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Most of our antibodies to gel diluent react only with the pre-diluted reagent cells, but not in cells suspended in MTS diluent 2 (auto control, XMs).  There are no antibiotics in the diluent 2 because those suspensions are discarded promptly whereas the reagent cells must remain stable for weeks.   If there are antibiotics in the gel itself, we have not seen reactions to that, but it makes sense.

You may not "mean to offend" but that does not make it any less offensive.  If you have nothing helpful to contribute it's best not to. 
I have worked in level 2 trauma centers with 24 / 7 coverage in the blood bank.  I have also worked in a rural clinic in a Wyoming county the size of most states east of the Mississippi and there was not hospital in the county.  The closest hospital was 2 hours by ground and if we needed a trauma center it was at least 3 hours to get a helicopter or airplane in and out.  You do the best you can with what you have.  The people of the county realized that one of the prices they had to pay for living in one of the most beautiful areas in the world was limited access to health care.  They understood, accepted it and were actually grateful for the level we could provide!  They neither wanted nor needed ..........   I best stop now. 

Just to add to this, ask your medical director if he/she is willing to help you out with study material. At the University Hospital where I work the medical director was kind enough to take us through the same material/coursework that the residents go through in order to prepare for their board examination. That along with a lot of studying on your on will have you on your way to an SBB.

You do not have to go to SBB school - BUT, the test is made so that those who do attend will have a better chance at passing. Challenge it . . . I did. Remember, this specialty exam has the least percentage of techs passing, but look at the knowledge you will gain in studying for it. Also, some blood centers offer study courses and I think there are some on line also. good luck

For us it would depend upon the patient's age and child-bearing potential.  If that is unknown or unclear, routine transfusion after MTP would be A NEG.  Additional massive bleeding A POS.  

Following - I am so glad you asked this question as I have asked the same thing to both Ortho and AABB with no direct response.
My question was, is there a requirement for an incubator and centrifuge to be an FDA cleared medical device?  We use them throughout the lab and blood bank for specimen centrifugation and for serologic tube testing, and those are not FDA cleared devices.  As long as your equipment is maintained and is meeting the requirements of the circular/instructions for use, aren't you compliant?
 

We accept verbal requests but should be followed by an order for emergency released (RBC, WB or plasma) placed in Epic. We issue blood with a triplicate form and require a physician's signature and a copy returned to the Blood Bank.  The form documents the units that were issued, product type, attestation statement, diagnosis, and issue information including a visual inspection of the product, person picking up the product, date/time for issue and the employee ID of the person issuing the product(s)

As for how many points to calibrate, my personal opinion is to do three points.  The lowest should be below the lowest range you'll use, the highest above, and then a midpoint.  This is not perfect, but it helps prove linearity.  Many places only do one or two points, though.  It also depends on the significance of what you're measuring.  For instance, a 20-second AHG spin... does it really matter if it's 20.00001 sec or 20.00002?  Of course not.  That's what leads some people only to do one or two points.
When you say they're using their phone, do you mean a timer inside the phone?  I stick by my original statement above; it's irrelevant for what we do as med techs... but..., in this case, as your assessor / inspector / regulator, I will want to see that you are using a traceable device for these measurements.

I am wondering if your lab uses the buffered gel cards to test with enzyme treated panel cells in parallel with non-treated panel cells to differentiate multiple antibody specificities, i.e., observing increased or reduced/eliminated reactivity of antibodies. I am still confused whether the buffered gel card can detect IgG antibodies as there is no anti-IgG.

Running a 10%  bleach solution through the system is part of manufacturer's suggested maintenance. We do this weekly (high volume testing lab). The carrier should have hot water run through from the top for a few minutes to remove encrusted salts. You can use a pipe cleaner for any outlet that is still appears blocked.  After running bleach through the system (let sit for 10 minutes), run 4 cycle wash with distilled water, and follow with a 4 cycle wash with saline to ensure no bleach solution remains.

Running a 10%  bleach solution through the system is part of manufacturer's suggested maintenance. We do this weekly (high volume testing lab). The carrier should have hot water run through from the top for a few minutes to remove encrusted salts. You can use a pipe cleaner for any outlet that is still appears blocked.  After running bleach through the system (let sit for 10 minutes), run 4 cycle wash with distilled water, and follow with a 4 cycle wash with saline to ensure no bleach solution remains.

