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AuntiS

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Everything posted by AuntiS

  1. Always great advice from Malcolm I find the use of anti-A,B is helpful - especially when the red cells from cord blood react weakly with the anti-A (which we know can be underdeveloped). We accept weaker reactions in newborn samples than we do for adult blood samples. However, that being said, if there is any doubt - we will not report the ABO group (often the Rh is needed for RhIG requirements) and give group O blood if a transfusion is required. sandra
  2. I think the intent of this "rule" was to not have the blood sitting around. The pre-transfusion checks should all be completed and the transfusion ready to be initiated as soon as the blood arrives. Now... in Canada we have a wonderful standard that states we can take the unit back if returned within 60 minutes. CBS did a lot of validation work to prove that there was no increased risk. Of course, we also require the unit to be transfused within 4 hours of issue. sandra CSTM 5.8.7.2 Blood components may be returned to the TS inventory if the following conditions have been met and documented: a. visual inspection of the blood component is acceptable b. the container is intact, including ports on bags c. at least one sealed segment of integral donor tubing is attached to red cell components. Alternately, an identified segment must be available to the transfusing site. d. the temperature of the blood component is acceptable as determined by one of the following: i. a suitable monitoring system indicates the unit(s) has stayed within the acceptable temperature ii. the unit(s) has been maintained in a container validated to maintain the appropriate temperature for the period that the unit was outside the TS iii. red cells, plasma and/or cryoprecipitate have not been out of the controlled environment for more than 60 minutes from the time of issue (per occurrence, not cumulative). e. The TS Medical Director may approve the acceptance into inventory of blood components that do not meet the requirements of this clause.
  3. There was a study done here by ORBCoN in Ontario, Canada. It showed that most (I think it was 99%) babies were delivered from people under the age of 46. So yes, not all. But most. Best of luck on your journey to conceive. I had mine at 40. So I'm always tired, but love her to bits.
  4. We are similar to those above - if a male or female over the age of 45 is using up all the Rh Neg stock we can switch them to Rh Pos. Earlier is better if they are a big bleed. We only require to alert the MRP it is happening. We also have no additional requirements/policies for switching back to Rh Neg once the bleeding has stopped.
  5. Here is my old validation. Hope it helps Validation of the Electronic Crossmatch at the GGH - signed.pdf
  6. I would love centralized temperature monitoring. Ideally, the whole hospital (i.e. pharmacy and what not) would be connected. How about electronic inventory management? RFID technology for the units? sandra
  7. We do a screen and, if indicated, A and B cells. sandra
  8. We didn't label the freezer drawers. But we do have a job aid hanging on the door with the freezer contents (by drawer). It makes it much easer if/when you move your contents around. sandra
  9. We do similar to labguru. We went from manual tube to automated gel (BioRad) and have found the same thing. If we have a discrepancy we send it out for genotyping. Most come back as a weak D type 1 (or 2 or 3). I am considering doing a manual tube type on our females less than 45 when they type as Rh positive the first time. And then sending out any discrepancies for genotyping. sandra
  10. Thank you for the feedback! We are pretty happy with the Bio-Rad cards and IH-500 as well. I'm still trying to figure out how to automate the antigen typing process with the QC available (needing a single dose for the positive QC) but feel like for our core lab staff using column agglutination for antigen testing has been widely preferred. sandra
  11. In Canada, our standards also add a requirement to clearly labelled/segregated area: CSTM 3.2.1.7 Contamination of blood components or blood products from patient samples, reagents and/or tissue products shall be avoided by ensuring that blood components and blood products are stored in designated storage equipment or in clearly labelled segregated areas within the storage equipment. (See guidance statement below: Physical barriers are needed to prevent contamination of blood components and blood products from other materials stored in the same equipment or area. Examples of physical barriers include a leak-proof shelf or container (preferably with a lid), clearly labeled to reflect the contents. If the physical barrier is a shelf, blood components/products should be stored above any potential contaminants (reagents, patient samples, etc.).) sandra
  12. We do the same using the same reagents (but called Bio-Rad) and the SAXO (similar to the Banjo, i think). Our reagents are all scanned into the IH-Com when using the SAXO reader - as long as the IH-500 uses the same reagents the QC flag is absent. sandra
  13. We use an IH-500. If the reactions in the software have no discrepancies (from previous or within the current results, weak reactions, error codes, etc.) they will autovalidate to our LIS. Our LIS does not autoverify. Those are always looked at before being released. sandra
  14. Wow, reading the challenges my American colleagues are having! I thought it was bad here in Ontario, Canada. The hospital laboratories here generally pay the same - unionized or non. And we don't generally have any sign on bonuses outside of working in the North, although I have been hearing some nursing/physician incentives. And I don't think I have ever heard of travelers here. We are starting to get creative with scheduling (looking at 12 hour shift models) and using more lab assistants to do work that does not require the MLT (or lab scientist in the US). Even in the blood bank. People are tired and burnt out.
