R1R2

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.  
 

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I would think that the freshest irradiated or unirradiated unit you have on hand would be suitable for a baby in a true emergency.   A full unit could be issued and tranfusionist would use what they needed and discard.   This plan should be discussed with all involved before it happens to make sure everyone is OK with this.  Perhaps a procedure should be written as well.     

we purchase pooled cryo from the blood center.  no more pooling
 

After validation studies are done, why wouldn't one or two comparisons be sufficient?

Most programs will not ID the antibody.   They are just a tool for the blood banker to use during ID.     In my experience, most blood bankers, including SBBers could not tell the difference between  an anti-D+C and either an anti-C+G or anti-G, anti-hrB, rather than anti-C+e or anti-hrS, rather than anti-ce (anti-f) IMO (sad but true).  

We went through this a few years ago.  The problem with any kind of written worksheet is that it becomes your primary record -- the computer entry is secondary. -- resulting in both sets of records must be retained.  When results are directly entered into the computer, almost all written testing records are not needed.
Scott

Malcolm, thanks so much for the article. It was very helpful. As it turned out, we sent mom's sample to our reference lab for MMA testing, and we also antigen typed her 2 brothers and her father. One of the brothers matched her Duffy and Kidd antigen types and was Coombs crossmatch compatible with her. He donated two units of packed red cells (at one donation) and was also confirmed to be Diego b negative. The patient's anti-Dib came back as clinically significant based on the MMA test. She did have a C-section after all and did not require any blood! The baby had a negative direct coombs so there were no issues there either!

Today, We performed Kell antigen phenotyping, revealing k-, Kpb-, Jsb- (genotypically predicted as positive using SNP typing).
Now, I believed his phenotype is Ko. 
I consider further genotyping using Sanger sequencing.
Thank you for your help.
 
Matthew Kim

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. 

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?

In my house, the cake would not make it to the next day.

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. 

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. 

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. 

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.  

Agree with TreeMoss.  I would check your FDA paperwork and make sure it is correct.   I took over a transfusion service and they had registered even though they did not need to register.   I changed that right quick. 

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

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 think it develops with experience.   Our older peers said the same thing about us. 

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

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