Gkloc

Here we have a list of requirements that the tranfusionist completes by checking off that they performed the task. This is on the transfusion tag that is attached to the unit. 2 of the items are Verify Interpretation of Crossmatch Tests if Performed and Verify Special Transfusion Requirements. Inspectors have been ok with these.

There is no hard rule that Blood Bank has to be in a separate room. The whole lab here is in the same room, including the Blood Bank.

I did forget to mention that I did do this prior to performing the eluate and testing against the Father's RBC's. I was able to find 8 low frequency antigens (Dia was included) but they all came out to be negative. Unfortunately that was all the low frequency antigens I could find on the panels that we have available here.

Update - We got a specimen from the father and ran an eluate from the Cord Blood with the fathers cells. The results of this were negative. We also found out that the mother gave birth in 2019 and the Cord Blood Workup for this infant was also O Rh Positive with a positive DAT.

We had a mother who had a C - Section yesterday and a Cord Blood Workup was performed on it. The Mom is Type O Rh Positive (negative antibody screen) and the newborn typed as O Rh Positive as well but had a positive DAT. We are unsure as why this occurred. The testing was repeated on a heel stick and the same results were achieved. Any help anyone could give as why this could happen would be greatly appreciated. Thanks

Here the Medical Director or designee is the one responsible for contacting the patient's physician. If the patient's physician refuses to contact the patient, our Medical Director or designee will end up having to do it.

Here our phlebotomists perform the Therapeutic Phlebotomist. They are trained in performing it prior to them being allowed to perform the procedure. They also perform it in an area where a nurse is available in case anything happens they can come in an assist the patient.

We keep 1 irradiated O Neg on hand for infant transfusions. We get a new one once a week. We also don't transfuse a lot of infants but we do have a NICU here and we will get an infant every couple of months that requires a couple transfusions.

I would familiarize yourself with whatever regulations your lab is accredited with (AABB, CAP, TJC). That helps get you an understanding of what needs to be done and why.

The OR staff collect the specimens.

The Cerus Intercept system for pathogen reduction does this.

Yes you are correct, if you use pathogen reduction you would no longer need to irradiate platelets.

I found the FDA Guidance for this which I have attached. There are a couple of ways that the FDA is saying will meet this Guidance. So if you don't keep platelets on hand you may not need to do anything if your supplier does the initial bacteria testing, but if you receive a platelet on day 4 or 5 of life you would have to check with your supplier to see if they would be performing that secondary bacteria testing on the platelets for those short date units. Bacterial_Risk_Control_Strategies_for_Blood_Collection_Establishments_and_Transfusion_Services_to_Enhance_the_Safety_and_Availability_of_Platelets_for_Transfusion_Dr.pdf

Yes there is a Guidance from the FDA regarding bacteria testing of platelets that has been a Guidance for awhile. One of the methods to be compliant in this is to use pathogen reduced platelets, or perform bacteria testing on platelets on day 4 and 5 prior to issue. I was told that the FDA is being told that they need to finalize this Guidance this year around October, I believe.

We use the STAT Spin Express 4 here which allows us to centrifuge our specimens for 3 minutes.