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pbaker

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Posts posted by pbaker

  1. On 11/4/2022 at 7:22 AM, AMcCord said:

    We report the baby as Rh negative, weak D test positive (if DAT is negative), mother is a candidate for RhIG.

    Can your computer system do that?  Ours cannot.

  2. 18 hours ago, Malcolm Needs said:

    Until there is a definitive answer, it MUST be D Negative, even though the chances are that, at that stage of life, the baby's immune system would not produce an anti-D if D Positive blood was transfused, BUT it could well be that the baby's immune system could be sensitised to the D antigen.  ALWAYS ERR ON THE SAFE SIDE.

    I agree with this if we are transfusing.  We would use O= anyway.  I'm talking about just the basic blood type of the baby.

  3. 34 minutes ago, Malcolm Needs said:

    Well, you cannot call the baby Weak D+, as there is no such antibody as Anti-Weak-D, but to answer your intended question, it depends on whether or not the baby's red cells are DAT Positive or not, and also on what epitopes your anti-D are designed to detect.  It could be that the baby is a Partial D.

    But the final interpretation of Rh would be positive or negative?????

  4. 25 minutes ago, amblanki said:

    We issue < 14 day RBC units (any additive), irradiated and HgbS negative.  Our products are leukoreduced, so are CMV safe.  

    Do you irradiate on site?  I was with a smaller facility that would only potentially transfuse if a transfer out was delayed and gave the freshest O neg possible as an emergency issued unit.  It sounds like maybe that is the situation you are in.  

    We are a 400ish bed hospital, but our NICU usually sends the really sick babies to nearby Children's Mercy.  We do not irradiate on site.  We would have to get them irradiated at the blood center and the docs usually don't want to wait.  I'm just trying to get information to adjust my policies since we ALWAYS have to get it out when a request comes through.

    Do you aliquot the unit to a syringe or send the entire unit to the NICU?

  5. For those of you that perform neonatal transfusions, what special products do you give your babies?  Irradiated, CMV seronegative, Hgb S negative, any others?

    We give about 1 neonatal transfusion per year and our policy is really old.  Just want to make sure we are giving the correct most up to date product.

  6. We had that problem with lot 134046.  I contacted Technical Support and shortly after that we got a Technical Communication that we were not the only ones with the issue.  It worked if we incubated at RT for a while.  We stuck it out because we knew our new shipment was due in a couple of days.  We got the SAME lot number!!  Immucor suggested confirmation of A1 reactivity by other methods and consulting your quality department and/or medical director.  We just continue to incubate at RT.  When it's colder in the lab, it works better ;)

  7. Thank you for the responses.  Let me add an additional question.

    About 30-40% of the patients with type and screens are discharged home from the ED.  Since there is really no diagnostic value to a TS, is this overuse?

    Some of those come to us as "trauma" and end up not being as bad as expected, so I get those.  That still leaves about 25% being discharged to home.  The others have an registration diagnosis of things like: altered mental status, abd pain, shaky/dizzy, shoulder pain, ETOH, N/V/D, etc..

  8. Does anybody have any data regarding how many of the type and screens ordered by the ED actually get blood products?  Those products could be given in the ED or on the floor after admission.

    One of my ED docs is trying to determine if they are requesting type and screens appropriately.  I did a 3 month retrospective review of data and only 28% of the type and screens ordered by ED actually got transfused from that specimen.  Doc wants to know if that is good or if they are ordering too many type and screens.

     

    Thanks,

  9. Patient is caucasian with cirrhosis, sepsis, ARF, among other things.  Not a healthy person.

    The patient hgb was stable in the 7s until a big drop to the 5s.  Even with transfusion, the hgb was having a hard time getting up to the 7 again.  So the doc ordered a DAT.  I really don't believe the Anti-P1 has anything to do with his hemoglobin issues.

    We use the Elu-Kit to for the elution and perform tube testing with no additive.

    Malcolm, thank you for the powerpoint, but I can't seem to open it.  

  10. Has anyone ever seen Anti-P1 eluted from RBCs? 

    We have a patient with a negative antibody screen.  The physician ordered a DAT because the hemoglobin has been dropping even with transfusion.  The DAT was positive due to IgG only.  Since the patient was recently transfused, an elution was performed.  When the eluate was tested, the pattern fits Anti-P1, with all other clinically significant antibodies ruled out.  Can it be???

  11. How does everyone record reactions that are only detected microscopically?

    Here are the versions I have seen in my various jobs and from my various techs.  I am trying to get it more consistent.

    +/=        wk+       mic+      0m+

  12. We are currently building the Bridge system for transfusion documentation.  I know AABB and CAP standards require "amount transfused" to be in the patient record.  Does anyone know if this is by individual unit transfused or a cumulative amount?

  13. A true trauma stat (not a drama trauma) is 60 minutes for ABSC and 35 minutes for ABO, from receipt in lab.  All other stats are 65 minutes for both.

    We batch our cord bloods and do them every 4 hours.  The nursery has it in their brain that it must be completed by then in order to treat the baby accordingly.  Of course, when they don't send it down for 3 hours and miss our run time, they get mad at us.

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