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Everything posted by jcdayaz
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True. What you say here is 100% correct. You never know what is underlying.... But "Clinically significant" in relation to transfusion practice as opposed to reference lab identification is different. I would not EVEN BEGIN to question something AABB put out......If "They"(whoever they are) support a practice we will go with it!!!!!!
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We would NEVER antigen type for Lua. We believe it to be pointless and a huge waste of time!!!!!! Your question of "Why is it on the panels"... Yes, for no other purpose other than to identify some weird reaction that doesn't match anything else. Look at your panels.....there are many non-sensical (in my opinion) antigens on there. Cw, Jsa, Kpa, Lua, etc, etc..... It was presented at AABB years ago that if the antigen you are trying to "rule out" on a panel is TOTALLY negative on all cells and you are seeing reactions you can rule out that particular antibody. (Not sure how I feel about this...but I most certainly don't think I know more than the AABB people!!)
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DON'T EVEN GET ME STARTED ON NURSES!!!!! As you well know, there are a mere handful of good ones....that's it!! How can a person, nurse--janitor--cafeteria worker--whatever...not notice a MISSING HEAD???
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Malcolm, I just stumbled upon this post. I am LAUGHING OUT LOUD right now!!! Thanks for making me wake my husband up!!:D:D:D:D:D:D:D
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I will confess to not knowing this information prior to your post. I will go to references right now and learn it!!! THANK YOU
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WOW!!! I'm so far out of my league here it's scary!!!!!
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VERY NICE!! I will use this comment the next opportunity I get.....
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WOW! This comment was used frequently by my son's preschool teacher when he was 4 years old.....Nice to be reminded of that time.....
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What part of Kansas are you in?? I lived in Wichita for a few years... So, I am curious...
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LOVE IT!!!!!!! I'm sure they THINK they are Sherlock Holmes!!!!! Don't they all???
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I second this thought adiecast!!! How nice it would be to occasionally get a break that you didn't work your you-know-what off for!!
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I agree with your "Very stupid Policy" statement. That is not only stupid....it is absurd!!!! I would have just overridden that ridiculous anesthesiologist's demand. I would have packed up O pos blood and sent it in a cooler to the OR. I hope that particular anesthesiologist is no longer practicing medicine!!
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No Malcolm, it is most assuredly not just you!!!! I think all real Blood Bankers talk to themselves when trying to figure out what step to take next in a difficult case. Sometimes it helps immensely to hear what you are thinking. Yes, even if it comes from yourself!!! Your colleagues don't sound like they "Get It"...ie..understand. We often times will respond to a coworker talking to themselves with "Let me know when/if you are talking to me. Let me know when/if I should respond."
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NM location, I am assuming you are in New Mexico, US?? I am going to make this post with that assumption in mind.... I am in Tucson, AZ. I would presume we have a similar patient population base. We also get a lot of women who have had NO prenatal care whatsoever!! We see, not infrequently, a woman who only presents to any sort of physician (ER) when she is actually in labor and ready to deliver. This situation does indeed complicate things. You have to assume if she is RH neg that she has not received Rhig due to the total lack of prenatal care. We would ID the antibody in this instance. We would not, however spend countless hours chasing down an Anti-D in a woman who we ourselves administered Rhig to earlier in the ER. Then we would have FACTUAL KNOWLEDGE of Rhig administration status. If the pattern appears to be Anti-D on the screen antigram we result it as "Passive Anti-D presumably due to Rhig dose given on_____"
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Same here. There is investigation happening on getting rid of the automatic O mother testing.....just guessing it won't change anytime soon. To me, it is POINTLESS to identify an Anti A,B on a cord sample from a type O mom. DUH, you will detect mom's antibodies EVERY TIME!!!!!
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We use historical type only for FFP. We have adopted the practice of transfusing non type specific platelets and/or cryo ( in most circumstances...not always....depends on the frequency of transfusion need). We still require a Type/Screen specimen prior to transfusion of these products if we have no history on the patient. We think it best to get a pretransfusion sample to get a "baseline"...ie..prior to anything foreign being introduced.
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Ha Ha Ha!!! I work with a woman who says "You're just jealous because the voices in my head aren't talking to you!" :D:D She typicaly makes this statement after she has been talking out loud to herself to work through some problem. :D:D:D
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YES! I attended an AABB Teleconference last week that dealt specifically with Bone Marrow/Stem Cell transplants. There was a part on its application to sickle cell disease and the recent success rates!!!
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Thanks Malcolm. However, we have an EXTREMELY conservative BB Medical Director (conservative to a fault on several issues). I believe he would immediately make the argument that patient status ie..GI bleed vs chemotherapy, trauma, liver failure status, etc etc has more to do with transfusion numbers than "Least Incompatible" blood does.
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We have the same "issues" here in the US. "Just give them O negs" is a common statement among ER physicians when there is an antibody issue. SCARY! As a previous post said, they probably get @ 3 hours of blood bank training in Med School/ Residency. Kinda hard to figure it out in that amount of time, I would say!!
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Any thoughts on how I might possibly be able to "prove" this to our Dr's? We don't have the equipment/technology to do any sort of flow (of which I am aware) with specifically marked cells.
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Question...what do you consider "Least Incompatible" at your institution???
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Whoa, that presents a whole different problem. I wonder about the mind-set of a pregnant lady who decides to travel to a different country near her expected delivery time!! My Obstetrician told me not to travel even a mere 3 hours away from her in the last month of my pregnancies. We still abide by the theory....If in doubt about RHIG status, do the full antibody ID. It is only when we have factual knowledge of a specific RHIG injection date that we will not ID the antibody. We are required here in the US to have translators available 24/7 for every language. So the language barrier is not normally an issue for us. (Besides from the nurses who THINK they are speaking English!!!---UUUGGGHHHH!:D:D:D
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We contact the patient's OB Doctor to ascertain this information. It is surprising to me to hear the number of women who know they "got some sort of injection" but don't know what it was.
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We do our testing in gel. It is an extremely sensitive testing method, sometimes too sensitive. Are you still doing tube-testing?? The gel method typically detects partials, mosaics, whatever. Okay...what's the "Bob's your uncle" comment about???? Sounds like a good one!:cool: