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John C. Staley

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  1. Like
    John C. Staley reacted to Michelle R in Premature baby with Positive Antibody Screen?   
    Interesting update. Received a very small amount of additional sample and performed a manual GEL (BioRad) crossmatch and it was compatible. Decided to try a 3% 3 cell screen (Immucor) converted to 1% for GEL testing and it was also negative. Very different results since we had been seeing pan reactivity in manual GEL previously (about a week ago). Possible preservative antibody that is neutralized (?) or non reactive in LISS tube? Hoping for more sample to perform repeat testing, maybe whatever it was has gone below detectable limits?
  2. Like
    John C. Staley reacted to jshepherd in Solid Phase Methodology   
    Hello! I've worked with Immucor over my entire 18 years in the BB - you should be able to reach out to your account rep for the info you are seeking regarding ABID troubleshooting. They have a collection of white papers that can help you. 
    Regarding your Rh negative confirmation in tube - that sounds like something specific to your facility. It's not an Immucor recommendation that I am aware of, nor do we do that at my facility. The CMT plates are literally just a blank microtiter well, so the reactions are very similar to tube, and are read the same way. The trouble with the instrument reading the reactions is that it will not detect mixed field or rouleaux and can have false positives because of that. 
  3. Haha
    John C. Staley got a reaction from Yanxia in Antibody ID   
    Most assuredly!!  She's a nurse and would not allow such activity unless performed with the upmost professionalism!  
  4. Haha
    John C. Staley got a reaction from Malcolm Needs in Antibody ID   
    Most assuredly!!  She's a nurse and would not allow such activity unless performed with the upmost professionalism!  
  5. Haha
    John C. Staley reacted to Malcolm Needs in Antibody ID   
    With a syringe and cannula I trust My Good Sir!!!!!!!!!!!!!!!!
  6. Haha
    John C. Staley got a reaction from Malcolm Needs in Antibody ID   
    Not many have my option.  My wife has an Anti-D, an Anti-K and for a short time a detectible Anti-s.  I would just draw some of her blood every so often.  

  7. Like
    John C. Staley got a reaction from Cliff in Antibody ID   
    Not many have my option.  My wife has an Anti-D, an Anti-K and for a short time a detectible Anti-s.  I would just draw some of her blood every so often.  

  8. Sad
    John C. Staley reacted to Malcolm Needs in Imelda Bromilow.   
    It is with huge regret that I heard today that Imelda Bromilow died towards the end of February.


     

  9. Like
    John C. Staley got a reaction from chupert in Ortho Panel A and B quality control   
    In all my years (30+) in blood banks and transfusion services I never QC'd panels and it was never addressed in any inspections/assessments.  When ever the subject came up I figured that if you were not QCing every antigen on every cell you were doing little more than providing some random inspector with smoke and mirrors so they would think you are doing something worth while.  A some point you need to trust the manufactures to do their job.  

  10. Like
    John C. Staley reacted to Cliff in February 2024 Challenge   
    Exciting news, we're only halfway through the month and have achieved the initial goal!  We have 56 responses.
    If you have not completed the survey yet, please consider doing so.  We'll review the data at the end of the month, post the results, and then start working on some of the suggested improvements.
    Thank you!!!

  11. Like
    John C. Staley got a reaction from SbbPerson in Timeline of repeating the antibody panel for a historical patient   
    Just a thought but you may want to check the AABB Standards instead of the Technical Manual.  Your question is more of a standards question than a technical one.  Since I no longer have access to the Standards this is the best I can do.

     
  12. Thanks
    John C. Staley reacted to SbbPerson in Timeline of repeating the antibody panel for a historical patient   
    5.14.4   A new sample shall be obtained from the patient within 3 days prior to transfusion in the following situations:
    If the patient has been transfused in the preceding 3 months with blood or a blood component containing allogeneic red cells. If the patient has been pregnant within the preceding 3 months. If the history is uncertain or unavailable. Day 0 is the day of draw. 5.14.5   In patients with a history of previously identified antibodies, testing shall be capable of detecting and identifying the presence of newly formed clinically significant antibodies. Standard 5.14.3.1 applies.
     
    5.14.3.1 When antibodies are detected, additional testing shall be performed to identify antibodies of clinical significance.
     
    Source: AABB Standards for Blood Banks and Transfusion Services, 33rd Edition, effective April 1, 2022 (Published: 12/21/2023 )
  13. Like
    John C. Staley got a reaction from exlimey in Temperature mapping in small refrigerator required?   
    I have no supporting references but for me, common sense dictates that in a space that small you could not get the probes far enough apart to get any significant temperature variations.  Having said that, regulations, requirements or other such problems seldom involve anything resembling common sense.  Much like common courtesy, common sense is seldom common.
     
