Justina

Tricore did a great job of citing all the regulations. We test 20 samples in parallel with the old manuf. and QC both each day of use during the validation. We also run it for 20 days....so a sample a day.

I haven't heard of validating phenotype antisera (Duffy, Kidd,etc), but we do validate antisera used for ABO/Rh (A, B, D, A,B )when switching manufacturers. I am curious to hear if anyone has been sited for this as well.

For a year we would review the record once we received it and if it was incomplete we would sent a copy to the Nursing Manager to go over with the nurse that didn't complete the record or that went over 4 hrs/missed a increase in temp, etc.... We sent a form with it that the Nursing Manager would send back to us stating what action was taken, usually nursing education. Compliance has improved significantly. Now we submit incomplete records as online occurrences.

We will at times use a hematology specimen if our BB tube was running low during an ABID and we just needed to confirm reactivity.

Just like everyone else I too do not like the idea of calling unclear reactivity a cold based on a prewarmed screen/panel. Not every antibody reacts text book and I feel more comfortable giving non-prewarmed cxm compatible units than prewarmed cxm compatible. I have also found that after repeating other techs work...they sometimes miss a weak positive reactions. So better play it on the safe side.

Same as everyone else, no low alarm temp.

Ditto

How about having a massive transfusion bleeder who is Oneg and not switching them, meanwhile the Oneg inventory is being depleted and someone wanting to set up the last two emergency Oneg units. Or delaying an emergency request for blood due to not wanting to verify a straight forward textbook antibody.

I hear your frustrations Aunti-D. Unfortunately it is all to common. All we do is put notes everywhere and have forms and more forms for things that are no brainer job tasks.

I recently had a patient with reactions almost like Davids. Just curious what others think of it. I sent it out to an IRL. But the patient had a negative ABSC with a previous sample was transfused 2 units and now is positive. Looks like mixed field in gel (the top layer on the gel seemed a little to thick to be fibrin), gel panel looked the same but the auto control was 1+ (no top layer), 2 of the 11 cell panel looked negative (with maybe fibrin on the top), and 1 of 11 looked like a good 4+ (really no cells on the bottom). So I was thinking an IgM/cold antibody. DAT- IgG negative, C3d positive (Pre transfusion DAT was negative). LISS tube method was negative at all phases. Cold Screen only the I negative cell reacted 4+ at IS, RT,15C and 4C, the AC was 3+ at 15C and 4C and Screening cells were 1+wk at 15C adn 4C. Any thoughts?

Ditto And we report all testing performed. I also agree with Liz and Malcolm AHG cxm. I had a work-up where Gel was 3+ with the screen and panel, AC 0. LISS, PEG, Saline was reported as wk. Prewarm was reported as negative, cold screen was reported as postive 1+-2+. Rest was negative x3 with LISS. When I saw the workup the "cold" didn't add up. So I ran high incidence (what we had in house) all reactive. Decided to repeat all previous techs work- prewarm was 1+, so sample was sent to IRL and ID'd as Anti-Coa, Anti-C, AutoAnti-I. Sadly I doubt some people would have questioned the work-up and would have reported it as a cold.

The reactions were weak to 1+ at best. Sticking to Immucor here.

The DAT is negative on that cell (we tested it yesterday).

Good to know, cell 2 is looking a bit funky.

I agree with everyone, it doesn't seem like a good idea. Multi techs or unit secretaries will pick up products, with our staff size there would be no one in the lab to set up any additional products or take the phone calls.

Right. I believe ARC types the units twice to verify the inital typing . Since ARC is our only contracted supplier we do not retype, we only attempt to retype units that are shipped to us from another facility (usually rare units).

I don't know of any independent bedside double checks by nursing staff. According to the Standards, you need two people or one person and an electronic method to match the recipient to the unit.

Thanks sgoertzen for the Standards Quote. Lesson learned, always check the standards.

A bit scary, but I guess if you don't have a blood banking background it's an understandable question right.

#2 only

I was going to say I don't think you would have to keep it, if you dispensed it as Emergency Release and then returned it in your LIS (tracking). As David stated, it might be best to save it.

I'm not sure about babies, but we are looking at making sickle testing on units obsolete for adult patients with SCD.

They are just cancelled as 'acceptable sample in lab'. Although if the sample is sent the day the previous sample is going to expire, we call to see if the patient is going to the OR late or if they will be transfusing early the next day and then make a decision on whether to cancel or process.

We have two and there schedule is set. They work every other weekend. I don't remember if they are considered .2 or per diem.

1. Transporter can pick up blood (multi-tech, RN, runner), we read the units to the courier. Though we are considering validating the pneumatic tube system for the OR only. 2. Specimen collection is done by a combination of phlebotomy, RNs and multi-techs. 3. No witness is needed, if they collect using the Positive Patient Identification label reader. If not, there has to be a witness, and both the witness and collecter sign a form that gets sent down with the samples. 4. N/A 5. Pretesting for surgery, is performed the day the sample is collected. No new sample is required the day of surgery. Antibody is identified the day the sample is collected and units crossmatched.