Malcolm Needs

Whoops! Yes I would. That will teach me to read the thread/post properly!!!!!!! :redface::redface:

Neither have I, and this is something that has worried me from the start of this thread.

TimOz, I agreed with everything you said until you got to the bit when you said, "Yet we seem happy to stagger into a lab at 2:00AM, knock over a few groups, crossmatch 12 units of blood for 3 patients and the most recent QC was a thermometer in the waterbath 19 hours before." I disagree strongly with the use of the word "happy". Although it is mitigated by the fact that I am being paid for on-call (albeit about an eigth of what I would get if I were a plumber on-call), I have never been happy about being called out at this time; you just ask my wife!!!!!!!!!! "tolerate" maybe; "happy" NO! Seriously though, you make some excellent points.

That is fantastic news feliciat. Thank you very much indeed. :D:D

Hi webersl, It means "Necessity compels". It comes from, "He must needs go that the Devil drives.", a quote from Shakespeare's "All's Well that Ends Well", I, iii. The French say, "Il faut marcher quand le diable est aux trousses." The Italians say, "Bisogna andare, quando il diavolo e nella coda." Just in case anyone thinks that this poster sounds intelligent, everything underneath the sentence, "it means "Necessity compels" comes from "Brewer's Dictionary of Phrase and Fable". I have enough trouble speaking (and most certainly spelling) my native English, let alone French or Italian!!!!!!!!!!!!!!!!!! :redface:

The first school of thought is correct in as much as, if the patient is haemolysing their own red cells to such an extent that it is becoming a life or death situation, you would transfuse e- red cells. BUT, the auto-antibody is much more likely to be a high frequency Rh antibody that happens to react more strongly with e+ red cells than e- red cells. e-, E+ red cells will still adsorb this antibody and will be sensitised in vivo by the antibody and will be destroyed by the RES, but at a slower rate than e- red cells. In addition, however, transfusion of any red cells can exacerbate the auto-antibody and strengthen the auto-antibody (at the same time making the specificity broaden) and, of course, the patient may also make a genuine allo-anti-E. This, to a certain extent, also answers the second school of thought (but also r"r" blood, if the patient happens to be, for example, a rr female of child-bearing potential, is as rare as hen's teeth). I hope all my blather helps!

Mollison's Blood Transfusion in Clinical Medicine, 11th edition, editors Harvey G Klein and David J Anstee, Blackwell Publishing, Chapter 3, pages 85 and 86.

Hi eric1980. For the rationale behind my post above, read my post in the thread ALL OTHER TOPICS, AUTOANTIBODY CROSSMATCH ADVICE. I'm not trying to push what I think. This quotes the AABB Manual. Read it (it will only take two minutes at most) and then sleep soundly! :)

Actually Tim, I wouldn't disagree with what you have said at all, except that the people in my lab have been performing titrations on pregnant women day in, day out now for many years. As a result, they are extremely experienced in the methodology, and have shown the predictive correlation between titre by CAT and outcome of pregnancy.......BUT I agree entirely with you that performing these tests by CAT in inexperienced hands is simply asking for trouble.

Thanks for the clarification concerning the age of the centrifuge TimOZ, and, once again, I apologise for getting the wrong end of the stick with regards to your connections. :redface::redface:

TimOz is completely correct in saying that such controls are highly important. I think that a lot of people, especially Quality people who have not worked in a Blood Bank, put too much reliance on a mechanical QC, leading to a false sense of security. That having been said, why replace the centrifuge? Why not just send the thing away and get it repaired? I hate to be cynical, but have you not got some connections with a company (DiaMed) that sells these centrifuges TimOz? I may well be wrong (I often am), in which case I apologise profusely in advance. :confused::confused:

Most of your OB MDs wouldn't have a clue how to do a Type and Screen. Surely what you mean is that they like to order a Type and Screen? When I was working in a hospital environment, we often had Clinicians telephone us and say that they would like to cross-match 2 units of blood for a patient. The standard answer was to invite them up to Pathology and tell them that we were quite willing to let them cross-match the 2 units, or would they prefer it if we did the cross-match for them. In the end, it usually worked, and they treated the people in the laboratory who could actually perform the cross-match with an awful lot more respect. I know that I am being pedantic here, but I do think it is important that we are respected for our skills by our colleagues, and should not run ourselves down by allowing disrespect, even if it is only unintentional (on both sides).

noelrbrown makes a very important point, which many people easily forget.

Then, with all due respect, why did you put warning fields on those that had an anti-A1 that did not react at strictly 37oC? Anti-A1, reacting at a lower temperature than 37oC, has not been reported as being clinically significant. :confused:

How many cases of anti-A1, reacting strictly at 37oC, do you think you have seen? :confused:

She was probably thinking, "Thank God that's over!!!!!!!!!!!!!" :rolleyes:

They do in my lab! Actually they are pretty good at this, all joking apart.

Good points John. Perhaps having a sample in the laboratory, rather than actually testing the sample in the laboratory is a far better idea than that I put forward.

Thanks irshadaad. The point about Kell being the System and K being the antigen is exactly the kind of thing I meant.

It has a chair, and I think if I really work hard at this tidying business, I might find a desk in a day or two! :D

Absolutely NO offence was taken whatsoever.

Same here.

You won't believe this, but the day before yesterday actually! Two trash lorries are taking away the detritous as I write. It turns out that my office has a floor. :p:p

Hey eric1980, we are only joshing (or, at least, I am)!!!!!!!!!!!!!!!!!!!! Can't speak for Rashmi, of course (wouldn't dare). :rolleyes::rolleyes:

See what I mean! "and comply with all my suggestions"! Learn from the master. Follow my managerial strategy! Sack anyone who doesn't say, "How high?" when I say jump!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :D:D:D