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Posts posted by rebeccarjthomas
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Yes -definitely get rid of the bleach! Also - bleaching plastic saline bottles may cause chemicals to leach out of the plastic - who knows how that would affect your testing!In a past job, we eliminated all bleach from the blood bank. In my current job, bleach is EVERYWHERE! We use bleach wipes to clean the counters, and the cell washers and saline bottles are disinfected with bleach weekly. I know there is evidence that it can denature the S antigen, but how serious of a threat is this? Do I need to put a stop to the bleach? My guts says yes.
If you don't bleach how do you clean/disinfect the cell washers and saline bottles? At my past job, I don't think we EVER cleaned the saline bottles, we just kept refilling them and never had any issue with contamination. I don't see any requirement in the equipment manual to bleach the cellwashers either. I'm sure I'll get a lot of push-back if I say we don't need to do any decontamination.
thanks!
In a past job, we eliminated all bleach from the blood bank. In my current job, bleach is EVERYWHERE! We use bleach wipes to clean the counters, and the cell washers and saline bottles are disinfected with bleach weekly. I know there is evidence that it can denature the S antigen, but how serious of a threat is this? Do I need to put a stop to the bleach? My guts says yes.
If you don't bleach how do you clean/disinfect the cell washers and saline bottles? At my past job, I don't think we EVER cleaned the saline bottles, we just kept refilling them and never had any issue with contamination. I don't see any requirement in the equipment manual to bleach the cellwashers either. I'm sure I'll get a lot of push-back if I say we don't need to do any decontamination.
thanks!
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This is not an uncommon situation. For quite a few years, I was in charge of a prenatal testing lab at Memorial Blood Centers. One of the services we provided was Kleihauer-Betke testing. For quite a few years we repeated FMH screens on samples submitted for Kleihauer-Betke testing due to pos FMH screens when the Kleihauer-Betke test was negative. We followed the FMH screen procedure published by Betty Sebring, who, also, worked at Memorial. In all cases, the FMH screen test in our hands was negative.Did anyone have the opposite from within the last few months? Where fetal screens came up positive but the KB was negative?
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Quite a few of our customers use the ECHO. At times they report positive reactions, sometimes strong, that we cannot duplicate using manual Solid Phase. My understanding is that: On the ECHO - pt. sample is added prior to LISS. Manual Soloid Phase - LISS is added prior to patient sample. Has anyone looked at this difference specifically? I don't think I've seen anything published on manual versus ECHO Solid Phase testing. Thanks, Becky
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Hi Everybody! This is my first post!
I am a Marketing Associate for Hemo bioscience (manufacturer and distributor of BB Reagents) and was hoping to gain insight into which educational conferences/conventions are considered the most valuable or which ones you enjoy attending the most or which ones you hear of the most...? We really appreciate the educational sector of this industry and I would personally like to commit to a presence at these shows. Any feedback appreciated!
Thanks
Adele
AIMS sponsored by SCABB in the spring. Great meeting!
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Ya.
Still... if we wanted to be really careful, we would completely phenotype for every significant antigen for both the patient and donor units. And I think that is where we are headed when we screen for E with anti-c patients, or for e with anti-C patients.
(In general, I think we are already enough anal-retentive!)
Scott
Molecular people would agree with your first statement. rjt
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I received an e-mail from a former Medical Director, asking me a question for which I do not know the answer. I have not used EGA in awhile (last couple of places used Generalists so we didn't get that technical).
His question had to do with using EGA on Cord Cells with a Positive DAT (mom O NEG; baby A NEG; Anti-A eluted) to go through to the Weak D phase (vs. resulting it as "unable to determine at this time" and giving Rhogam to be on the safe side). I know when I worked there, we ran Positive and Negative Controls for the Antigens we treated (but we did not use EGA for this purpose). I can't recall now if the Manufacturer's Inserts "recommends" both Positive and Negative Controls; or whether it is a "must?"
In asking a couple of technical experts, I received different replies:
1. 1 Reference Lab stated they don't use it for this purpose simply because they don't usually get cord work-ups; but they don't see why you couldn't. They said they just use a Negative Control for any Antigen they are typing after EGA Treatment (said in their experience, they have seen problems with the Negative Control coming up Positive for some reason). They "accept" the Manufacturer's statement as far as which Antigens have been proven to be destroyed by EGA.
