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SMILLER

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Posts posted by SMILLER

    Titers

    in Immunohematology Reference Laboratories

    Posted · Edited by SMILLER

    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

     

    Rh negative Patients that receive Rh positive blood

    in Transfusion Services

    Posted

    11 hours ago, Ward_X said:

    My lab (for trauma I center) does just that: our MTP prep. work includes having sets of O+ aside for male traumas, and O= aside for female traumas. For these untyped pts in emergency situations, the Rh is essentially determined by their gender. For platelets, male/women BCBY do not require Rh= receipt. You're right @Kari Reichenau in saying that giving O= to everybody really burns the inventory...

    We do the same for our traumas.  I think its a common practice.

    Scott

    gel diluent qc

    in Accrediting Agencies

    Posted

    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

    Centriguge speeds

    in Equipment

    Posted

    Whatever centrifuge or cell washer you use, you need to check it at different times for each speed.  What you want to see is how long it takes to get a clearly delineated cell button for both a positive and negative reactions, in addition to a negative that dissolves easily. 

    We check ours yearly, (I think it's regulated by our inspector-JCAHO).  And sometimes we find we have to adjust a time for -- say -- an IS -- from 15 to 20 secs or whatever.

    Scott

    Body fluid validations

    in General Information

    Posted

    When we got our DxH 800s a few years ago, we tried to correlate several types of body fluids, and decided that it was not worth the trouble.    The linearity was not very precise (or accurate compared to manual counts) at lower levels, like those found in CSF.  You will have to do a manual diff anyway, as no hematology analyzer is going to report out mesothelial or malignant cells.

    Scott

    pre-conception antibody titer request

    in Transfusion Services

    Posted

    I would say, like all pre-natal atypical antibodies, they are thinking ahead to see if a particular titre increases.  One would need a baseline to do this, and they already know the patient will produce antibodies.  I would hazard that a significant increase in titre would suggest a feto-maternal bleed, which for this patient, would need to be dealt with as soon as possible.  (There is no "S" equivalent to things like Rhogam...)

    Scott

     

    Picky anti-C?

    in Case Studies

    Posted

    I should have mentioned, the original screening cell that did not react with was listed as R1R1, while the patient reacted fine with R1R1 cells on the other set of screening cells and with the panel cells.  So, kind of odd.  We did call Ortho but they had nothing to add about the situation.

    Scott

    Picky anti-C?

    in Case Studies

    Posted

    We had a patient, 30-year-old female, B pos, who showed up last week with an anti-C along with a few equivocals.   When it was time to repeat the T&S (and antibody ID) a few days later, we went ahead and set up a panel along with the screening cells, since we already knew there was an atypical antibody that would show up.  To our surprise, the screen was negative (Ortho manual gel).  The panel reacted as expected, pretty good 1+ reactions for the C, with a few equivocals.  

    The second specimen's screen was with a different lot of screening cells.  We also tested with the original specimen's lot number of screen cells, and 3% tube screening cells -- those reacted as expected for an anti-C.

    Kinda odd.  The newer screening cells were checked with another patient who makes anti-C - that reacted as expected also.  Its just the one patient with the one lot of screening cells that did not react.  Kinda odd.

    Scott

    PPID in the OR

    in Transfusion Services

    Posted

    Periodically we audit bedside transfusions, to ensure the readback and other pre-transfusion procedures are followed there.  If you believe that your OR is not following your hospital's procedures, it seems like you would have to run an audit there to ensure that those associates are not cutting corners.  This si a department to department quality check so I would think you would have to set it up with the respective directors.

    Scott

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