Auntie-D

Just check the release date/version number of the insert - if that hasn't changed then nothing in it has.

Is she Rh neg? Could it be anti-c persisting from the Rhogam?

Very polite way of putting it... It would be interesting to compare the ones IV due to their mass compared to the ones just under the cutoff and still having it IM.

I understand now - in the UK it is required that it is quantified as guaranteed less than 2ml so KB for us for all pos babies. ETA - doesn't the manufacturer instructions state that the rosette test is only for antenatal use, not postnatal? I remember a thread quite recently...

You mean like the non-sterile bag of blood being hung in theatre?

Today my dear chap you win the internet! (again)

I just can't get my head round how any hospital can only be doing one a year. ETA - it seems an awfully faffy stain that you are using! If it isn't following the actual KB staining regime (which every other kit I have ever used does) then I'd be revalidating it.

Every lab I have worked in in the UK (and I have been around a bit) only do anti-IgG, and anti-C3d and an auto control as that's what is in the cards. Surely this is enough to pull up if it is clinically significant? Or should we be using 6 well instead of 3 well, cards.

Why do you keep your buffer in the fridge? It is supposed to be stored at room temp. Decent smears - it doesn't really matter if they are decent or not (unlike for a diff). 2 drops of saline and one of cells will 99% of the time make a prep that is a uniform monolayer. Lastly - if the foetal screen kit isn't quantitative how do you ensure you are giving sufficient anti-D?

Sounds like a real adventure! Think of how little cleaning you will have to do!! Do you have an awning for alfresco dining?

A KB doesn't take 30 minutes - 5 minutes to dry, 3 minutes to fix, 30 seconds to leach and 2 minutes to stain. How sensitive is the foetal kit? Can you judge the volume of bleed accurately from it?

As someone who has never done one - how is a foetal screen easier than a KB? KBs are so so simple I am finding it harder to envisage a simpler test.

How on earth do you get away with not doing them in the US, with it being such a litigious society? We do several every day...

Labs in the UK don't use the rosette - we KB all samples where the cord blood is positive. We have national QA to ensure competency (multiple times a year). We are a medium sized maternity hospital and we do 3-4 a day

In the UK the coroner requires it as part of the post mortem for any foetus that would have been compatible with life.

We have a double sided form to follow - one side for the ward, one for the lab Transfusion_Reaction_Form rbh.doc

We call them passive - but all of our records are scanned now. Some poor MLA had to scan all of our historic records but now it gets done daily.

Wharton's jelly?

We would only accept a verbal order from theatres - any other situation requires a hard copy.

Have a look on the Westguard Rules website https://www.westgard.com/clsi-c51.htm This is a good resource on it http://www.eurolab.org/documents/EL_11_01_06_387%20Technical%20report%20-%20Guide%20Measurement%20uncertainty.pdf And a 2012 paper here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387884/

Prelabeleed tubes in blood bank is an absolute no no - this is asking for a WBIT incident.

Do you mean a root cause analysis?

In the UK our units come ABO, D, K and Rh phenotype guaranteed - just to save you the effort of marketing it here.

Much safer this way - allows antibodies picked on one site to be viewed at another. Also less risk of WBIT ABO discrepancies with combined systems. Both labs must follow the same SOPs though.

Goodness no! We were told we did well in our last inspection only getting 13 minor non-compliances. I thought it was bad as when I managed the inspection in my lab we only got 4.