method for resolution, I did not receive any negative feedback regarding lack of documentation for Antibody ID comparison. There will only be new and more onerous regulations developed as time goes on. North Texas Blood Banker

I have been asked to draw through the heart on a post-mortem as well, I had to defer that to the physician in one instance and in another I actually drew with guidance from a medical examiner.

So let us assume that the ER does not have ready access to a blood warming device, would it not be prudent to slip two units of blood into overwraps and let them equlibrate in a plasma bath for about ten minutes or so? I would proposition that this method would be preferable to running units through a warmer, you could then infuse the units through a large bore IV in a rapid fashion.

zygosity is the state of inheritance for the specific antibody system. If the donor/reagent cells are homozygous they express one allele(Jka= Jkb +) which leads to a stronger reaction when screening or performing antibody I.D. Heterozygous reflects inheritance of both alleles (Jka + Jkb+) and can lead to weakend or non-existent reactions when performing screening or I.D.

I believe that if the staff at the satellite facilty follow their policies and procedures they will detect just as many antibodies as gel technique or Capture. The overiding concern with quality of tube testing is a non-issue as most of the transfusions prior to the mid-90's were all conducted using the tube technique for antibody screening in most small to mid-sized hospitals. Tube testing or gel testing are only as good as the person performing and reading the results.

Secondly, there may well be a temperature difference at which the red cells and plasma are initially mixed in the reaction chamber of the cassettes. This temperature difference may only be subtle, but it may just be enough.for the auto-antibody/non-specific antibody to sensitise the red cells quickly enough to result in agglutination. "Cold reacting" antibodies have a tendency to sensitise red cells very quickly indeed under optimal or just "suboptimal" conditions, but are not as quick to dissociate. It could be that the temperature difference between the manual and automatic technique is just enough to make the difference.

Our limited history with the echo has detected two Kell antibodies in the four months we have been live. One sample was a previously identified Kell and one sample was newly discovered. We used Gel testing prior to implementation of the Echo and IMHO the sensitivity is equivalent. In our validation testing we had a JKa that the Gel technique was unable to detect. Both platforms have issues and ultimately are improvements on the subjectivity of manual techniques for antibody screening.

pHiX is a phosphate buffer additive that is used on non buffered saline and is available from Immucor (six bottles to a box) It is used for testing on the Echo and Galileo for standardizing the pH for the saline cubes(20 liter) that are used to refill the PBS supply.

this is a great idea when you have an adequate amount of sample for screening units. Are you drawing extra tubes during the validation process for known antibody patients? Also, are you doing a full antibody panel on known antibody samples or are you only running selected cells for antigens not previously positive? We run a full panel on known patients using the Ready-ID and perform tube testing for selected cells in the event that the answer is not clear from the Ready-ID result. Our Echo is currently down as there is a software glitch and the instrument QC is not recognized as a pass event even though no errors were displayed during initialization. Apparently this is a new issue and we are awaiting a call from a software specialist. Barr Antilla, Blood Bank Coordinator North Texas, USA

Did this error happen after a scheduled restart following weekly maintenance? Our Echo has been live for almost a month now and this error primarily occurs when cycling the power. My workaround is to power the printer off as well when turning the PC off. The error has not presented again since I started doing this about three weeks ago. Good luck, let me know if this helped. Barr Antilla, MT(ASCP), Blood Bank Coordinator North Texas

In the AABB Technical Manual, the grading of GVHD is broken into four tiers and monitors are the severity of skin rash, total bilirubin levels, and persistent diarrhea. Stage 1 T.Bili 2-3 mg/dL Stage 2 T.Bili 3-6 mg/dL Stage 3 T.Bili 6-15 mg/dL Stage 4 T.Bili >15 mg/dL This is from the 13th edition AABB pg.534 Although in reading the guidelines it seems that irradiation is necessary for ECMO transfusions, Bone marrow transplant transfusions(stem cell transplant patient), intrauterine transfusions, and familial (directed donor) transfusions. I would consult with your pathologist and determine what your policy needs to be, we do not take any extra precautions for irradiating blood for kidney recipients. The primary patients receiving irradiated products at our facility are post-marrow transplant.

Hope you agree with me ? (If I had been in your position, I would have taken immediate steps to initialise computerisation in the Blood bank ! After all, "EXPERIENCE IS THE BEST TEACHER " best wishes !

Well, I think it is wonderful to have only one copy of the bagtag floating around, we currently have three. We do not have a Blood bank software module and we use a sign-out tag printed to nursing, a "bagtag", and nursing faxes the original upon completion of transfusion. I am thinking of doing away with the faxing since we now have the choice to review online the medical record for transfusion discrepancies. In the near future we are going to implement Horizon Blood Bank and I am hopeful that this diminishes our hard copy filing to near zero. Barr Antilla, MT(ASCP) Blood Bank coordinator

A second tech will retype from a new tube when the patient is already an inpatient or an Er for a transfusion only (anemia/onoclogy patient). We will obtain new blood samples when necessary, otherwise we pull blood drawn within 48 hours. All pre-surgical patients with no history are a retype on the same sample with a new suspension prepared by the second tech. The intent of the CAP standard is to protect the patient receiving a routine transfusion