R1R2

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.  

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

Just found this from the BBTS;
https://www.bbts.org.uk/downloads/bbts2016/presentations/15.00_wed_qs_3_kate_aplin_bbts_2016.pdf/

what the heck does that mean?   
 

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

Based on an observational study of ABO grouping in Gel I reported at the 1997 AABB Annual Meeting, ABO Plasma Grouping discrepancies occurred in 0.8% (26/3183) adult ABO grouping tests in Gel.  Anti-B was not detected in 24/26 patients, anti-A was not detected in 2/26 patients, and anti-A1 was not detected in 3183 patients.
In comparison, anti-A and anti-B was detected in 19/26 patients by the immediate-spin tube test, and was detected in 7/26 patients after 10 minute incubation room temperature incubation and centrifugation.
Based on this study and 20 years of gel testing since that time have shown me the anti-A1 is rarely detected in Gel and that 70-80% of ABO plasma grouping discrepancies are resolved using the immediate-spin tube test.  
Centrifugation is used quite differently in gel versus tube testing. Centrifugation is used to separate agglutinated cells from un-agglutinated cells within the gel column, but is used to enhance agglutination in standard tube tests by forcing cells together at the bottom of the tube.  This may contribute to the increased sensitivity of tube testing in ABO Plasma grouping tests.

Not all major ABO incompatibility transfusions result in death.   I recently read somewhere that a few percentage (can't remember the exact number) up to 30% are fatal.   In my career I have seen one not fatal and one fatal,.  
 
 
 

PERHAPS weak D was included because a positive weak D would alert you to a possible false positive fetal screen.  

There is no required number of samples to use for method comparison.   I would suggest 1 pos, 1 neg for Rh and antibody screen and pick your samples wisely - a nice strong K or anti D to eliminate those pesky (expected) discrepancies between different methodologies and required corrective action.     

PERHAPS weak D was included because a positive weak D would alert you to a possible false positive fetal screen.  

Below is the exact text from the guidelines.    I agree that potentiators added to the reverse group may detect non ABO antibodies in addition to the ABO antibodies but who adds potentiators to reverse group routinely?   One reason that anti c is mentioned may be that reverse group cells are usually Rh neg.   I have seen strong IgG anti c react in reverse group with no potentiators. 
 
 
Other reverse grouping anomalies: Potentiators in the reverse grouping reagents may cause IgG antibodies such as anti-c to be detected in the reverse group.

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

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

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
 

We do pretty much what Scott does. Once we go live with SafeTrace TX, we will scan the patient's antibody ID paperwork into their STTX record and shred the paper.

I like the way your new supervisor has you performing antibody ID and panels.   Why would you continue running full panels after the first if you can start narrowing down the specificity after the first panel and run selected cells?  For example, if you suspect the patient has anti e, why run any more e+ cells? 
 
Not sure I agree with the DAT if auto control is negative.  I think many transfusion services do not do this but I imagine that reference labs do.    There may be times when running a DAT is advised when autocontrol is negative but running DATs routinely when an auto control is negative will just take you down a path that will delay blood transfusion IMO
 

No need to take a separate internal temperature providing your digital temp is accurate.  You will need to validate your digital readout to NIST and  then you are all set. 

No need to take a separate internal temperature providing your digital temp is accurate.  You will need to validate your digital readout to NIST and  then you are all set. 

IN the US, a titer is not usually done before transfusing a non group O baby with group O pack cell aliquots.   I have only seen one case in which passive anti A was found in a neonate after transfusion of group O pack cell aliquots.   There was not patient harm. 

No you can't but you can run select cells instead of a full panel.  You may even skip the antibody screen and go right to the select cell panel. 

Your reverse cells are probably Rh- and may react with anti c.   Using gel will only enhance this reaction since the plasma/cells are in contact for 10+ minutes or more especially if using automation.   You probably ran your reverse tube without delay so you did not pick up the anti c.  If you incubated your tube reverse B cell at 37 you would probably pick up some reactivity.   I have seen this many times especially with anti c. 
 

Your reverse cells are probably Rh- and may react with anti c.   Using gel will only enhance this reaction since the plasma/cells are in contact for 10+ minutes or more especially if using automation.   You probably ran your reverse tube without delay so you did not pick up the anti c.  If you incubated your tube reverse B cell at 37 you would probably pick up some reactivity.   I have seen this many times especially with anti c. 
 

I will be retiring on August 9 and wanted to tell everyone that the forum has been a great source of information (and amusement at times).  I have spent time reading Malcolm's posts trying to imagine what he sounds like (just love a British accent).  Thanks for keeping the forum a place where we can all learn from each other