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Joanne P. Scannell

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Joanne P. Scannell last won the day on November 26 2019

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About Joanne P. Scannell

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    Senior Member
  • Birthday 10/10/1952

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  • Gender
    Female
  • Location
    Massachusetts
  • Occupation
    Blood Bank Manager

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  1. If you know this patient is A Pos and you know the discrepant backtype is due to a cold agglutinin, why are you trying to re-establish what you already know?
  2. We issue Group A Plasma (or whatever is shortest outdate as long as it is not Group O) until we have a BB Specimen and the ABO/Rh is verified. Then we switch to ABO compatible/specific. The expiration date of the specimen does not apply to non RBC containing blood products, so as long as the patient is wearing the corresponding BB Band, we will issue Plasma, Platelets and/or Cryo. I agree, the non-ABO match allogenic stem cell transplant recipients are a challenge, but as someone pointed out in an earlier post, these patients become obvious and we can deal with their 'new' blood type 'in the moment' according to our current protocol.
  3. We purchased bins from VWR International. They are manufactured by AKRO MILS if you want to check their website: https://akro-mils.com/ They are inexpensive and come in various colors: Red, Blue, Clear, White and many sizes. We got Item# 75854-808 ... a case of 12 clear, 4" tall x 11.625" deep x 6.625" wide. 6 fill one of our drawers (3 in front, 3 behind them) very nicely. If you message me, I'll tell you the price (very reasonable). They sell dividers for them, too ... again, in the same colors. We also use them for our reagents. We stole the idea from Chemistry, by the way, so I can't take all the credit for this idea.
  4. Ditto! More Questions: Didn't I read a few years back the the UK reference labs only do elutions within 2 weeks of a transfusion? What is the rationale for 3 months? I could never see the reasoning for that (Yes, I know an RBC 'lives' for 120 days but the math for that makes no sense to me.)
  5. Ael? Or am I dating myself? I agree with Malcolm, for transfusion purposes, it doesn't matter what you call it. And ADsorption vs ABsorbtion ... I always looked at it this way: It depends on whether you are looking at the cell or the plasma. Antibodies are Absorbed from Plasma and Adsorbed onto RBCs.
  6. Although I agree that treating a transfusion reaction is a lot easier than treating exsanguination, in this small hospital setting where they have only 6 units of blood to begin with, I don't think it would go so well to switch to incompatible after only 4u transfused. I'm with the group suggesting the hospital switch to stocking 4 O Pos + 2 O Neg RBCs. It is possible, don't let your provider tell you otherwise.
  7. Ditto. We haven't 'split' a unit for a non-neonate for over 20 years! I agree with the above ... we'll just state what we do if we ever do get an MD who requests a split unit. I'd only add that the usual approach is for the MD to instruct the infusionist to 'Transfuse over 4 hrs.' vs the usual transfusion rate of 1.5 - 2 hrs. Eventually, hopefully, the CAP Checklist Team get the message that splitting the unit is not the only answer and shouldn't be unless it's done often enough to maintain competency, etc.
  8. Devil's Advocate Asks: If we establish that the reason for the reactions in the backtype are due to cold agglutinin(s), why are we pre-warming ABO tests? Pre-warm = 37C reacting antibodies. If this is a valid alternative to RT/I.S. Crossmatch, then shouldn't we be performing an Extended Crossmatch (37C to AHG) to look for the IGG versions of the ABO Antibodies? Simple Answer: Immediate Spin Crossmatch: If due to cold agglutinin (other than ABO) = Compatible by Blood Type.
  9. Postpartum: Type and Screen (Pretransfusion specimen) upon admission to the Delivery/Labor Room. We do not repeat the Rh Type or Antibody Screen if an RhIG injection is needed but a KB is done (post-partum specimen) to determine the dose. Antenatal (28 week gestation dose): Rh Type + Antibody Screen Miscarriage/Abortion: Rh Type Emergency or Other Indications (Pregnancy): Rh Type + Antibody Screen, but we will issue RhIG if needed asap with only the Rh Type done. AS can wait. We still do the Antibody Screen because it is good documentation that will likely answer questions later, like 'Is this patient producing Anti-D or is this the RHIG injection she got a month ago?' As far as the MD is concerned, they rarely care about the AS result, e.g. we've reported an Active (as opposed to Passive) Anti-D and they still want to give the RHIG, so it's good documentation for that, too.
  10. 2+ is the only result possible as you have a mixed cell population in the tube now (patient/donor + check cells). The definition of a 3+ and 4+ is a clear background = not mixed field. And 1+ is just too weak, something is wrong.
  11. We take the temperature of the unit when it is returned no matter how it was sent. This has become an issue here in the US and the FDA considers these units 'in storage' if they are not moving so the restriction is 1-6oC.
  12. We use Sunquest as well. Our MTP does not drawn anything. All it does is print the order in Blood Bank. The BB Staff orders what is needed (Prepare Orders, etc.) and informs the provider IF a BB Sample is needed (often times we already have a sample). I suggest you get the order for TS out of your MTP order. We, too, put MTP on 'Downtime' protocol. Our Unit Tags are 3 parts: White Top copy, Yellow middle copy and card stock back copy. When issuing blood 'routine', the white top copy is discarded, yellow copy is kept in BB and card copy stays on the unit. For 'Downtime', the white copy stays on the Unit Tag and they use this for their dual checks, etc. Message me if you'd like more information.
  13. No, because, unlike tube testing, you cannot spin a gel test twice. Part of the calibration of the gel test, aside from the pipetting 'exact' amounts, is 'this is how far the cells migrate through the gel beads at this speed for this period of time', i.e. second spins cannot 'count' because to do so, you have violated the requirements of the test.
  14. Under routine circumstances, we do not prepare an eluate from positive DAT cells from a neonate because identity of the antibody can be determined from the mother's sample. Of course, if a neonate with a Positive DAT arrived without a mother, no maternal sample, or from a Group AB mother with a Negative Antibody Screen, we would likely prepare and test an eluate to aid the pediatrician with his/her care plan. (For the latter case we would request a sample from the father to determine if the mother is producing an antibody to a low incidence (aka private) antigen passed on to the infant by the father.) But, that's a whole 'nother conversation!
  15. Given that the BB/BB Medical Director has the knowledge and background to determine transfusion safety and is responsible for blood transfusions that the MD's order, we simply wrote our policy. Yes, sometimes we get questions from the infusionists, but the BB Staff can easily answer them.
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