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What can I do? I have an OB patient that we reported out as having an Anti-e unable to rule out Anti-C (no e neg C positive cells), Patient antigen types as C negative. We will give e neg C neg units,. The OB Dr. just put an order in to do a titer on both Anti-e and Anti-C, but I don't have any cells to titer the C. Any ideas?

No, I was considering putting the indicators on the products in surgery coolers, but wasn't sure if it was going to be a problem with nursing staff touching them, if only the indicators came with a little camera

Do you train the nursing staff not to put their fingers on the indicators?

This is very discomforting information. How would we determine auto from Vel if it is behaving like an auto?

I just answered this question. My Score FAIL

I just answered this question. My Score PASS

Does anyone have any feed back on the Grifols workstation using the card reader?

1 annually documented.

on some of the immucor that does not require a negative QC, I have thought about this and I think it is because for example when you do a negative tube screen you would use check cells to QC the negative result which is inherent in the test.

I was recently asked how to manage a patient who is pregnant. I was told the patient is older and has had complications of which I was not told. The patient is not wanting to be transfused if PPH occurs. I can only think of TXA and Cell salvage for this patient to avoid blood transfusion during PPH. Do you have any other ideas? I did recommend VERY STRONGLY that they discuss their concerns with their physician! Thanks Teresa

I agree that it depends on the results of the workup up to the point of the elution. I typically do the screen first.

Thank you Malcolm. Can you explain how the titer is able to differentiate immune from a "jab"? I was with the understanding they are both variable in strength depending on the patient.

Hello all, I was asked by another smaller lab if we can do an antibody screen on a cord blood. Me: it would be more appropriate to do an antibody screen on the mother. Them: Mother has Anti-D due to RhIG. A Neonatologist from a larger city is recommending they do the antibody screen on the baby. Me: If they want an antibody screen we can do it on a peripheral draw from the baby, but it seems more appropriate to do the DAT on the cord. Them: The Dr. was asked if they wanted the DAT and they sad no, only the antibody screen and specifically on the baby. Patient is discharged we won't get a peripheral draw. Me: I can do a DAT and if positive do an elution on the cord blood. Why would a Neonatologist be insisting on an antibody screen on a baby knowing the mother was given RHIG? I haven't considered doing an antibody screen on a cord blood because of the Wharton's jelly. Is there any other reason we would not use Cord? Also in a separate situation I have been told to do an antibody titer on a RHIG patient by I suspect the same Neonatologist. What information would be useful from a titer with RHIG? Thanks in advance for sharing your wisdom

cross trained, it is so hard for everyone.

I think I am missing something. When we identify an anti-A1 it is typically at immediate spin in the back type. So wouldn't that mean that my immediate spin crossmatch with A or AB would not be compatible ?

I thought you needed to do an auto control if using Ortho panel CONTROL OF ERROR 1. A control consisting of the serum and autologous red blood cells prepared according to the ID-Micro Typing System package insert should be tested in parallel with 0.8% RESOLVE Panel A. A positive reaction indicates patient abnormality which must be resolved before the test results can be interpreted.

This is a great idea. How long do you incubate your saline test for?

Thank you for your response, yes we do warm auto adsorptions in hours only if they have not been transfused. If they have been transfused we then send it to the reference lab for the differential adsorption. If the reference lab does the workup, we then have reference lab to the crossmatches.

We do use potentiator with the prewarm. We also use it when testing our WAHA patients. I know there are many labs who do not use it for WAHA workups. I was told that in the end the potentiator really only reduced your incubation time. If this is incorrect someone please enlighten me

When crossmatching for Warm Auto patient's we have it in our procedure to AHG crossmatch with the neat plasma and the adsorbed plasma. When the adsorption works this is a great tool, but when the adsorption does not work it seems redundant and useless. Am I missing something if I change the procedure to state that we do not have to perform the AHG crossmatch with adsorbed plasma if the adsorption did not work? I was also wondering what other labs are doing for workups for frequently transfused warm autos...I know they shouldn't transfuse, but they don't listen to me. We do the adsorption workup every 3 days. Our reference lab will not do the adsorption if the DAT has no significant change every 2 weeks. What do you do? Thanks for your time and knowledge

Thank you all this is very helpful.

We are a level II trauma center 2.5 hours away from our supplier. We have 3 platelets on hand usually. Can you share how many platelets you store, how far away from your supplier your are, and what trauma level you are? Thanks Teresa

2 cell for gel for cost reasons

I found out from one of the manufacturers that sterile saline is used to reconstitute the powder form of DTT They said it was better to reconstitute for each use then to freeze aliquots.....they didn't say no