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rravkin@aol.com

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  1. Can anyone give any references on the possibility of transfusing a unit of Single Donor Platelets that are reactive with EDTA?
  2. Have you ever tried using this scenario in an in-lab continuing education exercise?
  3. Thank you for the information Scott. It did compel some research where I found that the MCH actually measures the mass of hgb of the rbc in the middle (based on volume) of a group of counted rbc's while the MCHC is measuring the average hgb concentration of a group of packed rbc's, and therefore I stand corrected. I guess that I suspected a relationship between the MCH and MCHC because they both use the measured Hgb as numerators in their respective equations. Our DXH will flag an H&H check fail which will trigger a closer look at the H&H and the indices. If your MCV is low, MCH n
  4. I just answered this question. My Score FAIL  
  5. Scott, I have always understood the MCHC as being the statistical Mean Hgb concentration of the rbc whose volume would be in the middle the lowest and highest volumes of a group of packed rbc's representing the HCT. The calculation for the MCHC is Hgb/HCTx 100= MCHC. Also, we practice to incubated for 30min or an hour depending on how strong the cold agglutinin is as represented by the elevated MCHC >36.0. If lipemia is found then we would do a saline replacement. And if there is a combination of lipemia and cold agglutinin we would replace with warm saline. Additionally, I understand the
  6. Thank you TreeMoss but I was asking about Open Heart Surgical patients where their body temp would be lowered and as such some surgeons request a cold Ab screen be performed as part of the blood bank pre-surgical work up. If a blood warmer were used the cooler blood from a cooler surgical suite would course through a blood warmer and into a cooler then normal body, thus lowering the temp of the now transfused blood. Therefore, even if a blood warmer were used for this patient would a cold reacting antibody still be of some concern with respect to the minimal possibility of agglutination of th
  7. So Treemoss, do you know if rbc agglutination, and the damage it can do to the microvasculature, is a concern with this surgical patient group if a cold antibody is demonstrating?
  8. Let's not forget that we are dealing with a perishable product, packed rbc's, and not a non-perishable product like a book or a refrigerator.
  9. David, I am not sure if there is a difference between transported and delivered, outside of potential semantics. If a package is delivered it was certainly transported. But I think that the FDA's thinking is based on the stored conditions during the transport; thus taking the transport part of the equation out of consideration. If you are familiar with the convenience retail chain, Wawa, one of their limitations on expansion is the safe storage of perishable products being delivered directly from their farm to surrounding stores. With advancement in storage capability they are able to expand;
  10. Hi Scott and Exlimey, perhaps the idea of a hemolytic reaction is remote when considering cold agglutinins but if the patients body temp and OR temp are below normal body temp and room temp respectively, and, if the cold agglutinin is strong enough, either by way of concentration therein of bonding strength, does the cold agglutinin not have the capability of causing rbc agglutinins to form and remain stable long enough to cause damage to the microvasculature in the same manner as with Lupis Erythmatosis.?
  11. Hi TreeMoss, I gather that you and your crew were not real inspired by this line of testing. When the practice was first explained to me it seemed like a good practice, the idea being that if the patient had a cold reacting antibody and needed transfusion during the procedure when their body temp was less than normal, perhaps the OR staff would be better prepared in treating any adversities. I guess that your new surgeons do not agree with this practice. But can I ask what kind of incubators were used in your blood bank to test at 10, 15, and 20C? The reason for my question is that I have only
  12. Hi Dansket, can you explain what you mean when you say "level of control"?
  13. I was going to ask if distance traveled had anything to do with this distinction, transported or stored. But it is actually the container that is being transported and the blood is stored within this container. If the container is sealed such that the stored blood is not in any contact with the elements then the stored blood would be good until it's expiration provided the temp is maintained in this container. I think that the container's ability to maintain the appropriate temper for a given time and the time it takes to travel a given distance is probably where the question of transport and
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