I just answered this question.

My Score PASS  

You did everything necessary as others have said. At our facility, physicians seem to be unphased by the use of emergency released blood - we issue a lot of it.  It is not uncommon to discover that the patient has a historical antibody that may or may not be demonstrating. The physician and pathologist are notified when the history is discovered and the physician makes the medical decision to continue or stop the transfusion at that point. We perform antigen testing of the unit(s) and perform AHG compatibility testing of all units that are issued.  Further laboratory testing is ordered by the physicians caring for the patient. The most immediate concern is an acute hemolytic reaction and that is rare. Shortened survival of incompatible transfused red cells is expected.

why not just use grifols' cells?
 

Unfortunately, I don't have another supervisor, asst manager, or even a lead tech who can perform my competency.  And the only 2 techs who have bachelor's degrees work mainly in Micro, so they're not strong blood bankers.  But, according to CLIA, they're qualified to perform competency assessments in blood bank.  I think a lot of times these regulations look good on paper, but they don't always carry over to real world situations.  That's how people end up in supervisory positions when they have no idea how to actually do the job themselves.  There just aren't enough people who meet all of the regulatory requirements and have the knowledge and experience to do the job effectively.

We use ALOT of WB (we have WB in 2 ED refrigerators for their use and have a pre-hospital blood program with 4 air care helicopters and in multiple county EMS units)
our computer will allow for EXM if patient is admitted and we receive 2 samples.  otherwise we ISXM.

I've been a BB'er for 35 years (at the same hospital)  my very first manager (who was a good,  seasoned BB'er) used to tell us........., "if you have to hunt for it - it's not there".
As you become more adept at reading tube reactions - your eyes will not fail you!  Trust your gut.
As for your technique - it all sounds good!  Practice with a few techniques to find the one that works best for you
I "tilt and giggle", button up, The tilt helps with seeing Mixed Field - which we tend to see a lot here - It also helps with seeing "how" cells are falling off the button - are they chipping off or are they "swirling" off.....or is there a little of both?  (For some reason I always think of the "tail" of an old RPR test .....which probably dates me, LOL!)

I remember being really confused in school as I was trying to copy the swirling that the grad student did when reading his tubes. When I went to the hospital for my clinical rotations, the blood bank supervisor taught me to hold the tubes with the button up and just tip the tubes over the finger on my other hand and watch the button as it came off the tube. This has worked so well for me all of these years in the blood bank.

Need more info - what is your starting volume and hematocrit?  Use formula  C1 x V1 = C2 x V2.  DM if you need more  - jeanne.towery@prismahealth.org

Need more info - what is your starting volume and hematocrit?  Use formula  C1 x V1 = C2 x V2.  DM if you need more  - jeanne.towery@prismahealth.org

AABB standard allows for no agitation for up to 30 hours

Blood bank methods aren't expected to correlate perfectly.  We use their differences to avoid rouleaux, clinically insignificant, and weak warm auto reactivity so we can better detect any significant alloantibodies. No method will detect 100% of significant antibodies. I am going to tweak the above to say we can "better detect' antibodies so it works better with the next sentence and doesn't imply that we can detect "any" significant antibodies. 

We use both the CAP DAT and API Automated DAT surveys to cover automated, manual gel and tube testing.   The API surveys are graded.

If we have to hunt for a sample to use for this that will give consistently comparable results, we aren't testing the method, we are testing our ability to find a suitable sample.  I heard that CAP will sell you one that will consistently give the same results.  If we aren't going to change anything (can't recalibrate gel!) based on the answers we get (like chemistry would), then why are we doing this?  I talked TJC out of it last inspection (I probably got a little heated over the stupidity of it because I had to come in the day after a concussion to meet with them, but maybe they took pity on me and didn't cite me because of my unfiltered brain).  No one has been able to explain to me any meaningful takeaway from doing this comparison.  If I am ever forced to do it, we will just keep copies of sample results that we run by two methods to solve a problem and make a note that they are acceptable because we expect these differences between methods.  If anyone can give me a valid use for this, I would be very appreciative.

We use Softbank and print a bag label with patient/donor/product information that adheres directly to the bag.