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Posts posted by jnadeau
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I take plasma from group O patient samples (no longer needed) who have a negative antibody screen and add about 2 ul of antisera per 2 ml of plasma. This usually will give 2-3+ reactions in gel (but as Cliff said it doesn't always act as expected). I use expired 3% panel cells, negative for the antibody I spiked the plasma with, for them to use as a "patient".
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My guess would be that Ortho asked the FDA to delist - to sell more units. I'm now using a tube incubator that is older than me (well almost) until the new one arrives.
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We call them "Alerts" - new hemolytic antibody identified during pregnancy, pos DAT on baby, transfusion error or serious trx, no compatible units for a specific patient or delay of product. It's called and documented in the computer.
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I believe the 4C thio is for isolation of Yersinia - likes the cold - but I haven't worked microbiology in many years now. There's a special media micro uses for that now - I think.
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Thank you very much Malcolm - you're the best! If you would clarify in the second paragraph please - worth their salt "would" or "would not" report out... we're filled with Canadian smoke here and it may be causing me confusion
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Is anyone using the phrase "No antibodies detected" in resulting an antibody screen? I know "Negative" is commonly used but I remember using NAD someplace in the past - and seeing it through the years. Just thinking that it is clinically more truthful than a flat out NEG result. All detection methods have their caveats and can miss some patient antibodies - manufacturers have disclaimers in their IFUs. Maybe the patient's antibody is below detection with the method. Could also avoid finger pointing by the provider (or worse - a lawyer in a malpractice suit) if a patient DID have complications (or worse) and they were recently transfused. Some reference labs result as NEG for the serum studies but then it goes on with the Additional Comments - all clinically significant alloantibodies have been rules out using etc.
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No Dr. Blumberg - not the transfusion rate - the dialysis access flow rate evidently needs to be adequate to do the dialysis and also add in blood using an infusion pump as usual. The SOP (which is not mine) states a start rate of 75 ml/hr for the first 15 min, if vital signs are within normal limits/pt's baseline, adjust over 45 min and transfuse the remaining blood product within ONE hour".
This is unfortunately coming to the blood bank because anything with blood product infusion (and reinfusion) stumbles into our purview - e.g. cell saver, nuclear med reinfusions.
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Does anyone have a caution statement in their Blood Administration Procedure to "assure patient's hemodialysis access has blood flows > or = 300 ml/min before requesting any blood products from the Blood Bank? Many dialysis patients don't have that level of blood flow. What will transfusing blood with less flow do to the patient's access (or the transfusing blood)?
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We keep the opened segment used for the crossmatch instead of pulling segs on receipt or issue of units. I've done that at other facilities - seemed like just another thing to store and then toss. When a TRX is called it's easy to pull the sample with the segs used (rubber banded to sample), do the clerical check (match up the segment DIN and the seg # with #'s on the returned bag) and then get a couple more drops out of the seg for testing. Have never run out of cells and can "confirm" the right seg was used for the crossmatch.
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Meeting title is type O Allocation Initiative
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Our ARC rep has a meeting set up for the blood bank sups in our affiliation for this afternoon - 12/08/21 - we're in NY so it's not just your region Mabel.
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Yes we have too. Try Vista if MLA is backordered in your region.
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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.
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Thanks Malcolm - I'll let him know.
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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.
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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?
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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
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Hoping to be all PR too - we'll see.
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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.
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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.
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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)
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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.
ChemLabTalk: Acute pancreatitis
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