  14. Like
    John C. Staley reacted to Neil Blumberg in Dealing With Cold Agglutinins   
    I don't think the AABB comments are evidence based.  Washing with 37 degree saline is extremely unlikely to cause false negatives with clinically significant antibodies,  and I'm unaware of any evidence that this is so.  Any such antibody would be very low affinity to be washed away by saline at any temperature, and unlikely to have in vivo/clinical significance. 
    As argued persuasively above by Malcolm Needs, anything that doesn't react at 30 degrees or above in typical serologic testing isn't going to cause clinical problems.  Patients are neither at 30 degrees nor centrifuged :).  Our serologic techniques are overly sensitive,  in general,  for clinically insignificant agglutinins. 
    No need for cold panels ever, with rare exception, and more for intellectual curiosity than clinical decision making.  Perhaps a mini-cold screen someetimes just to confirm you are indeed detecting a weak cold agglutinin in 37 degree testing, which disappears with prewarm technique. 
    Like Malcolm, I've never seen a patient with an hemolytic reaction due to an antibody that disappears with prewarming, in close to 50 years of clinical practice.  I know there are in vitro examples of clinically significant antibodies that weaken or disappear with prewarm, but I've never seen any clinical consequences.
  15. Like
    John C. Staley got a reaction from Cliff in Average age   
    Thanks Cliff, that is some interesting data.  When I was working in Utah there was a push for licensing Clinical Laboratory Scientists every couple of years in the state legislature.  What I found most interesting, surprising and some what alarming was that the most strident lobbying opposition came from physician groups.  My assumption was that they did not want to have to pay for qualified people to do the testing in their office and clinic labs.  

  16. Thanks
    John C. Staley reacted to Cliff in Average age   
    This is a chart of our members by age.
    It only includes those who gave a year of birth and are not banned members.  That came to 6,920 people.  There is no data validation on this; some people may have filled in just anything or mistakenly entered incorrect data.  With this large volume of data, the few stray values are likely nullified by the people who want to provide correct data.
     

  17. Haha
    John C. Staley reacted to Malcolm Needs in Average age   
    I'm sorry, but I just don't believe the member who says they are 122 (Oh, I dunno though - I've just looked in the mirror!!!!!!!!!!!!!!!!!!!!).
  18. Like
    John C. Staley reacted to Cliff in Average age   
    Great idea, working on it now.
    I have so many thoughts on this. 
    When I was in the hospital, we had several agencies we worked with.  They rarely had any candidates for us.  I'm not talking good candidates, I'm talking any candidates.
    Last year, I went to a conference where someone from the state (Tennessee) talked about different healthcare fields, the projected need, and the projected supply (of staff) rate.  For all fields, the need was higher than the supply.  For all fields (except one) the need and the supply eventually met - maybe in 1 year, maybe in 5.  For med techs, the need continued to climb over the years, and the supply of staff went in the opposite direction.  They never met.
    Med techs are not paid a fair wage.  We need to go to school for 2 or 4 years, earn little to no respect, work in the basement, and are offered poor pay and benefits compared to people with similar educations.  It's hard to fill these jobs.
    When I was in the hospital, my lab had 45 FTEs.  We had about a 20% vacancy for years.
  19. Like
    John C. Staley got a reaction from Malcolm Needs in Average age   
    Cliff, I've been glancing at the birthday list and it got me thinking (dangerous, I know), how hard would it be to run an algorithm that could calculate either the average age or the median age of group members.  It might give us some perspective on the need to recruit more people into the profession.  Just a random thought.

     
  20. Like
    John C. Staley got a reaction from SbbPerson in Crossmatching using automation   
    I'm not sure if this is still the case but the IS step was intended to confirm ABO compatibility.   

  21. Like
    John C. Staley got a reaction from Malcolm Needs in Crossmatching using automation   
    I'm not sure if this is still the case but the IS step was intended to confirm ABO compatibility.   

  22. Like
    John C. Staley got a reaction from REN_NH in Crossmatching using automation   
    I'm not sure if this is still the case but the IS step was intended to confirm ABO compatibility.   

  23. Like
    John C. Staley reacted to Cliff in COOLER FOR THE OR   
    Return of Non-Transfused Blood Products.docx
  24. Like
    John C. Staley got a reaction from Ally in Massive Transfusion Recipient   
    First question, is the patient actively bleeding?  If not and they just want to "top them off" then A neg is the choice.  If they are and your A negs are very limited then stay with the A pos blood.  As far as RhIG goes, as mentioned above, forget about it.  All it will do at this point is cause more problems.   That's what I would do.

  25. Like
    John C. Staley reacted to jshepherd in Twins to mom with hereditary spherocytosis   
    Sounds to me like you should only be concerned with the fact that you might be needing 2 exchange transfusions and a bleeding mom to occur at the same time. Busy, but not unmanageable. Maybe make sure you have blood and plasma per your SOP for the exchange in house, and plenty of A pos for mom. Good luck! 
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