GCH LAB RAT

I have seen an unexpected reaction with cell 9 for the ortho panel A lot VRA226. This has happened before and the tech support explained to me that it had something to do with the HLA+ cells.

We use the macopharma phlebotomy bags (600ml) with the luer lock. That way we can attach any size needle onto the bag.

I just got cited for this checklist item. When I spoke with CAP, this was the response: TRM.31250 If expired reagents are used you must clarify that they were unavailable from the manufacturer at the time of use. (I was speaking to her about antigen typing sera, not RBC's) She stated that we must document in our records why we had to use the expired reagents (ex: on back order from manufacturer). I explained to her that we use expired RBC panel cells for rule outs ONLY and that we QC the panel with each use. She was okay with that statement, but anti-sera had to be within date even if we had QC that gave expected results, UNLESS it was on backorder or unavailable. So if hope this helps someone with this checklist item.

We also ask questions and hold the form in blood bank until surgery. I have attached a copy of the form for your review.

At my hospital, we do IS (buffer card) and AHG phase (IgG card) crossmatches with gel when the crossmatch if a full crossmatch. The IgG card only detects antibodies reactive at 37. It is also stated in the package inserts for the gel cards. Also, the Anti-A1 should be reactive with the reverse phase of the typing.

It isn't. That's why most blood suppliers went to pooling and pH testing (using the FDA approved methods) before shipping platelets.

At one hospital that I work, we used the blood gas analyzer, but the down side to this was that it took approx 5 mins for unit of platelets being tested. At the other hospital I work, we "used" a mini Lab pH meter. But now our platelets come from our supplier already pooled and pH tested. This was a way to reduce the bacterial contamination. Boy am I happy!!!!!

We have been using Rhophylac for a several years. The nursing staff requested that we only order this product.

We use EDTA and separate the cells only if the specimen is a surgery specimen drawn in advance.

Hi Jennifer. I also got cited recently on TRM.30950. I have attached my procedure that I submitted to CAP for my response. Hope this helps.

I would like to share a story: We had an OB patient that was new to our hospital and we typed her as D pos (Gel System 4+). She insisted that she always received RhIG with her previous births. So I called the hospital blood bank to inquire about her type. They had her as O neg, weak D pos. So naturally I done the testing in the tube and she was weak D. The doctor dosed her with RhIG because of the mosiac or missing parts of the D antigen. So are we missing these patients that are true weak D and have the potential to make an antibody to the missing parts. I would like your thoughts. Thank you.

I interepreted the question as you must compare you testing methods against each other. At my hospital we use Gel and Tube method so I take a CAP specimen or a patient specimen that is has a negative antibody screen and one that has a positive antibody screen and compare the two methods. My inspector was happy with this method.