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This post - and the replies - is one of the reasons this site is so amazing

Just curious... how does that work in the US? Who pays for the testing on the cord blood that you would not normally have tested but now must because of that neonatologist? Does the patient get billed?

We do cords from all Rh Negative moms, O moms, and moms with a clinically significant antibody or antibody of unknown significance (i.e. an autoantibody) s

It was before my time, but... 1. We don't have hemolytic reactions all over the place. In fact, we rarely have delayed hemolytic reactions at all. It is always very exciting for us - great teaching tool as well for students - when it does happen. Maybe 1 every 2-3 years? 2. I would assume cost was a big part of the equation. We use gel (manual) so you do use a lot less cards with a 2 cell screen! s

Very interesting!!! Something that could be done easily using the Echo, but less convenient if using gel cards... So, you are able to enter a blood group from another computer system into Meditech and it allows you to use it as a second blood group eligible for EXM? We are having some difficulties with that here... sandra

Hi John, This allows you to get the second blood group required for the computer crossmatch (EXM) without collecting a new sample IF PPI is used (our hospital uses Mobilab). According to the CSA Standards: 10.6.3.2 If a computerized crossmatch system is used, two determinations of the recipient’s ABO group shall be made: the first shall be on a current sample and the second shall be by one of the following methods: a) testing of a second current sample; comparison with previous records; or c) retesting of the same sample. Note: Retesting of the same sample detects technical errors only. It will not detect sampling or identification errors. See Clause 10.6.3.3. 10.6.3.3 Retesting of the same sample shall only be done in situations where positive patient identification technology is used at the time of specimen collection. sandra

Hello blood bank world! Background – we are currently not automated (use manual gel), do not use Computer Crossmatch (please don’t yell at me, CSA standards call it Computer Crossmatch ), but do have staff who collect blood using Positive Patient Identification. We are looking automation (not yet at RFP). We are planning ahead for Computer Crossmatch and Automation. What we want to do is retest samples collected using PPI without having to removing them from the analyzer or relabel with a new specimen number. We use Meditech (Magic). If you have a moment, can you provide some feedback? What automation platform do you use? What LIS? Do you use middleware? Do you use positive patient identification? To get a second blood group, by retesting the sample (i.e. PPI) do you: Generate a new specimen number and re-label or aliquot? Generate new tests for the same specimen number. If so, will the analyzer retest that same sample with the new tests and generate a second ABO/Rh? Do you use history from another site (like Clinical Connect here in Southern Ontario or other Electronic Health Record) as a historical result? If so, have you created a new test that your LIS will use as a second group to use for Computer XM? Do all your samples expire after 96 hours? Or do you have a pre-op policy that allows for more time as long as the patient has not been transfused/pregnant. We have a 28 day policy. Any other brilliant ideas or thoughts? Thanks in advance to ANY info you have! We just want to do this right from the beginning sandra

Agreed. Not only rouleaux, but also mixed field reactions. sandra

Good morning everyone, There is a familiar name on the Canadian Society of Transfusion Medicine (CSTM) blog. http://www.transfusion.ca/Resources/CSTM-Blog/February-2017/Musings-by Malcolm-Needs-Notable-Colleagues http://www.transfusion.ca/Resources/CSTM-Blog/January-2017/I-will-remember-you-Malcolm-Needs http://www.transfusion.ca/Resources/CSTM-Blog/January-2017/Malcolm-Needs-Special-Moment-for-A-Blood-Group-S-en Generous is a great word sandra

The latest is the 18th edition. I've got it on a thumb drive. BEST. THING. EVER. s

It's Modern Blood Banking and Transfusion Practices. It is what I used as a student, so it MUST be good s

To observe rouleaux or tube IAT, maybe? s

We tried using plastic as well and had problems with static. We stuck with glass as well. s

I wish I could make it!!! I would love to catch both talks, but especially the King Henry VIII! s

We do the same - issue until the sample expires. s

We allow 28 days for pre-admit patients here in our hospital. (Every other sample is good for 96 hours). Same time frame now that samples are not separated as it was back when they were separated and the plasma frozen. And, we have had no issues since making the switch. s

We used to separate samples here too (cells in the fridge, plasma in the freezer). We didn't have any problems, but I felt like it was inevitable. We don't do it anymore. Saves everyone a step which makes everyone happy! We also have fewer problems with cold precipitates and nuisance cold reacting antibodies after removing the plasma from the freezer for XM testing. s

We do not do an IAT XM if the antibody is only a passive anti-D. We still do IS XM here - but if/when we move to EXM I hope that it would allow it for passive anti-D. (Great idea above re: creating a new antibody! thanks!!) It can be a little confusing for some people, especially new staff, since we have generalists rotate through the core. But, worse case scenario is that they do extra work if they do an IAT XM. s

We are looking at automation for our lab (from manual gel). The rep from Immucor actually suggested we use the solid phase manual stations initially and then use the automation. Her rationale - since we were switching methodologies it would be good for staff to use and understand the solid phase before switching over to the automation part of it. I have to admit - I think it is something we would consider if/when we get automation! s

I have heard great things about the Tango! I have a question - what do you do for back up manual testing? s

KKidd - I think maybe we share a pathologist? Seriously tho... what else could it be? We do the modified Kleihauer with hematoxylin, but I wouldn't call it purple.... s

Thanks! We don't use the EXM yet here in our lab (it's on my long To Do List). When we enter the units in they are at AVA status. I guess you can set it up any way you like. So... do you retype all your units (which, I assume must have been done already by the supplier??? I'm in Canada, so I don't really know how that works in the US) and then perform an IS XM as well? Or do you use the EXM? Seems like a lot of extra work if no EXM. We do the same as mollyredone. Little yellow dots to identify the units that have been retyped. We use them any time we issue blood without a XM. s

Good morning! Just curious. It is set up so Meditech won't allow ANY type of XM without a retype? Not just an EXM? s

Oh they get used! We don't use the electronic XM yet. But, we need confirmed units for emergency XM. So we use the labels to ID the bags that have been retyped. Thanks for the post! When I finally do get around to setting up and validating the EXM I'll know we don't need to keep labeling! s

We do the same here s