ANORRIS

We screen units for Kell only for those with Anti Kell and Sickle Cell recipients. 

My Helmer D8 has a lot calcium deposits, which I thought was rust.  I use distilled water and Cleanbath.
Any ideas how I can stop this from happening?  I am on my 3rd order of new baskets.
 

In a grammatical sense, and from one who has studied Latin, isn't the usage dictated by the indirect object of the sentence? You're adsorbing bound antibodies to phenotypically known cell lines, and therefore interpreting the product that had antibodies pulled towards it. The whole point is to take off the antibodies (direct object) in a way you could identify them to selected RBCs (indirect object). Up for debate  

I think you have to rule out C and E using r'r and r"r cells.  Only very rarely does one find r'r' and r"r" cells (probably reference labs have some frozen). 
When you are r/o anti-D due to RhIg injection I guess you can go with single dose ag strength.  I adjust my anti-RhIg panel to include double ag doses whenever I can, except for C and E.

Except that you don't have much choice to r/o anti-C or anti-E but r'r and r"r cells.   We're talking RhIg anti-D, which is usually 1+ in gel

Whether it is residual RhIg or a developing allo-anti-D we (on the front lines) still have to r/o C and E with the heterozygous cells.  Granted, we can run w PeG or enzyme pretreated . . . to increase the sensitivity.

I think what you are doing is acceptable.  I am in the same boat.  I had a procedure for splitting units but can no longer comply w the labeling regulations.  I've never had an order and would recommend transfusing rbcs the same way you do.

If we only do D typing on babies from D negative mothers and a weak D or Du test needs to be performed, the results of the weak D is only valid if the DAT is negative, so a DAT would need to be performed. Therefore, an ABO and DAT would be a good place to start. Just my thought.

Why is the blood getting warm a problem (how warm is too warm)?  It's signed out; it's going to get warm.  The tube is not storage.  Don't need to maintain storage temp.

DRAMA TRAUMA...LOVE IT!  LOL

We will draw blood is the patient is receiving a transfusion. We put a comment on the results stating the patient was being transfused at the time of draw. We will draw a patient 15 minutes after transfusion. Here is the reference we used for our policy.
 
Elizalde, J.I., Clemente, J., Marin, J.L.,Panes, J., Aragon, B., Mas, A., Pique, J.M., Teres, J. "Early changes in hemoglobin and Hematocrit levels after packed red cell transfusion in patients with acute anemia." Transfusion Practice. Volume 37. (1997): 573.

Scott, you are kind of contradicting your self here.  In one sentence you are advocating avoiding the production of anti-c which can only be accomplished by screening units and transfusing c= units.  Then you say it would be nice if you did not have to screen for units.  I see a conflict here.  Bottom line, it's a gamble.  Either you screen for c= units now to prevent anti-c  or you take the chance they won't make anti-c and if they do you start screening units then.  The latter was always my choice. 

This is the form developed by our system transfusion managers.  It was based on a sample document shown in a CAP Focus on Compliance webinar a few years back. 
Transfusion competency-final.xlsx

Actually, if you look back at the responses you will see that the best answer is all three in the proper sequence.  

At the risk of sounding redundant----me too!!

Even the very best of managers or management teams cannot work miracles if they lack the appropriate resources.

The only time we perform an antibody screen on a postpartum specimen for RhIG is if, for some reason, we do not have record of one from prenatal testing.

I'm curious.  Since I've never heard of a Patient Blood Management program, what is it and what is it supposed to provide?

If we are giving unxm'd rbcs to a pt with an unknown type, O Pos unless a female of child bearing potential (up to age 50 for us).
 

You may have exchanged your pt by that time - then what type are you giving?   I want a sample ASAP.  I worked in a large tertiary care hospital, we would only give you one O= and then only if you gave us a specimen.  We opened that hospital brand new and set up the rules like blood bank should be run.  It was great - no one could say "we've always done it this way."

You may want your lab manager to talk to your trauma docs.  I am pretty sure that they are going to want to know that you can provide type-specific blood ASAP before the Blood Bank runs out of O negs.
Scott

Same here, entire unit...except well over 30 years.

Same here, entire unit...except well over 30 years.

We give them the entire unit.  Haven't transfused rbcs to an infant here in over 20 yrs.  One dose of plasma.

Signature each admission.  After discussion, this is usually done by a hematologist.  (It is really not that big of a deal "bureaucratically" for us.  Perhaps large medical centers have more turf issues with this type of thing.)
Scott