keathwade

Thanks for all the responses. This is very helpful. I think that I have found that our current procedure and routine is within the "mainstream" of current laboratory practice. It is a good thing when questions like this arise. It allows an opportunity for a review of a particular aspect of our practice, where we can reassure ourselves that our current procedures are optimal and/or find some aspects of what we are doing could actually be improved. I was glad to find the bloodbanktalk forum! Thanks again. Keath Wade

Thank you to all the knowledgable blood bank talk participants.

I did neglect to mention the repeat type and screen, which is part of our first-tier testing. I was curious to see if any tranfusion services were going beyond the required testing as a routine. We have an opinion on the table that we are below the standard of care by doing only the Standards required testing in most cases, and so I wanted to ask how others feel about this. Also how often you find that clinical circumstances warrant additional testing, even when the standard initial testing is all negative? Thanks for the responses. It is very nice to find this blood bank discussion group. Keath Wade

Our transfusion reaction workup standard has been to do a clerical check, dat, and visualization of serum or plasma for hemolysis. If these are negative, then the workup is signed out as "no evidence of hemolytic transfusion reaction" and no further workup is done unless some unusual circumstance or finding is present to suggest something else be done. It is fortunate, I think that it is rare that any of the first-tier studies are positive and the workup is virtually all the time limited to the first tier studies. One observer at our laboratory has voiced an opinion that in virtually every transfusion reaction workup, this limited workup is not adequate, and that every workup should include pre and post total and direct bilirubin, LDH, and haptoglobin as a minimum. This observer feels that the current standard of care requires these tests be added to the first-tier battery of tests. Could members of this forum comment on what your standard first-tier testing consists of, and how often you find that you add more tests when the first-tier tests are negative? Thanks for your input. and Happy New Year to all on the Blood Bank Talk forum! Keath Wade