goodchild

We wrote in our policy that we don't expect 100% concordance, cited several publications regarding the differences between the methods, and made a note that the blood bank supervisor and medical director will both review the results to determine the significance of any observed discrepancy.

We wrote in our policy that we don't expect 100% concordance, cited several publications regarding the differences between the methods, and made a note that the blood bank supervisor and medical director will both review the results to determine the significance of any observed discrepancy.

Wow. This is one of the reasons why our automated temperature monitoring system has an alarm point and computer access to monitoring directly in the blood bank. If an alarm goes off it starts playing Rock and Roll by Led Zeppelin (clicked all the way to 11).

Wow. This is one of the reasons why our automated temperature monitoring system has an alarm point and computer access to monitoring directly in the blood bank. If an alarm goes off it starts playing Rock and Roll by Led Zeppelin (clicked all the way to 11).

This may shock anyone using Meditech TAR at their hospital but we have successfully implemented TAR in ED and OR (i.e. anesthesiologists) this year !

Do you have a copy of the Technical manual, 16th, 17th, or 18th edition? This discussion can be found under Chapter 16: Identification of antibodies to red cell antigens. Under the section titled 'Probability.' Table 16-3 shows a breakdown of p values based on different mixes of positive/negative and different statistical methods. Our procedure looks for at least two reactive & two nonreactive.

We do 7 days presurgical patients. In-patients: 3 days, day of collection is day 0 (i.e. 96 hours).

From 21CFR606 CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS
Sec 606.121(c) Container label.
(13) The container label of blood or blood components intended for transfusion must bear encoded information in a format that is machine-readable and approved for use by the Director, CBER.
(i) Who is subject to this machine-readable requirement? All blood establishments that manufacture, process, repack, or relabel blood or blood components intended for transfusion and regulated under the Federal Food, Drug, and Cosmetic Act or the Public Health Service Act.
(ii) What blood products are subject to this machine-readable requirement? All blood and blood components intended for transfusion are subject to the machine-readable information label requirement in this section.
(iii) What information must be machine-readable? Each label must have machine-readable information that contains, at a minimum:
(A) A unique facility identifier;
(B) Lot number relating to the donor;
(C) Product code; and
(D) ABO and Rh of the donor, except as described in paragraphs (c)(9) and (i)(5) of this section.

I believe that practice stopped before you were born.

This was actually studied.
Schmidt, A.E., Kirkley, S., Patel, N., Masel, D., Bowen, R., Blumberg, N., & Refaai, M.A. (2015). An alternative method to dithiothreitol treatment for antibody screening in patients receiving daratumumab. Transfusion, 55(9), 2292-3. doi: 10.1111/trf.13174

You can never charge two HCPCs codes for a single transfusion. You also can't individually charge testing/processing CPT codes if there's a bundled HCPCs code that describes it best.

We perform a screen. Why would you give RhIg if the patient is already immunized to D? Or if they were recently administered RhIg?
We don't issue the RhIg either, it's in pharmacy.

Do you have a copy of the Technical manual, 16th, 17th, or 18th edition? This discussion can be found under Chapter 16: Identification of antibodies to red cell antigens. Under the section titled 'Probability.' Table 16-3 shows a breakdown of p values based on different mixes of positive/negative and different statistical methods. Our procedure looks for at least two reactive & two nonreactive.

Interestingly enough, I was at a conference recently where forum threads from Bloodbanktalk were used as source material and included as part of the lecture.

I would review some of these references with your pathologist. It's definitely not an exhaustive list.
Judd, W. J., Butch, S. H., Oberman, H. A., Steiner, E. A. and Bauer, R. C. (1980), The Evaluation of a Positive Direct Antiglobulin Test in Pretransfusion Testing. Transfusion, 20: 17–23. doi: 10.1046/j.1537-2995.1980.20180125036.x
Judd, W. J., Barnes, B. A., Steiner, E. A., Oberman, H. A., Averill, D. B. and Butch, S. H. (1986), The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited. Transfusion, 26: 220–224. doi: 10.1046/j.1537-2995.1986.26386209372.x
Stec, N., Shirey, R. S., Smith, B., Kickler, T. S. and Ness, P. M. (1986), The efficacy of performing red cell elution studies in the pretransfusion testing of patients with positive direct antiglobulin tests. Transfusion, 26: 225–226. doi: 10.1046/j.1537-2995.1986.26386209373.x
Domen R.E. and Grattan J. (1986). Efficacy of performing red-cell antibody elutions in patients with a positive direct antiglobulin test, Vox Sang, 51:324-326.
Johnson, M.F.M. and Belota, M.K. (1988). Determination of need for elution studies for positive direct antiglobulin tests in pretransfusion testing, Am J Clin Pathol, 90(1):58-62. doi: 10.1093/ajcp/90.1.58
Perkins, J.T., Arruza, M., Fong, K., Sosler, S.D., and Saporito, C. (1990). The relative utility of the autologous control and the antiglobulin test phase of the crossmatch, Transfusion, 30: 503-507. doi: 10.1046/j.1537-2995.1990.30690333479.x
Richa, E., Benidt, G., Tauscher, C., Stowers, R., Bryant, S., and Stubbs, J. (2007). Eluate testing following microscopically positive direct antiglobulin tests with anti-IgG, Ann Clin Lab Sci, 37(2):167-169.
Yazer, M. H. and Triulzi, D. J. (2009), The role of the elution in antibody investigations. Transfusion, 49: 2395–2399. doi: 10.1111/j.1537-2995.2009.02304.x

That's the best kind of job security.

