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Posts posted by Auntie-D
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On 6/6/2016 at 1:34 PM, AMcCord said:
A positive fetal bleed screen tells you if you might need to give more than one dose RhoGAM. The fetal bleed screen is designed to be negative when only a small bleed has occurred (insert says 'usually less than 2 mL'), which is easily covered by one dose of RhoGAM (which covers 30 mL whole blood in the US). Since the vast majority of fetal bleeds are small, the vast majority of fetal bleed screens are negative, thus very few Kleihauer-Betke stains are needed. Almost all of the Kleihauer-Betkes we send out are also negative. We had about 950 deliveries last year, so figure approx. 150 Rh negative patients - we sent out 3 Kleihauer-Betke stains. That's not worth doing in house.
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...
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3 hours ago, SMILLER said:
If a surgeon touched anything that was not sterilized or in the sterile field, I would hope that not a few people working with him or her would say something!
Scott
You mean like the non-sterile bag of blood being hung in theatre?
- Malcolm Needs and jnadeau
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On 5/26/2016 at 5:10 PM, Malcolm Needs said:
You could always irradiate the blood bag (as well as the blood), while the stupid nurse is holding it!!!
Today my dear chap you win the internet! (again)
- jnadeau, PalmerSil, Malcolm Needs and 1 other
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1 hour ago, Teristella said:
You seem to be misinterpreting the use of the screening kit. The fetal screen kit does not tell you how much anti-D to give at all, it simply screens for the presence of a bleed. As I said, they are used for two different situations.
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.
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On 2/26/2016 at 5:43 AM, Malcolm Needs said:
I would certainly do it in gel, but I would use the cards that contain monospecific reagents for anti-IgG, anti-IgM, anti-IgA, anti-C3c and anti-C3d.
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.
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20 hours ago, Teristella said:
For us it ends up taking that long, considering we do not have the stain out, the buffer has to warm, we have techs who work blood bank only trying to make decent smears and everyone has to pull out the procedure because we do them maybe once a year.
The fetal screen kit is not a quantitative test.
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?
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Sounds like a real adventure! Think of how little cleaning you will have to do!! Do you have an awning for alfresco dining?
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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?
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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.
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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...
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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
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On 6/12/2014 at 5:32 PM, L106 said:
This is probably a stupid question...........So if the KB Stain indicates that the baby has bled into the mother, exactly what action is the doc going to take?
(Assuming the baby is not mature enough to allow the induction of early labor and assuming that the situation does not involve RhIG.)
Donna
In the UK the coroner requires it as part of the post mortem for any foetus that would have been compatible with life.
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We have a double sided form to follow - one side for the ward, one for the lab
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Wharton's jelly?
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We would only accept a verbal order from theatres - any other situation requires a hard copy.
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Have a look on the Westguard Rules website
https://www.westgard.com/clsi-c51.htm
This is a good resource on it
And a 2012 paper here
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In the UK our units come ABO, D, K and Rh phenotype guaranteed - just to save you the effort of marketing it here.
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I try to scare them a bit...
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How long does RhIg really persist?
in Immunohematology Reference Laboratories
Posted
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.