R1R2

Agree with Kelly

This requirement is not new nor is it just CAP's requirement but rather a CLIA requirement. You can refer to this: What Do I Need to Do to Assess Personnel Competency? https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/Downloads/CLIA_CompBrochure_508.pdf.

Clot based tests are usually exempt from linearity.

I would just replace the battery and not tell anyone.

Congrats! Become very knowledgeable in all things BB. Read everything you can get your hands on and go to outside meetings. Learn why we do the things we do. Don't be afraid to change things that were always done that way. Get to know other BB leads/supervisors in other hospitals, they are a great resource. Don't let the staff push you around, you are not their mother or babysitter. Know the difference between anti A and anti A1 (pet peeve of mine). You got this!!!

Is this a regulatory requirement? We never reconcile. We do pull daily short date lists, expired lists and reconcile new shipments with invoice and LIS . We rarely have a unit go missing and we can always backtrack and find it.

Only ABO/Rh (and maybe not even that)

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Per CAP (not sure if you are accred by them) second type is only required for computer crossmatch and since the computer is down, there should be no computer crossmatches going on. Other than that, 1 type on file is perfectly acceptable to issue any type blood. However, many labs use the second type to check for WBIT. Anyway, you need to follow your lab policy. I personally, would feel uncomfortable giving non group O type specific with just one type on file during massive computer downtime.

I am not sure how contamination occurs either but it does. I think more frequently, incorrect labeling (patient ID) occurs which may be the case in the first gel card. On the other 2 cards, this looks like a case of the B antigen not fully expressed at birth and therefore giving weak (mixed field like) reactions. The difference in strength with the last 2 could be that there was some incubation of cells and sera prior to spinning. If you really want to do more work to determine if this is contamination, you could do some Rh phenotyping (just for fun) but mom and baby would have to have different Rh phenotypes for this to work. Rh is fully expressed at birth so there should be no mixed field. I am sure there are other ways to investigate contamination and I am sure others will chime in. What is APT (last pic)?

Whether it is acceptable or not is a lab/lab director decision. There are no regs that prohibit the practice. Your policies should address using an abbreviated panel.

I posted a stupid question and then deleted it. I answered my own question......

B

BB ran a daily report looking for Rh neg moms with Rh pos babies to make sure a a workup was ordered. An Rh neg mom with no baby blood type was followed up by BB staff.

Without knowing many details - A lot of reasons for #1 such as false positive or false negative. Another reason is an antigen on the screening cells is not on the panel. Would advise to go over everything again and ascertain testing was performed correctly, review antigen profiles on the screening cells to see if there is an antigen on it that is not on the panel cells (like Lua) and then give AHG compatible(and possibly antigen negative) blood. #2 - IN addition to false negative, antibody may be weak or screening cells may have weakened expression of the antigen. Rule out all clinically significant antibodies and give AHG compatible, antigen negative blood. This is only a very short list of what may be going on. I would advise you to find someone proficient in immunohematology to help you out before transfusing anyone.