I would review some of these references with your pathologist. It's definitely not an exhaustive list.
Judd, W. J., Butch, S. H., Oberman, H. A., Steiner, E. A. and Bauer, R. C. (1980), The Evaluation of a Positive Direct Antiglobulin Test in Pretransfusion Testing. Transfusion, 20: 17–23. doi: 10.1046/j.1537-2995.1980.20180125036.x
Judd, W. J., Barnes, B. A., Steiner, E. A., Oberman, H. A., Averill, D. B. and Butch, S. H. (1986), The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited. Transfusion, 26: 220–224. doi: 10.1046/j.1537-2995.1986.26386209372.x
Stec, N., Shirey, R. S., Smith, B., Kickler, T. S. and Ness, P. M. (1986), The efficacy of performing red cell elution studies in the pretransfusion testing of patients with positive direct antiglobulin tests. Transfusion, 26: 225–226. doi: 10.1046/j.1537-2995.1986.26386209373.x
Domen R.E. and Grattan J. (1986). Efficacy of performing red-cell antibody elutions in patients with a positive direct antiglobulin test, Vox Sang, 51:324-326.
Johnson, M.F.M. and Belota, M.K. (1988). Determination of need for elution studies for positive direct antiglobulin tests in pretransfusion testing, Am J Clin Pathol, 90(1):58-62. doi: 10.1093/ajcp/90.1.58
Perkins, J.T., Arruza, M., Fong, K., Sosler, S.D., and Saporito, C. (1990). The relative utility of the autologous control and the antiglobulin test phase of the crossmatch, Transfusion, 30: 503-507. doi: 10.1046/j.1537-2995.1990.30690333479.x
Richa, E., Benidt, G., Tauscher, C., Stowers, R., Bryant, S., and Stubbs, J. (2007). Eluate testing following microscopically positive direct antiglobulin tests with anti-IgG, Ann Clin Lab Sci, 37(2):167-169.
Yazer, M. H. and Triulzi, D. J. (2009), The role of the elution in antibody investigations. Transfusion, 49: 2395–2399. doi: 10.1111/j.1537-2995.2009.02304.x

We perform a screen. Why would you give RhIg if the patient is already immunized to D? Or if they were recently administered RhIg?
We don't issue the RhIg either, it's in pharmacy.

Become accustomed to grey area.

I would review some of these references with your pathologist. It's definitely not an exhaustive list.
Judd, W. J., Butch, S. H., Oberman, H. A., Steiner, E. A. and Bauer, R. C. (1980), The Evaluation of a Positive Direct Antiglobulin Test in Pretransfusion Testing. Transfusion, 20: 17–23. doi: 10.1046/j.1537-2995.1980.20180125036.x
Judd, W. J., Barnes, B. A., Steiner, E. A., Oberman, H. A., Averill, D. B. and Butch, S. H. (1986), The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited. Transfusion, 26: 220–224. doi: 10.1046/j.1537-2995.1986.26386209372.x
Stec, N., Shirey, R. S., Smith, B., Kickler, T. S. and Ness, P. M. (1986), The efficacy of performing red cell elution studies in the pretransfusion testing of patients with positive direct antiglobulin tests. Transfusion, 26: 225–226. doi: 10.1046/j.1537-2995.1986.26386209373.x
Domen R.E. and Grattan J. (1986). Efficacy of performing red-cell antibody elutions in patients with a positive direct antiglobulin test, Vox Sang, 51:324-326.
Johnson, M.F.M. and Belota, M.K. (1988). Determination of need for elution studies for positive direct antiglobulin tests in pretransfusion testing, Am J Clin Pathol, 90(1):58-62. doi: 10.1093/ajcp/90.1.58
Perkins, J.T., Arruza, M., Fong, K., Sosler, S.D., and Saporito, C. (1990). The relative utility of the autologous control and the antiglobulin test phase of the crossmatch, Transfusion, 30: 503-507. doi: 10.1046/j.1537-2995.1990.30690333479.x
Richa, E., Benidt, G., Tauscher, C., Stowers, R., Bryant, S., and Stubbs, J. (2007). Eluate testing following microscopically positive direct antiglobulin tests with anti-IgG, Ann Clin Lab Sci, 37(2):167-169.
Yazer, M. H. and Triulzi, D. J. (2009), The role of the elution in antibody investigations. Transfusion, 49: 2395–2399. doi: 10.1111/j.1537-2995.2009.02304.x

We go with 4 hours from the time they spike the bag.

We perform a screen. Why would you give RhIg if the patient is already immunized to D? Or if they were recently administered RhIg?
We don't issue the RhIg either, it's in pharmacy.

We go with 4 hours from the time they spike the bag.

To me, this really sounds like something was "lost in translation" between department/disciplines before the communication reached your friend.

We go with 4 hours from the time they spike the bag.