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Ardele Hanson

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About Ardele Hanson

  • Birthday 04/23/1954

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  1. I totally agree with all of you. And, no, we do not use the tube method for ABID - maybe once in a great while one cell from one panel kit; but tubes are not used for identification of antibodies. The reason I ask is because I work with a person who is demanding that all methods match. (Her title is System Technical Coordinator. Hospital System is 7 hosptials, only 3 use the Echo. Others use the manual solid phase station or tubes.) And it is frustrating to even try to explain anything to her. I have tried! Thank you for your help. I will share all your posts with her.
  2. "If the laboratory uses more than one instrument/method to test for a given analyte, the instruments/methods are checked against each other at least twice a year for correlation of results." My hosptial uses the Echo. We also have a Manual Station Solid Phase platform for antibody screens and antibody IDs. And we also have tubes, My question is: What happens when the Echo gets a 2+ for a Jka, the manual platform gives a 1+, and the screen is totally negative in tubes? Am I compliant? The Echo and solid phase are so much more senstive. Tubes are not going to 'catch' every single antibody - we know that. So, what do I do? Should I not be comparing tubes to solid phase (apples to oranges)? Or just say I am okay? Thanks for your help.
  3. How many out there have therapeutic phlebotomy collection as a lab procedure and how many facilities have it as a nursing procedure? We are discussing the advantages of have nursing do it, so I am just wondering. Thanks for your help.
  4. Liz: The cold agg screen is at 4C and the OR lowers the core temp to around 28-30C. There really is no correlation here, I realize that and from what I am reading of late, over 60% of the population will be positive to some degree with a cold panel at 4C. So, the RT incubation (about 23C in our lab) wouldn't even get it.....troublesome in so many ways!!
  5. Yeah. I did not want to hear that - about the surgeon getting what he wants! But we all know it is true. Why did you "used to a quick screen"? What do you do now? The quick screen might be doable, but the techs will not like it. So, do you do it for the crossmatch or do you include a tube screen along with the crossmatch? And then how is it reported? I imagine we would be requiring a new test in the LIS for resulting? Thank you so much for your help. This is very helpful.
  6. Thank you to Bill, Rebecca and David. I guess my question was about reporting......how is that resolved? We do the resolution steps to make sure there is no signigicant antibodies, but then the confusion is how to best report it out, without adding to the confusion of doctors or nurses. The coordinator here wants a positive result reported out on the Echo (because it is interfaced) and then negative for the alternate method. Then a comment is added that is not canned and seems like everyone writes as much or as little as they want. Just asking what others might do. Thanks.
  7. There is a surgeon here who is pretty insistant that we run a cold agglutinin 'screen' on all his CABG patients before they go in to the OR. This happened because of one patient who exhibited a fairly strong cold agglutinin once the temperatures were lowered in the OR and patient prior to surgery. A cold agglutinin was not found on pre-admit testing in the transfusion service nor in the CBC in hematology. What is a good answer for this guy? Thanks.
  8. How do you monitor the effectiveness of your transfusion services? An example would be following a unit to the floor and making sure all the requirments are documented - patient ID, 2 personnel verifying all the info, vital signs checked, no fluids running. Are there other ways to do this? Thank you.
  9. So, we have an Echo (red cell solid phase agglutination). A screen is positive in all 3 wells (we use a 3-cell screen). It mostly looks like junk. A panel and auto control are run - panel is all positive and the auto is negative. It is set up in tubes and the tube screen is negative. Would you report out the Echo result as positive and the tube as negative? Or report out the Echo result as inconclusive, repeated by another method and the tube method is negative? This is an issue about once every other month. Just wondering what others are doing Thanks for your help.
  10. The Circular of Information, revised Dec 2009, states: " Transfusion of CMV-negative blood is indicated in CMV-seronegative recipients who are at risk for severe CMV infections. These at-risk groups include pregnant women and their fetuses, low birthweight infants, hematopoietic progenitor cell transpland recipients, solid-organ transplant recipients, severely immunosuppressed recipients, and HIV-infected patients. Leukocyte-reduced components may be an alternative to CMV-seronegative transfusion in some clinical conditions." Unfortunately, it DOES NOT say what the 'some clinical conditions' are..... In addition to the cases stated above, we continue to give CMV-negative product to those who have tested CMV-negative. Their CMV status is entered in to our computer system so there is no question when they come in for transfusion.
  11. I want to thank David also. Now after reading the standard I see we are not compliant either! So, we are looking into the commercial QC kit prepared by Immucor - corQC Test System. This is solely for tube methodology and will not replace the QC materials for the Echo. I think it would be a good way to go, as we are a system currently with 5 hospitals. It would ensure standardization across the 5 hospitals. Thanks for all who responded.
  12. The 3-cell screen we use is R1R1, R2R2, and rr. We have 2 positives and 1 negative.....is that what you mean? I do see the 1+ or greater avidity. So, David, what are you currently doing? Thank you for your help.
  13. What is 'good sized'? And, do you have a recipe you would be willing to share? Thank you for your help.
  14. I am looking for a recipe for a dilute antisera that can be used in daily QC. This standard says using antiserea of 1+ or greater avidity. I am relatively new to a hospital that makes 50 ml of dilute anti-D. It degrades over time and is then 'spiked' to give acceptable results. Needless to say, I am not comfortable with this and am wondering what other places do. At my previous job we only made up 5 ml at a time and the strength of reaction held throughout. So, any recipe and also expiration of the dilute antisera would be great! Any help would be appreciated. Thank you.
  15. Just wondering what others are doing in these cases? We have recently taken on a farily large OB/Gyn Practice. When an Anti-D is reported on and Rh-negative female of child bearing age, we call and find out if RhIg has been given. If the answer is yes, we make a note of the date of injection. We are seeing requests for titers on these....So, what do you do? It probably is not a good thing to put an Anti-D in the patient's permanent record....or to do titers on these .... but how do others proceed?
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