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Not for 5 day plasma but they used to require it if you extended the expiration date of thawed FFP from 6 hrs to 24 hrs.

Anti-M does have both IgM and IgG components. It primarily reacts as IgM but can carry over to IgG. We had one last week. The IgM component caused an ABO discrepancy by reacting with with M+ A1 reverse cells in an A Pos patient. The IgG component showed up at coombs phase after the addition of Anti-IgG. We had to transfuse M neg units to have compatible cross matches.

you could use a specimen from Hematology that is drawn at a different time for your retype. The policy should be for all patients and not a certain age. Most preemies and babies get O Neg so then your policy could address that they only need 1 blood type if they are receiving O neg or a quick heelstick if you are doing type compatible.

You must follow the package instructions for the anti-sera and it clearly states storage at 1-10C. I don't care if you are doing QC on previously frozen antisera and if I was your CAP inspector you would get cited for improper handling of reagents because your procedure must state how to handle reagents and you would have to document that the storage is in the freezer. I recommend you stop this bad practice.

The nursing policy should say that the unit must be transfused within 4 hrs, so if there is a delay in starting the unit, they know it still must be finished within 4 hrs of receiving it on the floor. There is no more 30 min rule in the AABB Technical manual and in fact if your laboratory is accredited by College of American Pathologists [CAP], one of the checklist questions deals with return units and reissuing. What ever time you decide must be validated because inspectors ask to see documentation. When I did the validation for our hospital BB [300 bed], we found that after 15 min, the blood warms above 6 C so we changed our time to 15 min unspiked.

The purpose of a type and screen is for those patients where the probability of needing a blood transfusion is less than 50% so you don't want to tie up your inventory and you can crossmatch a unit and have it ready in 5 min. Now if your facility is requiring 2 blood types before you give out type specific blood rather than group O, then I recommend you collect a 2nd specimen [or get a CBC specimen collected at a different time] to verify the blood type. Then you won't be caught if the patient emergently needs blood. What does your policy say if you don't have 2 blood types on file? Give group O or O Negative? CAP recommends 2 blood types as a way to prevent hemolytic transfusion reactions, but as to how your implement that is up to your facility.

The "30 minute" rule used to be included in the Technical manual years ago but then was taken out. If you have CAP accreditation, there is a standard that asks about your return policy. it must be validated. So we took several units of red cells over the course of a week and left them on the counter at RT taking the inital temperature and temp every 5 minutes with a calibrated thermometer and discovered the units warm up to over 6 C after 15 min so we updated our policy and sent memos to Nursing and OR about the new rule change. 10 C is too high, that is transport temperature and taking a unit to the floor does not fall under that category. The unit should not go above your storage temp of 6 C.

I am always looking for a Kidd antibody when I have a possible delayed transfusion reaction. Since we don't have enzymes available, I use my Polyspecific AHG reagent with the elution [by tube] and it ususally comes up positive rather than using the IgG AHG reagent. Just a thought.

I am an A2B Negative [i haven't developed anti-A1 yet since I have never been transfused] but with the increased strength of the monoclonal typing reagents, my "A " type is 3-4+, but years ago it was 2+. There is no mixfield reaction with A2, that is with A3 I trust you ran the Anti-A1 against an O cell to make sure its Anti-A1 and not a RT alloantibody. Since it was nonreactive with A2 cells and reactive with A1 cells, your testing looks like an A2B with Anti-A1

You can distinguish Anti-LW from Anti-D by using DTT. Anti-LW is destroyed by DTT and Anti-D is not affected. Anti-LW more often appears as an autoantibody not by itself too.

The purpose of Emergency Release is to get the blood out the door immediately. We have a shelf dedicated to ER release and it contains 4 O Neg and 2 O Pos units. These units are rotated out weekly. We have a 10x75 mm tube that contains 2 segments that has the ISBT sticker on them and a orange Uncrossmatched sticker on it. We have generic Paper forms printed out in a folder near the issue desk. The minute we get the phone call from ER, OR or ICU, we open the cooler, put the gel packs inside, pull the labeled segmented tube, place 2-4 units of ER release blood and blank paperwork in the cooler and out the door it goes. The receiving dept has a ER consent form already filled out to hand to us and a specimen if possible. Then we do the testing and computer work afterwards or rubberband the tubes together and wait for the specimen.

Great case scenerio. Thanks for sharing this with us. I have had a weak Anti-Jka before and since it appears that you had a newly forming antibody, I might have repeated it with 4 drops of plasma and extended the incubation period for 30-45 min. We have a policy that if the C3 becomes positive that we do the panel manually with polyspecific AHG and that is how we found our weak Anti-Jka. I plan to share this with my senior CLS students.

Did you look at "agglutination" under the microscope? Since its weak, it sounds like possible Rouleaux to me

The Illinois chapter of ASCLS will be hosting a 2 day review seminar in April 2014. I facilitate in an SBB program and there is more to the Exam than the Technical manual. You need to have some Coagulation, Lab Management and Lab math books too or you will fail.