R1R2

Are their legs broken?  Who's going to prepare the products if the blood bank tech is delivering blood products? 

Are their legs broken?  Who's going to prepare the products if the blood bank tech is delivering blood products? 

I would not think that you would have to run other rule outs and  I wouldn't bother testing 3 Lua+ cells, just 1 would do. Some labs would not confirm at all and just go right to AHG compatible blood.  I agree with Malcolm in that Lua is not an antibody to spend time worrying about.   Our blood supplier would die laughing if we asked for Lua negative blood.   

Earlier this week at the 2015 AABB Annual Meeting "Ask the Standards" session, the AABB confirmed testing performed by the donor center as specified in this standard, DOES meet the intent since the Standard does not specify WHO does the testing, only that it be performed before transfusion. 

Blood Banks should not be using Fetal Screen on any sample except post delivery per the manufacturer's insert.   We learned that the first day of med tech school.  If I inspected a blood bank and they used Fetal Screen on any samples other than post delivery I would give them a deficiency.  

I would not think that you would have to run other rule outs and  I wouldn't bother testing 3 Lua+ cells, just 1 would do. Some labs would not confirm at all and just go right to AHG compatible blood.  I agree with Malcolm in that Lua is not an antibody to spend time worrying about.   Our blood supplier would die laughing if we asked for Lua negative blood.   

I would not think that you would have to run other rule outs and  I wouldn't bother testing 3 Lua+ cells, just 1 would do. Some labs would not confirm at all and just go right to AHG compatible blood.  I agree with Malcolm in that Lua is not an antibody to spend time worrying about.   Our blood supplier would die laughing if we asked for Lua negative blood.   

I would not think that you would have to run other rule outs and  I wouldn't bother testing 3 Lua+ cells, just 1 would do. Some labs would not confirm at all and just go right to AHG compatible blood.  I agree with Malcolm in that Lua is not an antibody to spend time worrying about.   Our blood supplier would die laughing if we asked for Lua negative blood.   

I would not think that you would have to run other rule outs and  I wouldn't bother testing 3 Lua+ cells, just 1 would do. Some labs would not confirm at all and just go right to AHG compatible blood.  I agree with Malcolm in that Lua is not an antibody to spend time worrying about.   Our blood supplier would die laughing if we asked for Lua negative blood.   

I have seen this several times with anti D and I agree with Malcolm.   I wouldn't worry too much.  

My Rh phenotype has helped me remember about who can make an anti f and who can't.   I asked about GEL IAT because I have seen some funky reactions when cord plasma is used in gel.  

3 things:
1.  I would ask your peds team for recent literature that describe the benefits of this practice.
2.  Your cord sample may not be an acceptable specimen for bili testing.  Check your specimen requirements for the bili test that they want you to run.   Some bili tests require testing within 4 hours of collection, separation of plasma from cells ASAP, non hemolyzed samples and samples collected in amber tubes etc.  
3.  You can send an aliquot of plasma to Chem instead of the whole sample. 
 
Are you using gel IAT to test the cord plasma?

I don't see a need to validate the bags if used for transport only and temps are taken if blood is returned.  I would make sure you have validated the process and it sounds like you did.   Nursing and lab SOPs should address this process and clarify that it is for transport only and not for storage of blood at the bedside, nursing unit, OR etc. and include instruction that units shall not be removed until ready to transfuse.   Maybe put a time limit of return (you may have already done this) to eliminate possibility of the bags being used as storage.   You may also want to look at your reasons as to why so much blood is being returned to warrant the red bags.   I would make sure that the gel pack storage refrigerator temp is monitored. 

pooled human urine from at least 6 healthy people used to do the trick back in the olden days.  

pooled human urine from at least 6 healthy people used to do the trick back in the olden days.  

I would toss them.  Why would you ever need to go back to them? I don't know of any reg to keep blank sheets.

we do everything except post screen, XM and UA. We continue to use pre sample unless something is found in the post.   

Does the supplier use his own transport container which should be validate?   If that is true I would think that you would not have to worry about temp.
 
Taking temp of the product tells only what the temp is  now.   It could have been out of range during some part of the trip.   

agree with Malcolm.   See this a lot with cord bloods.   

I DON'T THINK ORTHO GAVE ALL THE DETAILS.  THIS IS WHAT THE CFR STATES:
 
 
§ 606.151 Compatibility testing.
Standard operating procedures for
compatibility testing shall include the
following:
(a) A method of collecting and identifying
the blood samples of recipients to
ensure positive identification.
( The use of fresh recipient serum
samples less than 3-days old for all
pretransfusion testing if the recipient
has been pregnant or transfused within
the previous 3 months.

I DON'T THINK ORTHO GAVE ALL THE DETAILS.  THIS IS WHAT THE CFR STATES:
 
 
§ 606.151 Compatibility testing.
Standard operating procedures for
compatibility testing shall include the
following:
(a) A method of collecting and identifying
the blood samples of recipients to
ensure positive identification.
( The use of fresh recipient serum
samples less than 3-days old for all
pretransfusion testing if the recipient
has been pregnant or transfused within
the previous 3 months.

I spent 24 years working in 2 pediatric hospitals with level 3 NICUs and can count on one hand the number of times I or any of my colleagues did the procedure.  I doubt there is any hospital that does a lot of them.
 
For competency, you can save up expired RBCs and FFP so that you can do a direct observation. Make sure their final product has the target hematocrit. I would also make a thorough written quiz for assessment of problem solving skills. 

I like that Teristella!

I think that the 30 minute rule may be out of date for 2015...at least it seems to have been in 2013. I want to not toss units based on old practices. http://www.ncbi.nlm.nih.gov/pubmed/22845177

When nurses/doctors/phlebos don't use the blood tube as intended, instead drawing into a syringe and then uncapping the tube. 9/10 not recapping it properly or not getting the blood in quickly enough resulting in a clotted FBC and preactivated coag screen.
 
It's the leaking ones that get my goat the most but this just takes the biscuit! One was leaking and two didn't even have lids on!