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mollyredone

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Everything posted by mollyredone

  1. mollyredone
    Cliff, Just PMd you!
  2. mollyredone
    Here is a copy of our old procedure. We used to do our DATs in tube but switched to gel and just do IgG and complement now. BB S Direct Antiglobulin Test-Tube Method.doc
  3. mollyredone
    Does anyone have a copy of the AABB electronic reference that I could print? I bought the downloadable copy but there is no way to print it from the computer. I think that's ridiculous! It's very annoying to have to work with it on the computer instead of being able to write notes on it, etc. Send me a private message if this crosses boundaries. Thanks, Mari
  4. mollyredone
    For those who use Ortho panels, the 22nd cell on the 0.8% B panel is always homozygous for K.
  5. mollyredone
    Yay, the Christmas lights are back! Smash 'em while you can!!
  6. mollyredone
    Ortho actually describes the dual population as "mixed field" in its interpretation guide and shows pictures of equal amounts of cells on the top and bottom of the tube. I have a hard time training new techs that a little touch of red at the top is not a mixed field, but trapped fibrin. Ortho's manual also shows negative results as having a little bit of red cells at the top.
  7. mollyredone
    Mabel, I just looked at the AABB technical manual and it states that if both the IgG and Complement DATs are positive, you should perform a saline or albumin control. We have only had one DAT for hemolytic anemia in the last six months (27 samples) that was positive for both and we had to send it out due to a warm auto. We use the buffered gel card for our complement and run controls with each patient or run to make sure we have remembered to add the anti-C3b, -C3d reagent. We use Helmer UltraCW and add 3-4 drops of packed red cells, and then 10 microL in 1 mL of MTS diluent. We have only had one problem that I can recall, and that was with a cord blood and I just washed it a few more times.
  8. mollyredone
    We wash our cells 4 times for DAT. We only do it 4 times because that is where our cell washer is set and we wash babies 4 times.
  9. mollyredone
    We just do manual gel and haven't had any problems. We change our cells weekly.
  10. mollyredone
    AMcCord said it better than I did, but that is how we do it too.
  11. mollyredone
    We use A liquid plasma for emergency release and massive transfusion protocol. Once we have a specimen we would switch to ABO compatible. We only keep 4 liquid plasma, after which we would thaw plasma. If we still didn't have a type, I would thaw AB plasma, but we rarely have the need. Most of our MTPs, which start out with 4 PRBCs and 2 FFP, end up returning 2 PRBCs and 2 FFP. Not really true MTPs, fortunately but annoying that they call it an MTP. We have only thawed 1 AB FFP since September, and it expired because we don't use it in a non-emergency case unless the patient is AB.
  12. mollyredone
    It sounds like you would have to change the type of the baby from Rh positive to Rh negative if he/she came back in at a later time. We wanted to avoid that.
  13. mollyredone
    I apologize. I was just following the original poster's language. We have Meditech and it does have weak D testing for babies-although Meditech still calls it Du! Has that changed in your version of Meditech? We do ABO/Rh in tube and do not perform weak D on anyone other than babies (or moms with positive FMH) Therefore, we don't want to call a baby Rh positive with a weak D test if later in life we wouldn't perform weak D testing. We report the baby as Rh negative. But we do want to warn the physician that the mom is still a candidate for Rhogam. Otherwise they would see, mom neg, baby neg, no Rhogam needed. Does that make sense?
  14. mollyredone
    Some labs may still do Du routinely on patients, unless maybe that was when she was a donor. We just do immediate spin on all patients except newborns as you noted above. If we have a positive FMH the first test we run is a Du on the mother. We have had some Du positive results. The FMH is not valid in this case, as it is also not valid for a Du positive baby with our test kit. I would not want to report out a Du routinely on a mother, since she could still form anti-D. If we have a baby who is Du positive, we report it as negative (not wanting to change the type later in life) but enter the comment "Baby is weak D positive. The mother should be considered a candidate for Rhogam prophylaxis. FMH results are not valid. Please order a HGB FETAL if a fetal bleed is suspected.” I could be wrong, but I wouldn't want to report out Du positive, calling the patients Rh positive, routinely. If women start getting genotyped, as it is now being suggested, to find out if they can form anti-D (not types 1,2, or 3) we could avoid some Rhogam and Rh negative units.
  15. mollyredone
    Day shift does QC on a regular basis. Other shifts are required to do QC (the whole daily QC) on a quarterly basis. I get pretty good compliance with this.
  16. mollyredone
    Our labels are configured completely differently and are only 1-1/2 inch long, so there wouldn't be room for all that info. In Magic, when you scan the patient's barcode in result entry, the box pops up immediately so you don't have to click anywhere else. The pertinent lab values (hgb, hct, plt count/pt, inr) also pop up if products are ordered. I also have those lab values pop up when products are issued, so you can see if it's an appropriate transfusion or not. AB pop up.pdf
  17. mollyredone
    We have Meditech Magic 5.67 and if there is anything unusual in the patient history, a box pops up whenever you bring up a specimen on that patient in blood bank. So any antibodies, antigen typing, special requests-IRR, CMV, or comments put in history will show up there. We don't have anything that is printed on our specimen labels.
  18. mollyredone
    We have been using the tube system now for 3 years. We did an extensive tube system validation, then we did an audit for each location to which we send blood. If another area wants blood tubed, we would perform an audit before allowing it. Right now we tube to ICU, PCU, surgical floor and medical floor using secure send. With secure send, the tube will not drop down until the secure send code is put in and it alarms continuously. We have never had blood come back to us. I have had to call maintenance only a couple of times in three years to locate our tube, which was empty. We use a "special" tube, which is only different in color from the others, and it states on it to return to blood bank. We save our "unit ready" slip until the tube comes back so we know who to call if it doesn't.
  19. mollyredone
    Terri, That's what I decided as well, since it will save a lot of money and time to just do the AHG XM instead of sending it to the reference lab for a couple of days.
  20. mollyredone
    We are a small hospital, so we are behind the times and do type and DATs on all newborns since we only average a couple a day (840/yr). We have bigger fish to fry, although I know it's not necessary on a lot of NBs.
  21. mollyredone
    That sounds good to me as well. Next time I review my procedures for their every two years review I'll change it.
  22. mollyredone
    Thanks Malcolm! That sounds much more manageable! If I find an allo-anti-Wrb I'll send it to you as a retirement present! Ha Ha!
  23. mollyredone
    That makes sense to me as well, although we would rather save the patient (or hospital) money that would be spent on a reference workup and just do a gel crossmatch. So I may make an M37 that's significant. After skimming through the entire The Blood Group Antigen FactsBook for transfusion reactions and HDFN, it is my decision that according to that book A1, DRHIG, Lea, Leb, Lua, M, N, Wrb, XGA and Yka are clinically insignificant, as well as cold auto, and warm auto without specificity once underlying allo-antibodies are ruled out and a negative screen. Does that sound right? We have a current warm auto patient in house with no underlying allo-antibodies and they recommend transfusion with E-, c-, K-,Fyb- and Jka- red cells. Yikes! I should just order antigen negative units from the blood center, because otherwise I would have to screen 159 units to find 1 negative! Maybe she will move out of state when she has recovered!
  24. mollyredone
    Carolyn, That's what we do as well.
  25. mollyredone
    That would be nice to be able to document it in the patient's chart so any provider at the hospital could see it if the patient returned. I don't think I have access to that, although we do have Meditech. I put a copy of the letter we send and the card in the patient's antibody folder and check that before sending another one. If they develop additional antibodies, I send another letter and card. I do this once a month.
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