tkakin

We have a patient with a very strong cold antibody who also has icteric interference. In order to resolve the high MCHC we have to do a warm saline replacement, this works splendidly. My question is in regards to the retic. When we run the retic without doing a warm saline replacement vs with the warm saline replacement there is a significant difference in results. Are we supposed to do the warm saline replacement to get a valid retic count or is it unnecessary? Thank you very much

Thank you very much Malcolm- your response eases my mind...and heart burn.

I am questioning my original work flow for processing cold auto antibodies. Currently it is set up that if you suspect a cold antibody we will perform a 3 cell tube screen with auto control and test at IS, 4C, 37C, and IgG. If the patient is reacting at IS and/or 4C with all cells tested, and not at 37 or IgG, we report as a cold auto antibody without sending specimen to the reference lab. Recently we had a positive gel screen = mixed field in both of the 2 cells of the Ortho Gel screen. The cold antibody was also interfering with the blood type. Patient was positive with the IS and 4C phases, and negative with the 37 and IgG phases of the tube screen. The tech was having some trouble resolving the blood type, so it was sent to the reference lab (using Grifols gel) and they found the Cold auto and an Anti-E (mixed field reactivity with all E pos cells in panel). I repeated the tube screen, had another tech do the tube screen and it repeated negative at 37 and IgG. Is it wrong to not send Cold autos for a full panel workup?

We also get a new draw if no patient history on all banded patients. BUT Is it necessary to do a second ABO on a patient that is an O?

I see your point, but if this was to happen I could put in a separate thermometer to trouble shoot it, right? If the continuous probe is out for what ever reason it should alert me, and then I could put an internal therm in the device. And if it doesn't alert me, then having the internal probe is only useful when I look at it. If there is no regulation that requires the internal therm then, I do not see its purpose except to trouble shoot, and it that case I would only use it when I need it.

It has been my experience to have 3 thermometers in blood storage devices. I am questioning this practice 1. The built in external display 2. The continuous monitoring device 3. and an internal thermometer With the use of the electronic continuous thermometer, do we still need to have the internal thermometer? Is the internal thermometer required or is just recommended for larger storage device? Thanks in advance for input on this

This is very helpful thread. We are moving to Epic/Beaker also. has anyone used Haemonetics with Epic Beaker. I had not heard of Haemonetics and I do not see any threads that reference Haemontics when I searched Pathlab talk-maybe I am not doing it correctly. Never mind. Haemonetics is Safe trace. Mabel I will be using your same set up, so get ready to be bugged by me in a year or two

I have read many of your posts and value your opinion. I understand if you are honoring the requirement (can you point me to the requirement?)to provide compatible products for these patients, but in your opinion do you think it is better to give a non washed incompatible plt or a washed incompatible plt? I have received these patients and it is recommended they get washed platelets. My blood supplier argued not to wash platelets, and I see their point, but if it is a requirement I need to be able to present it, so that when I request it, they will fill it.

we use current admit specimen

Off topic, but why washed platelets? I have been told washing decreases your volume, expiration time, and quality of the products.

signature for the length of the specimen. New workup= new form. I am pretty sure they don't even read it

thank you

Does anyone know what educational requirements are for performing and recording blood type on units? Or where I can go to look it up? Thanks Teresa

I recently asked the Medical Director of our blood supplier what a "large volume" meant when transfusing incompatible plasma. They replied 2- 4 units.

Our supplier will not rotate WB

I am a small hospital. I was told by our blood supplier that when they provide LTOWB we will be contracted to order a set amount each month. For example I would order 2 and they will arrive on the 15th of each month. Now I use those 2 units on the 16th. I cannot have anymore until the 15th of the next month. This contract, and wastage encourages me not to provide this product, The same is true with liquid plasma. Mabel I agree that maybe the LTOWB will alleviate platelet constraints in traumas. I am hoping to see some more studies on the cold storage of platelets, I really hope this will be an acceptable practice in the future to extend the life of platelets. Teresa

Thank you Jason I appreciate your help

Both on the original order and add on. Curious are you able to have Irradiated and CMVN requests print on your add on orders that print?

We do not use Meditech, but our ordering facilities use Meditech-without a Blood Bank module, My IT department is struggling with an issue. When an order for 2 units of RBC's is placed it creates 2 separate orders/specimens. We need to be able to have multiple products "added onto" the same specimen. Does any one have any advice I can share with my IT department on how to manage this problem? Thanks in advance Teresa

We do not accept neither units cross-matched nor uncross-matched on patients from another facility. If I have the testing facility info, I call them to let them know if the products were not used. If they want them back I am happy to return. However, no one has ever asked for the product back. This is not something that happens very often here... maybe 3 times a year...

We are not phenotypically matching units unless the DTT treatment does not work or they have developed an antibody.

Thank you all for your response. I just realized I asked if you would order a fetal screen, but it should be a KLEI if they are weak D +.

I am looking at my options for testing Rh (D) negative cord blood specimens with a positive IgG. Currently we do EGA treatment (if the cord blood is immediate spin negative and the DAT/IgG is positive), before doing the weak D testing, but that is rare...only 2 times a year, so this is very expensive to maintain reagent and training for a test performed so infrequently. One of my concerns is that RhIG needs to be provided within 72 hours of delivery, and our reference lab is not accessible everyday. What are other people doing in this situation? Sending the specimen to reference lab and ordering a Fetal Screen? Not sending the specimen to reference lab and ordering a Fetal Screen? none/all of the above? I appreciate all your help Teresa

Hi Mabel, I was wondering how to handle the screen due to the positive reactivity at 37. Are you reporting out a positive tube screen then?

Plasmatherm II- is that what you are referring to? I am curious about it as well