Amber Gaucher

Excellent! I was using the 16th, but looking in the wrong place! Thanks for the help :-)

I *almost* posted this on the thread of a similar title with the mixed media, but that seemed to address media (gel vs. tubes) and was less about the two tests. The problem we've had in our lab is very occasionally we'll have a positive autocontrol and a negative DAT/AC3. We've a tech who simply does not believe this is possible and has taken to repeating the testing the following day after the specimen has been in the fridge overnight and then changing the results (triggering a corrected report and contacting the doctor). Aside of the obvious issues regarding interpersonal conflict, consistency in reporting and so on... my question is: are the original results possible? She is so insistent that I'm second guessing myself here. That is: can you have a positive autocontrol and a negative DAT? I've been looking through the web and the AABB tech manual and not finding anything really definitive that addresses this directly. Again, all the testing is in tubes, so this isn't an issue of comparing different media types. This came to a head today where I got a 4+ auto for a RT/4C screen and ran a regular DAT and got a negative result. I attributed this to some nonspecific, clinically insignificant CAA. Can someone direct me to a resource that can help provide some guidance on this? Thanks in advance!

To my knowledge, no. It might behoove us to, if only for some feedback (and perhaps to get a few quotes we can share with the newspaper should we decide to pursue a response).

I work in Fredericksburg VA in the Blood Bank. A local newspaper published an article this past Sunday (link included). The staff here were flabbergasted about some of the sweeping statements and are nervous about an influx of patients demanding blood attributes that could compromise our inventory. We have a very, very few patients who request "the freshest blood" we have, but if we get a lot of requests and have to accommodate them we could really find ourselves with a lot of wastage. Frankly, I have concerns that this article is ethically unsound. We did share this with our pathologist who "<sarcasm> loved it </sarcasm>" just to give him a heads up in case any issues arise from this. If anyone would read this and share their thoughts on the content and some techniques for dealing with potential fallout (this newspaper is pretty influential in the area as it was created and ran by a highly regarded family and has been around for generations and is the only local paper of the area), myself and my coworkers would appreciate it. Thanks in advance! http://www.freelancestar.com/2014-03-30/articles/32482/column-dont-assume-this-procedure-is-safe/

A unit of blood was spiked for transfusion and approx 40mL was transfused to the patient. The patient's husband noticed that the blood was not being put through a warmer per the Dr's orders (she has a very strong cold that reacts at 37C with multiple reactions in the past). The transfusion was dc'd with the hopes that the RN could collect the blood warming equipment and restart the unit. While she was trying to get the equipment together the question came up: Should the unit be kept down in the blood bank or on the floor? My understanding is that blood cannot be reissued if the unit has been spiked (per AABB standards). However, there is no storage on the floor for the unit and we're not even sure if the blood should be put back into a refrigerator or if that would impact the quality of the product with the fluctuation of temperature. Any suggestions on where the documentation is regarding situations like this or what you do at your hospital? Thanks in advance!

There's a minor disagreement about the extent of labeling required for saline bottles. How do you label your saline bottles at your facility? Thanks in advance!

I'm curious how many blood banks perform their own scheduled out patient and in house therapeutic phlebotomies. As far as I can tell our hospital is the only one in the state where this is not performed by a donor center, in a doctors office or through same-day surgery. Thanks in advance. Amber

Related question: we were nearly cited for not doing QC on saline this past CAP/AABB inspection. Our supervisor is considering switching over to buffered saline opposed to using the certified blood bank saline. Aside of the cost savings, is there any other benefit to this switch? How would this effect daily QC and would it still be required to be completed? Thanks in advance!