marvy1

We have a database that downloads with or without network connection, all blood bank data 24/7. We also have an "iPeople" link that displays a downtime EMR Viewer icon during Meditech downtime.  The downtime EMR viewer shows BBK history and transfusion history.

Unfortunately in Canada, we cannot get pre-pooled cryo from our supplier. AABB Tech Manual does mention adding saline to aid in the pooling process which is what we do. I haven't done studies, but I would guess a substantial amount of cryo would get left in the bags without the help of saline to "rinse" it out.

I use large saline (2L) bags from dialysis and add a small amount of yellow food color. For fake blood, I got a powdered fake blood that I made a concentrate from and then add a small amount to the 2L bags. I then use smaller bags (300mL) and spike the large 2L bags with the smaller bags to make the individual components.

Unfortunately in Canada, we cannot get pre-pooled cryo from our supplier. AABB Tech Manual does mention adding saline to aid in the pooling process which is what we do. I haven't done studies, but I would guess a substantial amount of cryo would get left in the bags without the help of saline to "rinse" it out.

We are going to RFP this coming year for some new automated analyzers. We did a quick look this spring at what is out there. I am surprised no one is speaking about the Biorad analyzers:  newly released IH 500, IH1000 (Gel based) and Tango Infinity (4th generation solid phase analyzer) along with stand alone  Gel readers and centrifuges. Although we are not sure which direction we are heading, I think they are certainly worth mentioning.

We are going to RFP this coming year for some new automated analyzers. We did a quick look this spring at what is out there. I am surprised no one is speaking about the Biorad analyzers:  newly released IH 500, IH1000 (Gel based) and Tango Infinity (4th generation solid phase analyzer) along with stand alone  Gel readers and centrifuges. Although we are not sure which direction we are heading, I think they are certainly worth mentioning.

We also use in IgA deficient situations. And one time with a patient who had presistent txn rxn (rigors and SOB) with no known antibody issues.

I have seen a Rh positive patient transfused 3 Rh negative units and subsequently tested on the Echo. Echo reacts negative with both Anti-D4 and D5. When taken to the tube, get a 2-3+ mf reactivity with Anti-D reagents.

I think those who are in the market for automated blood bank analyzers also need to look at what Bio-Rad is coming out with. I think both their Gel and solid phase automation platforms should be compared to the other vendor products.

We get a lot of patients reacting like this. Attribute reactivity on the Echo to an autoantibody. Do need notice cold autos coming up that much, so assume it is a warm (Echo supposedly on reacts with IgG). I'm guessing if you do tube DAT it might be microscopically positive for IgG? If saline IAT  tube reactivity is negative we issue blood that is compatible by that method, especially if the patient was not recently transfused. I find autoantibodies love solid phase method.

Tightening or loosening the belt on the strip carrier can optimize the strength of the reverse cells. On the Echo I have found the strengths to normally be at least 1 grade less than tube strength. With regards to Gel vs Echo, I have found approx equal number of clinically signficant antibodies on either method that were not found on the other method (We use both Gel and solid phase methods)

I have used many Lab LIS systems over the years including Meditech and Soft. The set-up and underlying code of the Bank module in Soft is logic based. I am unsure what the Meditech system is based on, but it is not logic.

I have used many Lab LIS systems over the years including Meditech and Soft. The set-up and underlying code of the Bank module in Soft is logic based. I am unsure what the Meditech system is based on, but it is not logic.

We have 2 echos for our primary testing. As well, we use Gel, PEG and SIAT for secondary methods. We get samples referred to us from other hospitals who almost exclusively use Gel. We notice that the referring hospitals have pos screens by gel and that we identify various antibodies by gel (E, K, S) that are either completely missed by Echo (Neg screen/ Neg panel) or only found on the Echo by panel testing (Neg screen/pos panel). I have brought examples of these to Immucor tech support and they did not really give me a good reason as to why this is happening. Will continue to bring examples to them to see if they continue to give me the same responses.

Consider asking Meditech, if it is possible to do a customization so that blood types from the historical conversion are treated as tested blood types.
 
Allow me to translate the above sentence: Consider asking Meditech if it is possible to do a customization so that their Electronic crossmatch actually works the way it is suppose to work.
 
We are going to start working on Electronic XM in Meditech and I'm so impressed that once again Meditech proves they really know nothing about Transfusion Medicine. I was also shocked to hear that someone else did a conversion of historical data in Meditech. It took us over a year (and many many software changes and fixes) to accomplish that conversion. In other computer systems, blood bank conversions can take 1-2 days.

Consider asking Meditech, if it is possible to do a customization so that blood types from the historical conversion are treated as tested blood types.
 
Allow me to translate the above sentence: Consider asking Meditech if it is possible to do a customization so that their Electronic crossmatch actually works the way it is suppose to work.
 
We are going to start working on Electronic XM in Meditech and I'm so impressed that once again Meditech proves they really know nothing about Transfusion Medicine. I was also shocked to hear that someone else did a conversion of historical data in Meditech. It took us over a year (and many many software changes and fixes) to accomplish that conversion. In other computer systems, blood bank conversions can take 1-2 days.

We routinely use Anti-AB to retype our Group O blood units coming in from our supplier. It is cheaper than using Anti-A and Anti-B for that purpose.

We routinely use Anti-AB to retype our Group O blood units coming in from our supplier. It is cheaper than using Anti-A and Anti-B for that purpose.

We routinely use Anti-AB to retype our Group O blood units coming in from our supplier. It is cheaper than using Anti-A and Anti-B for that purpose.

John Moulds wrote a one-page QandA on this topic in the AABB news (Jan 2010). In sum: don't go looking for a cold ab...if it shows up in the ABORh testing for a cardiac case, there may be use in doing a 28 or 32C thermal range test (as well as the regular 37C). 4C testing is pretty much useless as most everyone reacts at that temp.
 
Malcolm Needs also replied in a similar topic thread back in Feb: 
 
There has just been a reveiw paper published on the is very subject.

Jain MD, Cabreeizo-Sanchez R, Karkouti K, Yau T, Pendergrast JM, Cserti-Gazdewich CM. Seek and You Shall Find - But Then What Do You? Cold Agglutinins in Cardiopulmonary Bypass and a Single-Center Experience With Cold Aglutinin Screening Before Cardiac Surgery. Transfusion Medicine Reviews 2013 http://dx.doi.org/10...mrv.2012.12.001.

Basically, it says that doing such screens before surgery is a waste of money!