I'm hoping someone is bored this Christmas/New Year's vacation, and can help me get a jump start on a project. I've been sitting on this one for some time! Our current procedure states that if Ab screen results look as though a cold antibody may be present (Immediate Spin screen positive, AHG negative or positive), a "cold mini panel" with cord cells, etc. must be done, in the room temp, 18 degree C, and 4 degree C phases. This is in addition to a regular antibody work-up. The theory is that "you have to know what you're pre-warming away". It seems it's necessary to determine whether it's Anti-I, Anti-IH, etc. . They're also concerned that an Anti-E might be pre-warmed away. I know that happens, but how does ANY procedure cover that??!! The current procedure obviously is a tedious process that to me, has no merit. Our pathologist is typically VERY cautious, not wanting to miss anything. But I think the major reason this is done, is that our staff is mostly a cross-trained staff that doesn't work too often in the blood bank. Many don't have the basics of blood banking deeply ingrained, so they're trying to avoid a missed antibody. Just a guess?? Does anyone have some sort of flow chart already made up, that guides you through what to do, starting with Ab screen results? Oh- did I fail to mention we also do patient auto controls (patient serum with patient RBCs) with every screen? So, one of the possible scenarios is that only the auto is positive. (I'd also like to delete THAT from our procedure. Wouldn't we rather not know??) Please forgive my negativity here, but this has been a thorn in my side for some time!