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SMILLER

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Everything posted by SMILLER

  1. Ya. If I recall correctly, this patient had a strong 1+ reaction with all C pos cells, except for that one screening cell. That one screening cell otherwise reacted normally with anti-C from both reagent and another patient. So just have to forget about this one. Scott
  2. Some important stuff here, too... https://www.youtube.com/watch?v=1VKt2LysGxA
  3. Not being familiar with HFAP, I would wonder why they do not inspect Blood Bank along with the rest of the Lab? Scott
  4. Yes. At least we got a reaction with anti-C reagent. Likewise, that particular cell reacted with another patient who was producing ant-C. Scott
  5. The patient is long gone. But the same method -- manual gel -- was used for both the screening cells and the panel cells. As I mentioned, the reagent cells were both all R1R1 (but from different donors)--yet only the cells from the one screening set was negative. Had to be something wrong with that particular cell and that particular patient. Scott
  6. It seems like you are suggesting that CAP inspect your lab for all departments except BB, which you would have done by AABB? Is this even possible? Can you be selective about what CAP looks at? Under CLIA, regulations for all areas in the Lab are pretty stringent, whether AABB, CAP, JCAHO or FDA. If you want the extras ('prestige'?) that come with paying the AABB for another inspection, then I guess it's worth it. Scott
  7. Agree with the comment above. While the patient is in your chopper with your blood, it's your patient. Somehow you must be be charging for the ride and any other care in flight. And like any unit transferred with a patient to another facility, you will have to follow up to finish the transfusion record. Scott
  8. You almost got it. But I think the original question here was about using gel diluent with QC materials to create positive and negative control cells. Scott
  9. I am not explaining myself well. Perhaps it may be hard to understand unless you have used such a system. In a transfusion service, like a hospital, the BB armband number (regardless of the name or other information on the label) is placed on the specimen when it is drawn. That number goes into the BB computer system when the type and screen and other testing is done. If a product is ordered, that BB number is on the tag on the unit. When it is issued from the blood bank, that number must be on the request form brought to the BB--otherwise no issue no matter what information matches up. (Of course, name, birthdate, etc. must match also.) When the unit reaches the patient, the BB number on the unit tag must match the BB number on the BB armband which is on the patient. Its a full-circle kinda thing. The unit is very unlikely going to go to the wrong patient--no matter how they are otherwise ID'd--if a strict BB number and armband system is used. With such a system, which is relatively common I think, the patient can come in and be under a false ID, and still get appropriately matched blood products. One cannot say this for a system that only depends on two separate draws for assurance that an electronic XM is appropriate. If the wrong patient is drawn once for some reason resulting in WBIT (like in the wrong bed in a room)--the same circumstances can cause the second draw to be WBIT. Then if the unit goes to another patient---well, that's when the God Help us comes in! Scott
  10. Right, but I am sure that you do not antigen type all patients and give them antigen negative units as appropriate for those antigens! Scott
  11. Except that the QC manufacturer's diluent used to make a control antibody solutions is not used in any phase of patient testing--it does not need the be QC'd--it is QC. I would think the point is that the gel diluent is being controlled (which it should be), by showing it does not produce a positive reaction as a negative control. When patient or unit cells are being tested in gel, you use that gel diluent to create an 0.8% suspension--so for a positive gel control, if you are creating your own 0.8% suspension, again you want to use the manufacturer's diluent. Scott
  12. With a BB armband system, the blood drawn at the time the armband is applied is going to have the same BB ID as the unit being transfused. Even if the patient is initially registered mistakenly with another persons ID, they will be getting safe transfusions as long as the BB armbanding system is used appropriately. (In such a case, no matter how many draws you do for the ABO/Rh, they will all be wrong for that registered name--but at least the transfusions would be safe for the mystery patient.) Scott
  13. This goes back to some comments made earlier in this thread. It is impractical to screen for all antigens for a particular patient that may induce an antibody response. However, for a patient that is actively producing (or is known to have produced) an antibody for a particular antigen, transfusing known antigen positive blood would clearly not be indicated if it can be avoided. Scott
  14. I would think that you can define "properly delineated" for that particular cell washer however you like--as you have the manufacturer's input on what it is going to look like. As for fill volumes, we have a Ultra cell washer (not a CW II though). If it fills to 80% of the tubes and all tubes are within 1 cm of each other, then we say it is good. Scott
  15. That observation makes a lot of sense to me. Also, I think that the comment noted above by StevenB, regarding the unusually lukewarm AABB position, is telling. If the AABB is not going to take a hard stance on the issue, then routinely screening for little c in these cases seems to not be indicated under most clinical situations -- and certainly not required by any regulatory standard. (As for my lab, it wasn't that long ago when we were still screening for e negative units for patients making anti-C!) Scott
  16. I just read what I posted yesterday and would like to officially submit that post for longest sentence of the month. Scott
  17. Except that if you know the patient has been transfused in the past, and now has anti-E, and you also know they are c antigen negative, it would be nice if you could avoid having them produce anti-c. You already would know that they are a responder, and for future transfusions (for, say, a chemo patient), it would be nice if you did not have to screen units for little c. (Extended phenotyping of patients to avoid transfusing certain types of blood is indeed done for certain cases, such as Dara or sickle-cell patients.) Scott
  18. See the topic: 'Gel Diluent QC' started a few days ago. There are some comments and ideas there. Scott
  19. I may be mistaken, but I think the idea behind freezing an initial specimen that was titred and then thawing and running in parallel with subsequent titres, was so that if there is any variation in technique between one testing event and another, the retest of the initial specimen along with testing the subsequent specimen would eliminate any question as to how the titres have risen (or not)--in comparison to each other as they are being tested at the same time--when the subsequent specimen is received and tested, Scott
  20. We do the same for our traumas. I think its a common practice. Scott
  21. On the other hand, if those 15% are in another emergent situation in the future... Scott
  22. We used to get them from time to time. We just use a generic body fluid cell count and diff order. Scott
  23. You would want to check the Ortho Instructions For Use (all Ortho IFUs are online) for stuff like this. I believe the MTS diluent is listed as being usable until its label expiration date (opened or not). The notes about QC are there also. I am pretty sure our Ortho customer rep went over all this stuff with us when we switched from tube to gel years ago. Scott
  24. Oh, yeah. That's true! I think Ortho wants to make sure that you do not respin and try to re-read used cells. And still, you would not want to try to "fix" a bad card (liquid off the gel) by re-spinning before use I think. Scott
  25. I think you need to worry about the quality of the cards before they are used. We also have had some bad cards shipped to us earlier this year (we do manual gel). Bad as in no liquid on top of the gel. According to Ortho, the gel goes bad in situations like this, so "fixing" them by re spinning doesn't seem like a good idea. They should just be rejected. Scott
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