  15. Hi everyone! I'm looking for anyone with experience using the Bio-Rad or Diamed antigen typing cards. We are validating (verification) their use in our lab. We are using the Rh/Kell card, and single antigen cards for Jka, Jkb, Fya, Fyb, S and s. So far we love them for manual column agglutination testing. We also have the Bio-Rad IH-500. I guess I'm looking for any experience using the cards an the automated platform. Pros/cons. What you use for QC and how it is programmed. Any other feedback. Anything you have is greatly appreciated! sandra (This will also be posted on the Blood Bank Professionals group on Facebook, so please excluse the multiple posts )
  16. I agree with Ensis01. Sometimes gel can give a false positive - if there is a problem with the card/well or sample (bit of fibrin, etc) - which is resolved upon repeat and/or tube testing. Otherwise, yeah, if you can explain it = great, group specific (meeting all other policy, of course) If not = O. sandra
  17. Sorry - just saw this reply now. Canadian Blood Services tests all donor units for K. If K negative, the donor end label has K- on it. If K positive, the end label doesn't have any K antigen testing information listed - the K+ status is only embedded in the donor unit phenotype barcode. All donor units are treated the same - so the K+ units are available, as all other units are, but it is easy to select a K- unit for females of childbearing potential and who are on a drug like daratumumab. sandra
  18. Hey Nikki, You planning on an IH-1000 or two IH-500? Or a combination with or without the SAXO? sandra
  19. We require any request for blood component or blood product pickup to have the following: Patient Name Patient MRN (i.e. hospital number) Type of product required Location (for phone requests to send via pneumatic tube system) A sticker or other official paper is not required. The info can even be handwritten - but all is required and it has to be correct. sandra
  20. Same. We don't select K negative units once off the dara. Here in Canada, all our units are K typed by Canadian Blood Services. It wouldn't necessarily be more work to select K neg units, but we feel it isn't needed.
  21. We share an LIS with a couple of other hospitals. We allow those previous blood groups to be the confirmation sample. We have access to a validated computer system that pulls results from other hospital LIS systems and matches using a unique ID (here in Ontario Canada it is the OHIP number). Names/DOB are double checked. We allow those for the second blood group as well. All our labs are accredited. I'm not sure what the difference between using the other hospital result in the LIS vs the other validated computer system would be. Also... my experience has been that blood testing done recently is MUCH more reliable than testing from many years ago - even if in the same hospital. Use of automation and positive patient ID systems has greatly reduced the risk of error. sandra
  22. In Canada, all blood components and blood products (derivatives) require informed consent.
  23. Here in Canada, the same sample can be retested IF the sample was collected using positive patient identification. So, here in our lab, we are super lucky because we have MLA who perform phlebotomy on 95% of the patients (some are nurse collected in the ED and ICU). Our MLA use positive patient identification technology (Mobilab). We allow for the retesting of those samples. Anyone else needs a new sample - which we order for lab collection, thus avoiding the workarounds where a second sample is drawn at the same time as the first but tucked away until needed. We also allow the previous ABO to be from another lab. We have access to blood bank results from area hospitals. If the blood group from our hospital matches another hospital we don't need the restest. sandra
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