DPruden

From "Guidelines for Prenatal and Perinatal Immunohematology" from AABB: see attached PDF. We only workup Rh negative moms and we are no longer routinely doing DATs on any baby, unless clinically indicated. Scan001.PDF

Speaking of changing names, there is a bug that used to be Pseudomonas maltophilia and it was changed to Xanthomonas maltophilia. Soon after it was changed again to Stenotrophomonas maltophilia, I was working in Micro (I know micro and blood bank is a weird combo!) and a doctor called the lab and said "I'm sorry, I'm hoping you can help me because my patient seems to have a dinosaur!"

You should check your package inserts, Ortho gel cards are supposed to be stored between 5C-25C. We installed a min/max thermometer for room temperature monitoring after having this pointed out on an inspection. If you do donor testing, some of the NAT reagents have humidity requirements. I used to work at the blood center in Denver (also very dry here) and the NAT room had to be humidified. I think it was Chiron that was being used, but I'm not entirely sure.

I think Haemonetics makes a secure blood fridge too, but I can't remember what it is called.

Our computer system logic will not allow the selection of ABO incompatible units regardless of the patient's antibody status, it doesn't just alert us, you can not choose an incompatibile unit. If the only purpose of the IS crossmatch is to identify ABO incompatbility and the computer system covers this, then why is an IS crossmatch needed?

The powerpoint presentation was really good, thanks for posting that. I attended a disaster planning seminar where the New Orleans Blood Center CEO spoke about the Hurricane Katrina flood. One of the things I found particularly interesting was their discovery that mobile phones weren't reliable, but texting did not take as much bandwidth, so texting on personal cell phones was their only mode of communication while the phone line were all down.

We used to make everyone in the blood bank spit into a tube and used that! That was quite a while ago however!

We do both Fetal Screen and KB in Blood Bank. We also issue the Rhogam. We also do a fair amount of KB stains on Rh positive patients from the ER, the doctors are looking for evidence of a fetal bleed.

We use the handwritten Typenex bands currently and we do reject specimens for even slight misspelling errors. We use patient name, DOB, date and initials, we will accept MR#, but prefer DOB so that it can be verified verbally with the patient (if possible). I will not go to a pre-printed label until we have bedside barcoding. We have too many mislabels with the pre-printed labels in the main lab for me to feel comfortable using them for blood bank specimens. The floors all know that we will reject specimens, so they are pretty resigned to the fact of the redraw. There is a very interesting article in Transfusion from 1997 about a study Johns Hopkins did around mislables. they found that specimens that failed to meet the criteria for specimen acceptance were 40 times more likely to have a blood grouping discrepancy. Every time I see a tube with only one letter missing, I always think of that!

Thanks for all the input!

We may be switching blood bank computer systems in the near future due to some consolidation/sponsorship changes.:raincloud We are currently using HCLL by Mediware and will be going to Sunquest for the whole lab. The last time I used Sunquest blood bank module, it was pretty bad. Does anyone have any newer experience with this system? Thanks!

We are not doing electronic crossmatch, but our computer system will not allow the selection of ABO incompatible units. The computer system was validated to this effect. Shouldn't that count for the ABO compatibility portion of the crossmatch?

Sent them today.

FFP and FP24 are considered "clinically equivalent". I have some good references on this if you would like, I could send them to you.

You might also want to take a look at the medications the patient is receiving if you access to that.

I attended the (9425-QE) Challenging Compliance Issues from the CAP and CLIA at the AABB conference in October and the take home message was don't go overboard to meet this new requirement. There are still discussions going on at CLIA regarding this item. If you have the sync-to-slide from AABB, I would recommend listening to this one.

In answer to #1: We had that same question about re-irraditating here when a rad-sure was not applied to the unit before the irradiation process. The techs wanted to re-irradiate to save the platelet, but unfortunately the answer is to discard the product. It can no longer be labeled as non-irradiated or irradiated and the FDA is very firm on not allowing mislabeled products. to #2: I would think the most probable explanation is transfusion at another facility. We have had a couple of patients who hop back and forth between hospitals and lead us down a merry path trying to figure out their situations.

Standard 5.13.1 refers to the patient testing that must be performed pretransfusion. 5.12.1 refers to the type confirmation performed by the transfusion service, and from what you have said your ABO and Rh from the segment post-labeling meets the requirement of both 5.12.1 and 5.9.5, since the units are kept under one roof.

LA-82-** Crossmatch tag or tie tag incorrect or missing information {Use LA-82 if tag physically attached to the unit is incorrect or missing information, or both the tag and transfusion record are incorrect or missing information; Use LA-83 if transfusion record, accompanied with unit, is incorrect or missing information} LA-82-04 Product type or code incorrect or missing I would use LA-82-04 if the tag was physically attached to the unit, but it could be LA-83-04 (depends on how your transfusion record is attached. See the link below for further explanation. http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProblem/BiologicalProductDeviations/ucm129721.htm#bllbl

We managed not to get cited on this in June. So, what are people doing when the methods don't correlate and we all know they won't in some instances?

Thanks, I was writing it for our generalists who were mightily confused with ABO discrepancies.

We do this too. Particularly on serologically difficult patients.

I have just finished revising our SOP, it was a bit of a mess too! But I finally got it written. I will attach it. 02-LABT-2041-04 ABO Discrep.doc

We had a couple of different FFP products that were not modified in the computer, so the tag and unit still had the original 1-year expiration when issued. Those were both FDA reportable because the expiration date was "extended". We chose to use the ISBT labels and change the product code when a unit is modified in the computer and made all of the frozen product codes non-transfusable so that a tech could not issue a product that was still listed as frozen in the computer. There is an electronic second check when a product is re-labeled in our computer system.

The tags that we use for the Trauma, Patient are the same as the tags we use for normal use. So, the nurses fill out the tags as usual.