[Valid blood type]

Agree with Kelly

 

[CAP REQUIREMENTS FOR TECHS PERFORMING COMPETENCY]

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.  

 

[HMS Plus linearity]

Clot based tests are usually exempt from linearity.   

 

[Calibration of timers required after replacing batteries?]

I would just replace the battery and not tell anyone.   

 

[Blood Bank Lead - Any advice, tips, ?]

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!!! 

[Inventory reconciliation]

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.  

 

[Order requirements for components (plasma, platelets, cryo)]

Only ABO/Rh (and maybe not even that)

[anti-Lewis a,b]

On 11/13/2018 at 11:46 AM, SMILLER said:

Not too different from what we are currently doing, except when there is only a history of anti-Lewis with a current neg screen, we are required to get Lewis antigen negative units form our blood supplier (they do get annoyed about these types of requests),  

Scott

.    

[ABO Confirmation, 2nd Draw]

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.  

 

[cord blood]

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)? 

[Passive Antibodies]

On ‎12‎/‎3‎/‎2019 at 6:24 AM, jnadeau said:

Thank you all but I still can't find a reference for acceptably using an abbreviated panel (Ortho 0.8% panel) to rule out other clinically significant antibodies on the panel when passively acquired Anti-D is suspected (i.e. a negative antepartum antibody screen and documented administration of RhIG)

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.   

[Strong Anti-D after Rhogam]

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

[How to answer this question]

B

 

[Doctor forgot to order DAT on O+ baby with O- mom. How does your lab deal with this?]

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.

[Hi, I have a question for the blood bank!!!]

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. 

[AMR -AABB]

What does AMR stand for?

[Cell Phone Camera]

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. 

[Just for fun]

Clarifying question - Is it Friday afternoon or Monday morning?  

[CORD BLOOD NOT MATCHING HEEL STICK TYPE]

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.  

[Confirmatory test for ABO groups in first attend patients]

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? 

[Confirmatory test for ABO groups in first attend patients]

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

[How do you say EGA?]

EGG AH

[30 minute rule]

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.

[AABB Accreditation]

2 hours ago, Johnv said:

A number of years ago the President made a visit to our area.  His advance team visited our hospital and the blood bank.  They asked if we were AABB accredited which we regrettably answered no.  We are accredited by the Joint Commission   Consequently our blood bank was told we could not provide blood product in the event of a medical emergency!    

what the heck does that mean?   

 

[AABB Accreditation]

I agree with David and would not bother with the expense of AABB accreditation.