Sue Miller

Thank you Liz. That is exactly what I needed.

We have had a rash of incidents where the nurse are puncturing the RBC unit with the infusion set as they spike the bag. Does anyone have any visual aid information that we could send out as an education tool to the nurses for the proper procedure to enter the bag?

We also have the same issues. We keep the cells in the refrigerator when not in use. I also split my monthly shipment receiving 2 vials in one shipment and then 1 vial in a second shipment 2 weeks later, trying to have fresher reagent in use. Quotient is working on a C3 check cell prep kit that will allow you to make your own in house, which should be much stronger since the 28 day expiration will start there instead of at the manufacturing facility. Looking foward to whenever that is ready for release.

I suspect that noone has been cited by CAP because CAP is a peer inspection and most of us do not think an IS crossmatch is required when you are performing an AHG crossmatch and entering results in a LIS.

We had similar results as GIT on last PT. We have switched to Ortho in spite of former problems with handling of recalls because of the false positive results we were getting with Immucor and their seemingly lack of concern. We have only been using Ortho since Jan. so we are monitoring the false positive rate.

For us TypeSafe is .16 each and hematype is .20. One of our techs works at another facility who had an issue with a broken tube and exposure with TypeSafe so we are reluctant to switch even if it is cheaper.

John Judd did a large study (222,000 antibodies) in 1997and concluded that if you use 2 screening cells that are R1R1 and R2R2 and one of these is homozygous for Jka is adequet for antibody detection. Ortho and Immucor both have this product. The paper was titled "Commmentary: testing for unexpected red cell antibodies-two or three reagent red cell samples?"

Please send me a copy also.

My checklist is based on our Blood Administration policy. I just have listed what we state in the policy and make sure they adhere to it.

We have been using the Plexxium with hard wiring for about 3 years and have been very pleased with them. We have 2 nodes and about 35 systems connected to them. We also have chart recorders as a back up on our blood bank equipment. When inspectors want to see temp charts it is so much easier to show the graphs from the Plexxium that diggng through charts.

We store our anti-C3d,C3b and complement control cells in the refrigerator and only have them on the bench when in use. I have also split my standing order to get shipments every 2 weeks.

I bought one of the Westcott smaller racks thinking that the techs would like them because they do not take up as much counter space. They never use this rack. After 3 years of using the larger racks they do not want to change.

The recent lot number seems to be better. Our saline always has a pH of 7.2 and we still experienced many false positives beginning about September.

We also have seen many false positives with negative KB stain. Immucor originally advised washing the specimen numerous times before beginning testing when this problem appeared. Sometimes that seemed to work but not always. Then they advised not washing the specimen. The current lot number seems to be doing better. We have been documenting our fetal bleed and KB results and how the specimen was treated, i.e. wash vs not washed. I sent this information to Immucor but they really did not seem very interested. They wanted to say the problem was with our saline which we have used forever. They had me do a pH on each cube we were using and all were in range.I am anxiously awaiting the to see how everyone performed on the CAP PT from November.

We currently perform a DAT on any patient who has a type and screen or type and crossmatch and has been transfused within the last 3 months to identify delayed transfusion reactions. I would like to discontinue this practice. What does everyone think of this practice?