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Thank you, Malcolm. That was a very kind thing to say! Maybe we could get you to the Chicago area for a conference sometime! Donna

Soooo sad that I can't join you!!! Donna

On Friday Immucor Service suggested that I clean the washer manifold and try a different lot # of indicator cells (which we had just received, fortunately.) I did those two things and the Echo behaved nicely over the weekend. (So far, so good.) (Still, it's strange that the Ready-ID panels were always trashy or up to 3+ positive, but the Extend panels were just fine.) Donna

We are seeing a lot of unexplained reactions on the Echo since we started using the Echo Antibody Screening Strips Lot # 535 and the Ready ID Panel Lot # ID239 the last couple days. The Echo Antibody Screens are Positive, many cells of the Ready ID Panels are Positive, but "Extend" panels on the Echo are Negative. (The Antibody Screenings by manual tube testing with PeG are all Negative.) Anyone else having a problem lately? Donna

Once again, I agree with goodchild.

I'm with goodchild.

Agree!

I do the same.

Monthly reports may also include information such as: Total # of units transfused (broken down into components) # and kinds of transfusion reactions reported # of massive transfusion cases # of technical errors # of clerical errors / corrected reports # of specimen labeling errors (broken down into types and who collected them) # of wasted blood products (& reasons) # of QC failures Total down-time of instruments/equipment (& reasons) Turn-around-times of Stat crossmatches # of complaints (& reasons)

Yes. Our form that the physician must sign has areas for the following (and the tech checks which box is appropriate): 1. Issuing incompatible blood. 2. Antibody is present, not ID'ed yet, and crossmatch is compatible. 3. Pt has history of clinically significant antibody and crossmatch is compatible, but unit has not been screened for antigen.

Thanks for sharing, Dr. Pepper & Karrieb61. Beautiful memories. Wishing everyone a Merry Christmas and a wonderful New Year. Donna

I will start the ball rolling with how we handle some of the issues you have addressed: 1. Antibody is present, but not ID'ed yet, and crossmatch is compatible: We have a form that states that the antibody has not been identified, and although the crossmatch is compatible transfusing it does carry some increased risk because it has not been screened for the corresponding antigen. Ordering physician has to sign the form. (Pathologist is not usually notified.) 2. Patient has a history of a clinically significant antibody and the crossmatch is compatible: We have a form that states that, plus the comment that transfusing it does carry some increase risk because it has not been screened for the corresponding antigen. Ordering physician has to sign the form. (Pathologist is not usually notified.) 3. Antibody is present, but not ID'ed yet, and crossmatch is incompatible: We have a form that states that the antibody has not been identified and the crossmatch is incompatible and carries an significant risk of a possible hemolytic transfusion reaction. Ordering physician has to sign the form. Pathologist is notified that we are issuing incompatible blood. The above situations are spelled out in our policies/procedure manual. In any of the above situations, if the supervisor or assistant supervisor is present they are consulted and get involved in the situation (to make sure we are doing the best/safest thing for the patient.) If supervisor or assistant supervisor are not present, whether they are consulted/notified depends on the expertise/experience of the tech involved. All staff are certainly welcomed to call us at any time, but a few of our experienced techs are comfortable handling the situation. Donna

Welcome to pathlabtalk, Serafin! Donna

We, too, just used the current lot number of the FMH this morning and our Positive Control did not work.

Besides the technical issue, I believe that if you order (and charge) a Medicare patient for tests that are not performed (ie: Antibody Panel), it could be considered to be Medicare fraud. (That's not somewhere you want to go!) Donna

We are a little larger than your facility, WFMB. We've had an Immucor Echo for 7 years and have been satisfied. It's just right for our size. Donna

We have to have a group & type on a current valid patient sample for red cell transfusions. However, we will issue plateletphereses and plasma based on their historical information (ie: if name, medical records number and birthdate all match our previous records.) Donna

I agree with Kate also. Donna

Oh, wow!! Thanks for the article. I will share with my staff. So glad that your event had a positive outcome. Incredible!!

Hmmm....Wonder why we haven't heard about it until this year. Thanks, Ann. Donna

I believe this is something new. I have been told that we should be receiving our customized CAP checklist soon. (Our next CAP inspection is due in the early months of 2015.) Donna

I totally agree with you, DebbieL!! Donna

I would probably be a little more cautious if the patient had been transfused during the several weeks before the first specimen was collected (in case he is still building new antibodies in response to a transfusion several weeks ago.) Donna

Megan - Since CAP does not offer an automated DAT survey (as far as I know), my suggestion would be a variation of the #2 option in your list: 1. Perform your regular manual proficiency testing on the CAP-DAT Survey samples (and report your results to CAP.) 2. Then perform the DAT testing on the CAP-DAT Survey samples on your Echo instrument. 3. Don't submit your Echo results to CAP. Rather, keep the results in a file. When you get the results report from CAP, compare the report with your Echo results, document whether your Echo results were satisfactory, and have your Pathologist Medical Director sign and date this (and return it to your file.) Donna

Hospital staff that transports blood products are trained on the delivery protocol (and what to do and not do, then, etc.) They are then observed/evaluated by their superior. Is annual competency testing actually required? I realize that it is a good idea, but isn't annual competency testing mandatory only for "testing" procedures?