jnadeau

"Compatible blood for a corpse is not a triumph" (sorry - forgot who to attribute this to)

Trying yes - but the anti-IgG DAT is negative so...not that this hasn't happened to be helpful before in a full IRL workup but we are in front of the patient and need to transfuse ASAP. A full crossmatch would be much quicker.

Thanks Malcolm - I'll let him know.

So Malcolm, do you see any need to do a full crossmatch if say, the patient was transfused in the past two weeks (antibody mopped up, so negative antibody screen but hgb dropping and only complement pos DAT )? I know this is far fetched with EDTA spec but this new tech is really smart...and I'm having trouble keeping up.

We have a new tech training in blood bank and I have an old Case Studies packet I give towards the end of the training. One of the results for interpretation is a clean type, neg antibody screen and a DAT with a positive complement result. The crossmatch has immediate spin results and the "answer" key indicates that a full crossmatch should be done in this circumstance. Now years ago, with serum samples and performing a DAT with every spec... I remember this being done if the patient had been transfused in the last __?__ weeks. Now we're testing patient's plasma so... Can anyone refresh my memory please?

I read an article one of my techs forwarded - no fact checking done by them - admittedly - but it's: https://medium.com/@agaiziunas/covid-19-had-us-all-fooled

Hoping to be all PR too - we'll see.

We've been in short supply of RBC's and platelets for so long now it's going to be hard to notice. One good thing that has come of it is the intensified scrutiny of every order - providers have been made keenly aware and are re-evaluating their ordering practices. I guess necessity is the godfather of compliance.

Thank you ALL for your insightful posts - my student is a little overwhelmed with some of the replies (and might be sorry she asked) but she's very sharp and also appreciates your expertise - it's led to some thoughtful discussions here. Since we would have a negative antibody screen performed shortly before they would give a RhIG shot and since we "rule out" some antibodies without respect to dosage when performing an antibody screen I think we'll continue with the abbreviated panel in these instances. Happy Holidays to you all.

Thank you all but I still can't find a reference for acceptably using an abbreviated panel (Ortho 0.8% panel) to rule out other clinically significant antibodies on the panel when passively acquired Anti-D is suspected (i.e. a negative antepartum antibody screen and documented administration of RhIG)

Thank you Malcolm. Just to clarify, this abbreviated panel is done only when the prenatal antibody screen was negative and a RhIG shot has been verified as given.

On the topic of passive antibodies, I have a student in transfusion services right now who wants to know why we don't have to respect zygosity when ruling out on an abbreviated panel (Ortho 0.8%) performed when passively acquired anti-D is suspected to be the reason for the positive antibody screen. I have emphasized the importance of ruling out using zygosity or possibly missing an antibody. Now with the abbreviated panel I tell them ruling out with zygosity is not necessary. Anybody have any history on this?

Sorry no, I'm not that clever Mable. Came across it a while ago (2009) researching best practices on consents to update our P&Ps. Obviously it's much older with that language (wantonly!). Maybe some youngster can find out. My search engine is tired.

I came up with the attached and had them laminated and distributed to every unit - can't confirm that the info is always presented in full but...all we can do is try to help.informed consent2.docinformed consent2.docinformed consent2.doc

A gentleman and a scholar (and a natural comedian). Thanks for sharing your knowledge in such an understandable way through the years - and now with this pic I can point to my reference! Congrats again