2. A 2nd Reference Lab said you could use EGA for this purpose but that you should run a Positive Control; and that Positive Control should be an Rh Positive Cell.
The Medical Director is questioning whether a known Weak D Positive Cell would be required to be tested as the Positive Control (which would be tough unless you had frozen Weak D Cells around).
What are your thoughts....and do any of you use EGA for this purpose (and if yes, what controls do you run)?
Thanks,
Brenda Hutson, CLS(ASCP)SBB
WHen using EGA treated cells for Weak D testing, we run a Weak D positive cell as a control. This is a cell that you can purchase. RJT
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Sorry - we only read with oil. Definitely not my favorite test!
Mike - DOn't you remember learning the Kleihauer technic all those years ago when you rotated thru Prenatal Lab at Memorial? Memorial has never read Kleihauers using oil. Hope you are well - give my regards to Marsha. You should get Dr. Megan to invite you to ICII. IT's in MN this year. Becky Thomas
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Wow- this sure sounds like age discrimination! What you really have is a long term training issue.
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Well how about when you suspect you may have a weak aby present - use ads. and elution to concentrate. (Adsorb a large volume of serum versus a smaller volume of cells say a ratio of 3:1 using an untreated adsorbing cell; elute back post adsorption to concentrate suspected weak aby).
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Well - there again I think you need to think about how sensitive the test method is that you are using. Some labs, for instance ARC IRLs, routinely rule out aby on heterzygous cells when testing in PEG, enzymes, GEL or Solid Phase.
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What about the possibility that the child was sensitized by Mom if Mom RH Pos? Jane Swanson had a person with, I believe anti-Fya, that the Mom seemed to be the only possible explanation for sensitizing event.
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INteresting. I worked for a long time at a facility where we repeated adsorption studies on patients with WAA every two weeks - recommending as compatible or more compatible than ac during the intervening time. However, we had a patient that developed a new antibody (anti-Kell) within one week post adsorption study. So at that time, we revised our policyon repeat adsorption studies to repeating once every seven days. Of course, one policy just like one technic serve as our best, thoughtfully considered practice - but exceptions happen - like your patient. Wow, did you just get a phenotype and start giving this patient phenotypically matched units?
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Malcolm,
Say if you com eto MN (maybe for the ICII meeting next June) you could take a side trip up to northeastern MN. In Ely , gateway to the Boundary Waters Canoe Area, there is a fascinating well established Wolf Center. OR - you could read about it on the web. Maybe they would have some ideas to save "your" facility.
Becky THomas
P.S> I grew up in Ely.
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I agree - would be great Malcolm. Becky Thomas
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Hi. I would probably make some monolayers with fresh RBCs. This would possibly tell me if the patient sample was actually reacting with RBC agn, or reacting to the stroma (or some alteration to RBC agn when stroma prepared and layered onto the microwells). If the tests were tests were neg with the fresh cell monolayers, I would report that the patient sample reacted with all commercial solid-phase cells tested (stroma) but was neg with fresh cell monolayers and tube tests. I would add a comment that patient serum reacting with stroma - no significant aby present.
Happy Holidays! rjt
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For many years, I worked in a Ref Lab that chose to QC each of our In-house panel cells daily. This was done in response to an inspector's suggestion. We made sure that each panel cell was used in some part of the general daily QC (o cell for anti-AB, test cells for each enhancement with weak aby, neg cell with AHG reagents). Becky
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Well, I worked for many years in a Ref Lab that routinely tried to duplicate the method used by the customer. This was a starting point, often reflex testing in PEG. Currently I'm working in a Ref Lab that chooses to use two methods on each sample. Many of our current customers use the ECHO. We are going to be performing manual solid phase panels in an attempt to see if we are missing any thing by tube and/or gel that our customers are picking up. As to Malcolm's comment about the insignificance of something detected only by ECHO - I disagree. Would you not honor an anti-Jka only found in ECHO?
Becky Thomas
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Contact your local blood supplier - they may be willing to help with this. Becky Thomas
Is a panel cell listed as Ror considered to be single-dose or double dose for D antigen
in Transfusion Services
Posted
We had a patient referred to our Ref Lab that had an anti-D reactive strongly in Solid Phase with all D+ cells but Ro cells. Customer was certain there was an unusual aby here.