R1R2

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.

What does AMR stand for?

have your lab director talk to the pathologist, His is not a tech call. THis is why your lab director gets paid the big bucks.

Clarifying question - Is it Friday afternoon or Monday morning?

I have seen this so many times and have always come to the conclusion that it was a mislabeled sample. Let us know what you find.

I see that you are not in the US. In US, ABO typing is considered non waived, high complexity testing. All those that do the test will need documented training, followed by competency assessment as well as documentation of education, i.e., diploma or transcripts. Do you have similar requirements in Brazil?

Agree with AMcCord. Can't and don't want to imagine nursing personnel performing this test.

EGG AH

I read a journal article a while back that looked at the detrimental effects to blood if left out at RT for different amounts of time and then but back in the fridge. They did this multiple times to each unit of blood. The result of their study was that the 30 minute rule, if there ever was one, could be changed to the 1 hour rule. I thought that was really interesting. Anyway, we take the temp of every red cell returned. If OK we put it back into inventory. The LIS will prompt for integrity/appearance acceptability and return temp.

what the heck does that mean?