AuntiS

In my opinion, if you have: A cold antibody (not pathological), and Have done the workup to show that there is no other antibody present (i.e. a clinically significant antibody such as anti-E), and Your LIS dictionary set up so that your reported antibody is not deemed as clinically significant You can set it up so that the computer (electronic) crossmatch can be used. If it is a pathological antibody, we use incompatible (i.e. Least incompatible in Meditech)

@Cliff Wow. That's a LOT of irradiated units. Here in Canada, irradiated blood has a shorter expiry due to the red cell membrane damage. Is that the same for you? Our policy - if an MHP is called on a patient who requires irradiated blood - is to inform the physician and provide the oldest RBC (preferably over 14 days old) because the number of viable lymphocytes should be decreased. Of course that doesn't help for PLT.

Our hospital prefers to use the term birth parent instead of mom/mother. I've been making a conscious decision to try and use the more inclusive terminology

Haha no. But it fits!

We have a hold sample that is ordered by the patient care area. It is built so it pulls the birth parent's hospital number, bloody type, and antibody ID (if present). This can only be done if the birth parent and newborn are linked at registration. From here we decide if the cord sample needs to be processed - resulting a Y reflexes the required tests. There is something else built in the test somehow that automatically orders the testing if the birth parent is Rh Negative. Otherwise, the Y orders the testing.

We do that. You could also use LISS (or PEG) to complement your SIAT. Make it more sensitive. sandra

At our hospital... New employees (who are licensed) training can enter and verify results under their own log in. Unregistered technologists (haven't received their license yet) and students may be able to log in to the LIS and enter results but they are unable to verify results. That must be done under the supervising MLT's log in. So they either review/result or it is done under the MLT's login under supervision. sandra

This is a great book :)

For serological testing or for clinical situations?

Never have I ever done this for eluate preparation. Never had a problem. But, I like the way the 4 pipette people think!

I'm trying to get rid of this practice as well (ours is called "keep on hand"). I think it is completely unnecessary. If there is no antibody = electronic crossmatch and blood is ready immediately. If the sample is more complicated, we already make sure we have blood crossmatched so there is no delay. Slowly but surely....

Same here in our lab.

I really enjoyed this talk!

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

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.

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.

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.

Here is my old validation. Hope it helps Validation of the Electronic Crossmatch at the GGH - signed.pdf

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

We do a screen and, if indicated, A and B cells. sandra

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

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

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

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

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