[XM for a newborn with mom's specimen]

You need a specimen drawn after delivery which is less than 3 days old.

[Same Day Slides]

Slide review only once every three days unless significant change in measured parameters

[Anti-D after RhIg injection]

We do same as adiecast and if there has been documented RhIg injection, we do not titer

[Recipient notification]

David is correct--for our lookback program for any infectious disease, we notify the recipient's physician with a request to return information about any additional medical history that may be related to the transfusion. It is up to the physician to notify the recipient if he/she thinks it is necessary; we do enclose a letter from our Medical Director to the recipient if the physician wishes to use it.

[RHIG Workup]

Post partum but no dilution.

[Gel testing anyone?]

What is your goal by changing to gel? Gel is a good time saving method when testing multiple samples; however, it is much more sensitive than tubes methods and there will be times you will need to revert back to tube testing. Gel is not a cure-all for blood bank testing.

[Blood Distribution Staff Qualifications]

Why can't you tube to directly OR, ED, and all nursing stations? That would save at least 4 FTE's not having a distribution station and/or eliminate a refrigerator or vending machine.

[3.9.2 Computer Systems Records]

Any time you have computer downtime and use your downtime procedures, record it as a test. Especially when you have scheduled downtime.

[basic qc on machines]

According to New York State, JC, and AABB you must QC with at least 1 positive & 1 negative reaction for every cell and antisera except for antibody ID panel cells. Makes no difference if it is automated or manual. If you use different reagents for manual testing, then you must test those if you use them that day. Rare antisera/cells must be QC's each day of use.

[Abbott's Architect]

Best system on the market today for hospital lab setting. Having said that, it is not perfect. The biggest issue is that reagents & supplies cannot be loaded while the instrument is running patient samples. It is imperative that the daily startup includes loading adequate reagents & supplies. It is reliable, fast, easy to use, small sample size, open reagent system for chemistry side but not for immunochemistry. If you have specific questions, send me a message and maybe we can chat on phone.

[Shelf life of whole blood collected]

You are sure of the 4-8 temp? I do not recall ever seeing anything in CLIA, AABB, or FDA stating storage at any temp other than 2-6 and transport at 2-10 degrees. As far as the tie knot, I used it 30+ years ago on rare occasion and it worked fine.

[Electronic crossmatch billing setup]

You do not say where you are from but if your are in US and have Medicare/Medicaid patients: EXM is considered the same as a calculated test like Anion Gap or INR, and cannot have a $ charge to it. You can and porobably should show it on the bill, but the charge must be $ 0.00.

[ABORh Recheck -]

According to CLIA regulations, Moderate Complex testing (ABORh is considered this) must be performed by a medical laboratory technician or medical technologist. If this person does not meet the educational standards for either, then she cannot perform the tests.

[Validate IV infusion pumps used for blood products?]

One hospital that I worked in the BioMed Dept checked all that at least twice per year. The records they had from the manufacturer were flawless. There were tests to check free-flow prevention. Delivery volumes at low rate and high rate, those with warmers had temp checks with volume load and a specific test for cutoff temp.

[Misc Gel Reactivity: Grrr!]

David, you are sooooooo correct when you say gel and capture are toooooooo sensitive. It is that reason that we can not remove tubes from our testing. Too bad there is not automated tube testing!!!

[Need HELP with extended antigen testing worksheet...]

Adiecast, your worksheet looks very nice. I am going to update mine to the same. THANKS!

[Platelet Utilization]

Part of yearly report to NYS Health Dept

We expire approx 4-6 per year. We are 2 hrs from supplier.

[Platelet Utilization]

Part of yearly report to NYS Health Dept

[For routine ABORH, is it a must to run against O cells ?]

Have never run routine back type against O cells--for reasons that Malcom states.

[Transfusion Reaction Benchmarks]

In New York State, every transfusion service must report all transfusion reactions to the state Health Dept each year. There may be some data at www.wadsworth.org, which is the lab/blood bank website. I will try to search in next 2-3 days and post more if I find the info.

[historical and present blood groups don't match]

The IS dept or Meditech should be able to trace the registrations, from what I was told from Meditech--every keystroke is tracked, but for how long that info is kept I am not sure.

[specimen requirements]

The original formula for gel seperator tubes would give a false negative results. There was a phenol molecule in the gel that would tend to seperate some IgG bounds (at least according to the Corning Medical PhD's who invented the original gel. This goes back to the very early 70's (1971-73).

[Keeping outdated Antigrams and Panels]

Those sheets that have patient results on them would be considered a worksheet. In New York State, worksheets must be kept 1 year. Also keep in mind that many of these panels repeat with same donor (by the donor number) so you can track changes in patient reactivity if you keep them when you have the patient present nine months from now. When I have a patient with a history of antibody, I like to see if the "pattern" has changed.

[historical and present blood groups don't match]

I would change Meditech to unknown and follow SMW's advice.

[RhIg or WinRho to Rh negative patients receiving Rh Positive blood]

The standard states you need a policy, it does not say you must give it.