Liz

[ATTACH]614[/ATTACH] Lets see if i can post a simple template, you can add to it ofcourse. Yes i did.

I had a form for many units. But recently changed it to one form per unit.

But, in the gel, I did incubate the donor rbcs and the patients serum at 37C before spinning. so it cannot be a cold. The gel AHG test was stronger than the IS.

Makes sense and the major crossmatch was done in the gel and Poly AHG so couldnt very well disperse. Thank you.

ah wait we used the polyspechic AHG for the major crossmatch. oh. I'll work with the IgG and tell you how it goes.

The patient has never had a transfusion before. He is 70, male. Previously in an outside hospital they could find compatible blood and they drew preop autologous. I advised the dr to perform Intraop Isovolemic Hemodilution tomorrow. He has.. hmmm what's it called, Spinal stenosis or something.. he is near paralysis What do you mean .. how long and why and. at what temp should they sit together. Dave, thank you for your prompt reply! Liz

Patient A neg, Ab Sc neg, DAT neg, Ab Id neg. IS incompatible then after a few minutes the incompatiblity disappears. Not rouleaux. gel Major Crossmatch incomp. What is it?

I hear they tear the bag open with Blood Loc... what is Final Chek? and what is the best... well, best in defying human mistakes and negligence and stupidity and.. ok I'll stop here.

yes that is true by CAP because it is a mechanical barrier.

there is no way around it, you must write your own SOPs so that they conform to your practice and not someone else's. Those books will help you as will the CAP checklist. Use your custom CAP cheklist...though.

Of course you are having those problems, ... and hopefully the mechanical barrier will be smarter than them and not be by-passed :bonk:we are acquiring the hand held bedside barcode reader for transfusion... it shouts and gets out red flags if the unit is not meant for that patient.

The transfusionist (nurse) identifies that the Patient's triple name (on wrist band and verbally if possible) and ID MPI # match the triple name and MPI# on the tag, she/he also verifies that the info we have sent is correct: Blood Group, etc and that the crossmatch is signed by the BB, she/ he then signs to that effect. Then the witness (a nurse or MD) repeats the whole procedure separately and aslo signs to that effect. With the introduction of the handheld bedside barcode reader it will be a barrier that "should" help prevent mishaps.

Relapse does not always mean her Blood group will revert back. Initially she did not, later she did.

Exactly. You give what is compatible with the patient's blood. But you must repeat the Blood group, one patient was B neg and after transplant engraftment became AB pos so we were able to give her positive blood and basically any blood group but we stuck to O pos as long as it was available. She later relapsed and we went back to B neg.

How does the administration react? What is the disciplinary action?? Because if you have a system in place and all the checkpoints failed this is negligence not system failure! Do you suspend, official warning? treat equally in the action you take...?

hahahahhahahahahaha!!!!! that would make you > 100yo!!!!

Absolutely....

in-vivo crossmatch, Malcolm.

What does "extend crossmatch" mean?

I would be interested in knowing if anyone else does the CT ratio like Dave mentioned: "by service and by MD". We get good numbers and the Blood Utilization committee said this was thanks to the Internal Medicine Oncologists who keep it balanced. I broke it down and indeed surgery was high and balanced out by Medicine. But by MD, that would take a lot of time.

Yes, AHG crossmatch as long as there is a question mark.

Yes it was a cold allo. I could not identify it but did stop it from interfering. Merci.

Exactly Anna, 100 kgs small!!! what great news!! Thanks Malcolm. I think that makes me underweight.

great. thanks. I'll post what happens.

So what shall I do now...