Joanne P. Scannell

I just want to mention the saline titration procedures that are in the Technical Manual and that the CAP promotes as their preferred procedure. Their supporting paper will pretty clearly show that saline technique can detect antibodies (see the CAP website). I have seen many antibodies react when titrated by a saline technique.

I think I'll pass on joining this discussion since I am old, retired and can't possibly contribute, but thanks for asking.

Hi labgirl153,
I won't weigh in with an opinion or facts regarding your question, I will ask that you reconsider your harsh tone toward some very smart people who are offering advice and their many years of experience. People here are not paid for the time they spend helping others, and responses such as your will lessen their willingness to continue. Remember, You can catch more flies with honey than with vinegar.

Well labgirl153, there was a little paper written in 1945 by Coombs et al (Coombs RRA, Mourant AE, Race RR. Detection of weak and “incomplete” Rh agglutinins. Lancet 1945; ii: 15-16) that rather contradicts your theory of this SOP being "bogus". I think that you should remember that, before we had enhancement, this was the ONLY indirect antiglobulin technique that was available and that, although a few patients may have been "lost" due to incubation period, none were "lost" due to antibodies not being detected, as long as the test was performed correctly.
If you do not acknowledge,remember and learn from history, you are doomed to live through it again.

Yes, the same unit.   once it is hung it is good for 4 hrs.    No need to use a new blood  product.    limit donor exposure. 

KBs are performed in our Hematology Department.  This test is not uncommon as it is run for more reasons than just to figure out RhIG dosage.  I believe, because of this and their more acute training/experience in microscopy, this is the best place for this test to be done.
Competency for KB belongs to the section who is performing the test no matter what anyone else uses those results for.
The only 'competency' determination that I believe is necessary for the Blood Bank is to assure that the BB Tech who is processing RhIG orders knows how to acquire the KB result and how to calculate the dosage using that result.

KBs are performed in our Hematology Department.  This test is not uncommon as it is run for more reasons than just to figure out RhIG dosage.  I believe, because of this and their more acute training/experience in microscopy, this is the best place for this test to be done.
Competency for KB belongs to the section who is performing the test no matter what anyone else uses those results for.
The only 'competency' determination that I believe is necessary for the Blood Bank is to assure that the BB Tech who is processing RhIG orders knows how to acquire the KB result and how to calculate the dosage using that result.

Sounds to me like an inspector who is "uncomfortable" because it's not how they do it.  I recommend a nod and smile and a comment such as, "We'll look into it."  As long as who is doing it, are trained and competency is documented it should not matter which department is doing it.  To rephrase what Malcolm said, the procedure is more in haematology's wheel house. (It's kind of fun spelling words with more letters than necessary!)

We have been using an Erytra Eflexis (Grifols) for almost 2 years now and we are very happy with it and the service team.
It is interfaced to Sunquest.

I'm also wondering how one manages to validate that all units of blood remain within temperature range when the ambient temperature and handling is not consistent.
We can't even validate our coolers for the same reason ... and one never knows if the cooler is left open or the units are removed then replaced.
Are you using 1-10oC or 1-6oC?
FDA instructed us to use 1-6oC for the coolers because they are really 'in storage'.
If not in a cooler, we can go up to 10oC because they are 'in transit'.  I haven't implemented that part yet, but I will be soon.

I'm chuckling reading all of this because it's like the question, 'If the parents are both Group O, can they produce a Group A baby?'
Ask a student, they'll say 'No way!'.
Ask a BB fanatic, they'll say, 'Sure it could happen ... and here's how ...'
And in this forum, there is never a simple answer!

I'm chuckling reading all of this because it's like the question, 'If the parents are both Group O, can they produce a Group A baby?'
Ask a student, they'll say 'No way!'.
Ask a BB fanatic, they'll say, 'Sure it could happen ... and here's how ...'
And in this forum, there is never a simple answer!

I'm chuckling reading all of this because it's like the question, 'If the parents are both Group O, can they produce a Group A baby?'
Ask a student, they'll say 'No way!'.
Ask a BB fanatic, they'll say, 'Sure it could happen ... and here's how ...'
And in this forum, there is never a simple answer!

