trisram

25 year old female got admitted into the ER with a knife wound. She was a bone marrow recipient last year. Blood is ordered for her. I do a ABO/RH and this is a her result: Anti-A = 0 Anti-B = 0 Anti-D = 4+ a1 cells = 0 b cells = 4+ What could explain the discrepancy here with her ABO typing? And what type of blood should be issued? Here is my answer: Patient orginal blood type may have been A+. But she might have been given O+ donor marrow when she had the marrow transfusion last year. I check her medical records to confirm this. If that is the case, then her marrow is making O+ cells but her B antibodies are still in her plasma. I do an Ab screen, and if that is negative, I issue 37o crossmatched compatible blood for her. Did I miss anything? Thank you

Sorry, yes I am taking a test. I already said I was taking a test in another thread. I have my answers already, I am just double checking. Thank you

Yes, you're right, thank you.

Thank you Joan. You're right, I am taking a test. I already written all my answers down, it is just that I am just double checking them and looking for any corrections or extra suggestions I can add to them. I usually work microbiology and hematology. They have me cross training in blood banking now, so I am just trying to get more familiar and more knowledgable. Okay, let's see. So basically this is what I have right now: 1) Do an ABO/RH and DAT on baby 2) Do Ab screen and AB ID(if neccessary) on mother 3) If DAT and Ab screen is both negative, issue 37 degree crossmatch compatible units 4) If DAT is positive, then prewarm and wash several times, and retest. 5) If Ab screen is positive, antigen type for corresponding antigen for both patient and donor cells. Then issue only the antigen negative, 37 degree crossmatched compatible units Does this sound about right?

Wow, check out the big brain on Malcom!! Thanks so much!

He's a newbie doc. He is asking us for suggestions.

Thanks! I didn't think about that! Okay, her mom is B pos too. So I give her 37 degree crossmatched compatible B pos units and that should be okay, right? What about amounts? Do you think I should split the bag?

Malcome you're amazing! Thanks so much! Thank you too joan. Happy holidays!! Thank you all!

The patient is a newborn boy with a low hemoglobin. The doctor wants to do a transfusion. Here is the blood typing results: Anti-A = 0 Anti-B = 4+ Anti-D = 4+ Is there anything special we should do here? Besides just issuing B+ units? Thank you all so much!

Sorry, the question didn't include that information. Thank you though

That happens a lot where you're from? Where there are more O neg units on stock than O pos? I would like to work where you work

A 65 year old man was admitted into the ER with pneumonia. A blood sample was drawn and this is the result of his blood typing: Anti-A = 4+ Anti-B = 0 Anti-D = 4+ a1 cell = 4+ b cells = 4+ What could be the explanation for this dispcrepancy and what blood should you issue him? Thank you so much for your time.

A 75 year old lady was admitted into the ER with a CVA and was treated with lots of anticoagulant and 9 units of FFP. 3 days later, units of blood was ordered for her. And a new blood sample was collected from her for blood typing. This was the result of her ABO/RH typing: Anti-A = 0 Anti-B = 4+ Anti-D = 4+ a1 cells = 0 b cells = 0 What may be the explanation for this discrepancy and what blood type can you issue her?

I would issue the unit. Once the nurse is out of the room, the computer will somehow accidently crash to the concrete floor, smashing into tiny little pieces

We don't QC our panels at all. We just throw them on the shelf and pray that we don't get an positive antibody screen. Hey, don't ask me why, I just do what I'm told.

You should be able to sit for the MT exam? In my opinion, a BB and a MT is almost equivalent in stature and pay, the only difference is, that one of them is supposedly better at blood banking.

can anyone give me some information of give me a link for instructions on selecting the ABO RH of blood products like plasma and red cells for all the different ABO RH type patients? Like O+, O-, AB+, etc... Thank you for your time

Thanks , but I don't have a manual. What does it say ?

I think it was more of a computer program thing than an actual testing thing. In our computer program, there are two different codes for Anti E, one is ABGE and the other is ABIGE. If ABIGE is used, then the patient cells should be c postive. I think it is because I used the ABIGE, that I needed to do the antigen c testing, just to make sure if the units and patients were really c posiitve. I couldn't change to ABGE, because I saved it already. I think that is what my supervisor was trying to say.

I think perhaps she was just trying to show off how knowledgable she is in blood banking, and that the c antigen typing was unnecessary. If that is truly the case, all she accomplished was confuse me more.

Thanks so much Sir. But my patient was male though. Here is what happened? 1) I got a request for 2 units of blood 2) I did an Ab screen on the patient 3) the screen came up positive 4) so I did an ID panel 5) I was able to rule in Anti-E and Anti-K 6) Then I antigen typed 2 ABO compatible units. They are both negative E and negative K 7) I also did an initial spin cross match and a gel cross match for for both donors and with patient plasma. Results were negative, so units are fully compatible. I though I was finished, then my supervisor told me to also antigen type for c. Why I am wondering is why is this situation so special to require c antigen typing? I understand what you are saying about the patient being antigen c positive, and it would not be wise to give him/her c negative blood. Then why don't I antigen type for c everytime for everyone? But wouldn't the gel crossmatch be able to rule out any Ab/Ag non-compatibilty between donor and patient? Basically, I was just wondering, why is this situation different that I had to do an c antigen typing? Sorry, I am training in blood bank, iand t has only been a few weeks. Usually, I work microbiology and core lab, but we are short of staff, so they have me filling in for the time being. Thank you for your answer, it has been very enlightening. T. Ramon, MT(ASCP)

I ruled in Anti-E in my patient's antibody ID panel. Then my supervisor told me to antigen type for little "c" for both patient and all donor cells. She explained it to me, but I didn't quite fully understand what she meant. Anyways, can anyone explain to me? Thank you in advance for your time and help.

I am sorry, can somebody explain homozygosity for me? It's been a long time since I have been out of school. Thank you.

Thank you so much!

Well, I just needed to get a general idea on how to go about issuing donot units if the patient/recipient has a positive Ab screen. So far I haven't caused any hemolytic transfusion reactions ... Thank you