AuntiS

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

I'm so jealous - all these labs where the KB is performed in hematology! Here ours are done in the BB. To be fair, we are a core lab, so the staff performing the test are the same. I would just rather not own the test and all the competency that comes with it

We have been using a Bio-Rad IH-500 (and a SAXO as backup) for about a year now. Very happy with them. They work with the IH-Com that serves as a command centre for both and as middleware. We also use the antibody software and upload our QC to Unity. (We were manual gel/tube prior). sandra

Thanks Ensis01! I haven't even gotten that far yet - so I didn't know that the concentration of DTT is different :) s

When I was trained (many years ago!) we used +/- for microscopic tube reactions. Now, I encourage MLT to only use the microscope if they are looking to verify a mixed field or rouleaux. I suppose there could be other rare times to use a microscope - like an anti-Sda? But generally - no microscope. But they love the microscope...

I'm also developing a procedure for DTT treated cells. Can I assume that the DTT treated cells can be used to help ID antibodies other than daratumumab without additional validation? I am intrigued by the use of DTT for differentiation between IgG and IgM antibodies but I don't think we will go forward with it here at our community hospital

We do the same as Nikki. If an eluate is needed, an acid elution is done. No LUI freeze on the menu. sandra

Nikki - my calendar says it is 4am to 5:30am here! I hope it is available as a recording! sandra

Is it possible you have someone new who is not cancelling the units properly? s

It's an interesting idea - one motivated I suspect to provide a more attractive product to the hospital? But retyping in the hospital also theoretically covers any errors in donor entry into the hospital LIS. sandra

I've uploaded a Canadian Report from earlier this year that you may find interesting. Pages 11-12 have discussion and recommendations. Some of the discussion includes the following: Unnecessary testing:  Performing mid-pregnancy screens on Rh positive mothers  Testing DATs for all cords, or from all group O mothers or all Rh negative mothers, regardless of hemolysis indications sandra Obstetrical and Pedatric report -COPTN-Survey-Report-2019.pdf.pdf

We have a log book and a white board. The log book is a daily calendar and it is for more date specific items (i.e. order a specific product on that day) The white board is for more general or urgent items - something that doesn't fit on a day or would span over a longer period of time (i.e. shortage of a product). sandra

The reagent we use includes instructions that only specify a positive reaction is required. It does not give a minimum grade. I remember being taught 2+ many years ago, but we now only require macroscopic agglutination. sandra

Same - we report the number and a %

In our lab, the required additional testing is built into our procedures - which is authorized by the pathologist. If we have weak D results or something like an auto-anti-D in an Rh pos person we can send it out without asking for approval. We scan the report we get back into our LIS. I'm in Canada - so the testing is done by Canadian Blood Services at no additional cost the the hospital. sandra

Here in Canada, the CSA standard 10.10.5 states: CSA 10.10.5 A blood component that has been returned to the blood centre or transfusion service shall not be rereleased unless a) for red blood cells, there is at least one remaining sealed segment of integral donor tubing attached to the blood bag or available to the transfusing site. Previously removed segments may be used after confirming that the tubing identification numbers on both the removed segment(s) and the blood bag are identical; b) there is documentation to a. indicate it is being re-released; and b. confirm that it has been visually inspected before release; c) a suitable temperature-monitoring system indicates that the blood component has not reached an unacceptable temperature since being released or, in the absence of a temperature-monitoring system, that the blood component has not been outside of a controlled environment for more than 60 min (measured per occurrence, not cumulatively); and d) the blood bag closure is undisturbed. I know that isn't necessarily helpful for you currently, but this was new in the last revision. Perhaps changes coming soon to other countries? sandra

Here, a temp >1 degree Celsius over baseline AND any other symptom gets an automatic culture. Plus I suppose we would honour any direct request for a culture (not that I've seen that happen).

We do that. Patients who come in through our pre-op program are good for 28 days if they are not pregnant and have not been transfused in the past 3 months. There is a query that must be completed in our LIS to confirm the answers to those questions. Any other patient that is not seen via pre-op is 96 hours. Rationale: patients seen through pre-op have sat down with a nurse or physician prior to their surgery and given an accurate medical history. Translators or family members are present as required for language or any cognitive deficit (dementia etc.). Any other patient? - who knows what their status is. This works very well for us. Sandra

If we know the patient's history and they are Rh Neg we might start off with a couple of Rh Neg O's. We switch them over pretty quickly if they are going to use more. Otherwise - they get O Pos. Took people in and outside of the lab a little while to get comfortable with this policy, but now no one blinks. sandra

In Canada - CBS abandoned going the pooled cryo route since the trend is to move away from cryo and use fibrinogen concentrate instead. I'm actually in the process of doing just that at our hospital. We use a small amount (around 50mL) when pooling as per AABB. I can't imagine not using saline to get all the sticky bits out! Do you have a patient with a rare factor deficiency who is using all this cryo? Interesting! sandra

Hi! We use a traceable thermometer with a probe placed in a gel card well, too. https://ca.vwr.com/store/catalog/product.jsp?product_id=4556196 We replace it when the certification expires. sandra

We do not use them. We require two blood groups before transfusion (or given O). Positive patient identification (Mobilab) is used here at our hospital. We are lucky - PPI with majority of blood collected by MLA).

Congratulations! Very well deserved!

I haven't heard anything, but I'm just outside of Toronto. Interesting idea! I'll keep my ear to the ground

I agree with NicolePCanada - I would have made a special effort to search you out and introduce myself Malcom Good conference overall. More research based than conferences I'm used to going to (I've been to CSTM and AABB in the past), but really interesting. However, I'm concerned that the rest of the world thinks Canadians eat cookies for breakfast, lunch, and dinner . sandra