I'm chuckling reading all of this because it's like the question, 'If the parents are both Group O, can they produce a Group A baby?'
Ask a student, they'll say 'No way!'.
Ask a BB fanatic, they'll say, 'Sure it could happen ... and here's how ...'
And in this forum, there is never a simple answer!

I disagree. Most gel cards and Anti-D reagents won't detect DVI for patients. Fortunately I can find numerous suitable quotes, because it's true. 
 

 
 
https://labs-inc.org/pdf/361_3.pdf
 

Yes, but DVI donors need to be typed as D+.  Donors are not patients.

I'm also wondering how one manages to validate that all units of blood remain within temperature range when the ambient temperature and handling is not consistent.
We can't even validate our coolers for the same reason ... and one never knows if the cooler is left open or the units are removed then replaced.
Are you using 1-10oC or 1-6oC?
FDA instructed us to use 1-6oC for the coolers because they are really 'in storage'.
If not in a cooler, we can go up to 10oC because they are 'in transit'.  I haven't implemented that part yet, but I will be soon.

We use 1-6 for coolers, however, the BT-10 only shows breach above 10 so, there's that. We place a NIST certified thermometer in the cooler to show that it is 6 or below upon return. We do not scan these units with the temp gun.
It's 1-10 for anything returned not in a cooler. 

We use one from Fisher. It is certified and we replace it every 2 years when the certificate expires. I am curious, for those who have the 15 minute limit, did you validate that in all scenarios in your hospital?

When we first started using Gel, my techs would point out the shadows or 'jumpies' as they called them. 
I'd suggest 'Run the screen again using maxtime.'  If they still saw the shadows, I'd just let them run a panel (maxtime) and go crazy with the results.  After a while we all learned to ignore those reactions. 
Keep in mind, there are always a certain percent of any given cell population (especially stored reagent cells) that are just not going to make it smoothly to the very bottom solely because of steric hindrance (broken, aged, crenated, tagged for destruction, etc.).

When we first started using Gel, my techs would point out the shadows or 'jumpies' as they called them. 
I'd suggest 'Run the screen again using maxtime.'  If they still saw the shadows, I'd just let them run a panel (maxtime) and go crazy with the results.  After a while we all learned to ignore those reactions. 
Keep in mind, there are always a certain percent of any given cell population (especially stored reagent cells) that are just not going to make it smoothly to the very bottom solely because of steric hindrance (broken, aged, crenated, tagged for destruction, etc.).

When we first started using Gel, my techs would point out the shadows or 'jumpies' as they called them. 
I'd suggest 'Run the screen again using maxtime.'  If they still saw the shadows, I'd just let them run a panel (maxtime) and go crazy with the results.  After a while we all learned to ignore those reactions. 
Keep in mind, there are always a certain percent of any given cell population (especially stored reagent cells) that are just not going to make it smoothly to the very bottom solely because of steric hindrance (broken, aged, crenated, tagged for destruction, etc.).

When we first started using Gel, my techs would point out the shadows or 'jumpies' as they called them. 
I'd suggest 'Run the screen again using maxtime.'  If they still saw the shadows, I'd just let them run a panel (maxtime) and go crazy with the results.  After a while we all learned to ignore those reactions. 
Keep in mind, there are always a certain percent of any given cell population (especially stored reagent cells) that are just not going to make it smoothly to the very bottom solely because of steric hindrance (broken, aged, crenated, tagged for destruction, etc.).

When we first started using Gel, my techs would point out the shadows or 'jumpies' as they called them. 
I'd suggest 'Run the screen again using maxtime.'  If they still saw the shadows, I'd just let them run a panel (maxtime) and go crazy with the results.  After a while we all learned to ignore those reactions. 
Keep in mind, there are always a certain percent of any given cell population (especially stored reagent cells) that are just not going to make it smoothly to the very bottom solely because of steric hindrance (broken, aged, crenated, tagged for destruction, etc.).

It's good to be famous and remembered!!