bb4me, I also got cited by CAP for not running negative controls on anti-A and anti-B, but I challenged it with the package inserts which state that only a positive control has to be run, and the challenge was successful. The checklist states that both must be run unless "manufacturer instructions state otherwise", and my reagents from Immucor state that only a positive control needs to be run. Hope that helps, Molly
Donna, would you be able to share any of your flowcharts on this forum? I'm in the same situation as Jane, with generalists rotating through. I made up some flowcharts, but I'm always looking to finetune them. Thanks, Molly
David, the procedure addresses uncrossmatched units, or giving out crossmatch compatible units without complete resolution of the antibody problem, or warm autoantibodies; anything the lab feels is not completely solved, but the doctor is requesting units anyway. As I said, this procedure was written 10 years ago by someone else and I have taken over the department and want to make sure everything still makes sense. Molly
Thanks Malcolm! I think I will just remove that statement from the procedure to prevent creating any new problems. David, it was in a procedure for high risk transfusions and I'm actually not sure what it referred to! Molly
I am currently revising many procedures in blood bank that have not been revised for over 10 years. In my high risk transfusion procedure there is a statement that if time does not permit for a complet antigen screening that units should be screened for the these antigens in the following order: Jka and Jkb, Rh system, K, and Fya and Fyb. I have been googling like crazy and haven't been able to come up with anything to corroborate this statment. Can anyone point me in the right direction...Malcolm??? Thanks, Molly
Have you read the package insert from Safe-T-Vue? It states that "sometimes a pinkish hue or cast can be observed in teh white disk at the start. THIS IS NOT A TEMPERATURE CHANGE. Depending upon the light source, it is a muted refraction of the bottom red disc." And yes, I agree with BankerGirl that the technique of the tech applying the indicator can be at fault. I apply them the same way she does and don't usually have any problems. Also location of indicator is important-it should be on the bottom third of the unit if stored upright. Leave one out at RT and observe the color change. Also, be sure to refrigerate an unopened pack for 24 hours before use per package insert. HTH, Molly
I think what LCoronado is trying to say is that with a gel crossmatch, having a computer system which detects ABO incompatibilites would be equivalent to an IS crossmatch. I don't think she was talking about an electronic crossmatch for patients with antibodies. Our computer system will not let us crossmatch an A unit to an O patient, just like an IS crossmatch.
We don't test for negatives on our daily QC for anti-A,anti-B,anti-AB, and A1,B, and A2 cells, as per our manufacturer's package insert. We just had a CAP inspection where we were cited for not doing a negative, but challenged with the package insert and it was accepted.
We send down a release form with the emergency units, usually someone from the ER picks up the units. We make a photocopy of the form when we set up the units as emergency release, and will follow up with that if the other one gets lost in the ER. We don't have a time limit but try to get it within 24 hours.
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