tar1heel

So what is everyone going to do about clinically insignificant cold/room temperature antibodies that we avoid doing an IS crossmatch on and go straight to gel to get our compatible crossmatch? I'm referring to those anti-M antibodies that are not detected at AHG but create havoc at IS. Will we be forced to use M negative units for these patients?

If you have more than one tube submitted on a patient (for example, 3 microtainers on a child), after pooling the plasma, do you confirm the blood type on each of the tubes? Thanks for your answer!

Hi I would like to find out what other hospitals have established as their STAT turnaround times for a type and screen and an immediate spin crossmatch. I would also like to find out what your routine turnaround times are for these tests. Please include whether you consider yourself a small, medium or large facility. We are a large facility and I feel that the turnaround times we established over 10 years ago are no longer applicable because of the increase in our workload (at least a 50% increase from 10 years ago). The protocol of statusing all specimens from surgery as STAT has also impacted the number of STAT specimens we receive at the same time. In case you are wondering, our current STAT turnaround times are 45 minutes for a type and screen and 10 minutes for an I.S. crossmatch. It's the type and screen time that we seem to miss by just a couple of minutes. Thanks for your input! Happy Spring!

We had this problem and after sending positive specimens to Immucor (which they got as negative), we used some PHIX to buffer our saline to a pH of 7 (we purchase blood bank saline but we had never pH'd it - when we did it was 6.0 - too acidic). The buffered saline did the trick! We retested some specimens that had been positive and they were negative. So - check the pH of your saline. If you get it between 6.9 and 7.2 you should be ok. Otherwise, buffer it!

We also have Meditech, ours is Client Server. For ISBT labeled units there is no need to create a new product if you have the software and digitrax printer to create labels directly from Meditech. Our process is to take the unit and make 2 aliquots out of it when we receive the first request for an aliquot. We then relabel the mother unit as the A0 aliquot and the other aliquot as the B0 aliquot - the correct product codes etc print out on the ISBT label. Meditech tracks the DIN with an alpha in their system - but you can print a label without the alpha at the end of the DIN, and you can print assignment labels and the transfusion record (IT card) without the alpha at the end of the DIN. The part information (A0, B0, Ba, etc) can be placed on the assignment label and the transfusion record for positive identification with the labeling on the aliquot.

My interpretation of the statement on page 455 referred to by the original poster is that the author was stating what some "workers" do - they were not presenting 3 months as a "standard". Here is another quote from the Technical Manual 15th Ed. page 456, "In the case of transfusion reactions, newly developed antibodies initially detectable only in the eluate are usually detectable in the serum after about 14 to 21 days." Based on this statement, we perform an eluate if the patient has received blood components in the previous 4 weeks. Sandy

If you pack the cooler with ice below and above the blood/FFP - the temperature remains between 1-6oC. We validated this for a 12 hour period. Be sure to have barriers between the ice bags and the component - we use bubble wrap. We were never able to maintain a temperature range of 1-6oC with only one layer of ice.

AABB standard 5.13 states - "Bbood submitted for compatibility testing shall be tested for ABO gourp, Rh type and unexpected antibodies to red cell antigens." I don't know any one who is performing compatibility testing with FFP or PLT products. I believe the AABB does not want to take a stand regarding this issue. To those who have replied that they get a specimen for FFP every admission but not for a PLT, I think this is hypocritical. If you are concerned about the possibility of transfusing incompatible plasma in an FFP if the patient's historical type (determined in the previous 12 months) is incorrect, why are you not worried about incompatible plasma in a PLT? The plasma volume in a PLT is as much as an FFP - so what's the difference? To conclude, we do not require a specimen every admission for FFP or PLT if the patient has an historical type that was determined in the previous 12 months.

If the blood is remaining in the cooler in the OR it's storage, and you've got to find a monitoring device that tracks temperatures between 1-6 degrees - and so far I haven't found any that stick on the unit that capture this. They all go to 10 degrees which is transport only - not storage. Annually we validate our coolers (which are used for storage in the OR) by packing a mock unit with a thermometer in it with the real units. Upon the return of the cooler we record the temperature of the mock unit (which should be 1-6oC).

If you run into the voltage problem, ask your Helmer rep to purchase a transformer for you. We did and the problem is solved.