Auntie-D
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Posts posted by Auntie-D
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Perhaps I am missing something here, but my understanding is that a bubble ensures that there is an incubation period prior to the cell/Liss mixture meeting the gel, beads(in the case of ortho BioVue) which contain the AHG/reactants etc. In the case of AHG reactions I would think it important to have a bubble, reverse groups which are immediate spin and no reagent in the gel less so.
Steve
:)That too but less so - the contact surface is actually quite small... Lack of vortex mixing and prozone has more of an effect.
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The segment we removed from the unit the patient had the reaction to? It's easiest to just leave it in the daily segment container (a clean, empty pee cup [handy little things, eh?]) to be bundled up with its friends at the end of the day.
So if the bag is returned and the segs on that used does a stored seg ever actually get used? I'm failing to see the reasoning behind keeping them...
Maybe it's the bubble bath, wine, candles and chocolate that is disturbing my thinking... God I'm sad - in the bath and still chunnering away on here
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We did an interdepatmental team exercise covering paperwork first - huge amount of paperwork was able to be 'merged' rather than duplicated
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Can't scan them
the writing is just too small Galvania's suggestion is a good one. -
When I was trained I was told that the reactions happen better if kept in the well - and was taught to pipette at an angle down the side of the well (but not touching). The reason they say this is that if the cells end up down the column part you don't get a complete vortex when you you add the plasma and thus don't get proper mixing. It *can*, in very low titre sample, result in the prozone effect. Correct pipetting technique completely eliminates this problem
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Unit bags are discarded on the floors after transfusion. Bags from reactions are returned to the lab.
Sp if bags from reactions are returned to the lab do you need to keep the pigtails/tag lines?
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Noone here uses red ink but it does state in our SOP that any amendments must be made in a different colour to the original and signed and dated - makes it easier to identify who, when and what...
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I'd love to share mine on line but it turns out it is against hospital policy to share procedure
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Yes, both please. What other sorts of IgG testing can you do on Diamed gel cards besides LISS? Enzyme, I assume? Anything else?
Were only a small lab so only do LISS - anything else gets sent away. From my past jobs in teaching hospitals it seems their use is pretty much unlimited. Sing it now! 'Anything tube can do gel can do better, gel can do anything better than tube'.
Some say gel is oversensitive any causes unnecessary further investigations but IME that is balanced by the fact that it can pick up clinically significant antibodies that have titres that are low enough to be undetectable by tube. Safety first and all that...
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Was it cord blood? Any chance it could be Wharton's Jelly contaminations. Has the sample been repeated?
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We quit getting empty blood bags back when AIDS came on the scene. No more blood bags carried dripping through the halls.
Ew - ours are sealed with bungs and carried in sealed bags.
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I would be nice to see a package insert/instructions for use for the Diamed gel cards to see what they say about the formulation. Does anyone in Europe have one to post?
I'll see if I can scan one and post on here. Which do you want ABOD and Liss Coombs?
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OMG I've just realised I forgot to thank Diana on here... I hope I did it by email *tootles off to check and blushes with embarrassment*
Thank Diana and Donna!!
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Mine is complete now if anyone would like a nosy...
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We are not allowed to store samples and reagents in same fridge ( CPA stipulated this)
can't believe mhra allow used bags in same fridge as samples / reagents ( esp reagents ) you must have got them on a good day
We got pulled up on our temperature variability of our fridges - we are a really small lab with very little 'stock' so the temperature goes out really quickly if we just have a few reagents, even in a small fridge. As a result of this we have one small fridge for all of our samples and reagents. There are 3 shelves that are labelled (on this they did insist) and each type of item is kept on its respective shelf. Both the CPA and MHRA felt this was better than temperature variability. We have the smallest rapid-return fridge available.
Edit - we had this all in writing before it was put into place and also before our inspections. They did comment but I just produced the paperwork from them saying what we do is acceptable...
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We only store our emergency ONeg segs. With each unit possibly being crossmatched multiple times, storing each time creates extra work. We store our transfused blood bags in the fridge for a week - thus only storing tags where a transfusion reaction is possible.
IMO handlabelling tags (or even sticking autogenerated barcodes) is adding an extra step for mixup. What happens if you have a transfusion reaction and the two units segs have been mislabelled accidentally? How can you confirm you are investigating the right unit? By storing the empty bags you are taking the segs from a bag with a unique and permenent identifier and thus eliminating a mixup step.
We don't do anything glamourous with our blood bags - just shove them in the bottom of the fridge. For those in the UK - MHRA state that used bags must be stored in a separate area to the reagents and samples. Our inspectors advised us that a seperate shelf in our reagent/samples fridge was sufficient. They also stated they must never be stored in a fridge with uncrossmatched units.
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Found another that probably started out doing major and minor crossmatches!
I still do an immediate spin tube XM when doing an XM just to confirm ABO compatibility - to confirm I haven't mixed up samples more than anything
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Aunti-D -
Just relaying what CAP told me. I don't disagree that panels need QC, just stating what CAP relayed during an interpretation the CAP checklist question.
John
Maybe the CAP person didn't understand?
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Secondly have you fine tuned your analyser to what you see on a blood film, i.e. if the blast flag comes up on the analyser have you confirmed this microscopically and adjusted if the the flag is oversensitive or otherwise?
Steve
Of course
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We had this come up in a CAP inspection also. I called CAP and was told that the antibody ID was considered an extension of the antibody screen and no QC needed performed. That was a few years ago, and things may be different, but is two subsequent inspections that answer was considered valid.
??
John
All reagents for use MUST be validated daily - this includes panels. You are controlling the reagent's functionality not the method. This of it like a shop - you buy a potato and a cucumber at the same time - just because the potato is fine 2 weeks later doesn't mean that the cucumber will be...
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Red cells should be infused within 4 hrs of releae from the BB . . . once signed out, you can delay starting as long as you want, as long as the infusion is complete within the 4 hr timeframe.QUOTE]
This is my interpretation of the regulations also. (And I believe that the time limit is 4 hours from time it left the Blood Bank refrigerator, not 4 hours from time the unit was spiked.)
Donna
Agreed
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I am a new blood bank supervisor and thought I would check here to see what everyone is saying about panel qc. the last place i worked did not any panel qc, but this place does an anti-D positive control on cell 1 and a negative control on cell 1 every time the panel is used (but they only do it on the "in-date" panel and not on the panel they use for selected cells). the CAP checklist say all reagent cells must be checked for reactivity and specificity each day of use. this has me completely confused. i am not sure what I am qc'ing. if I use anti-D, ok, great I know that my D antigen is on cell 1, but this really doesn't tell me anything about the other cells or antigens. Any thoughts/input would be appreciated.
The Anti-D pos and neg is the control you need to do for every batch to control the methodology. This is in addition to a single daily QC for all reagents and cards in use.
For the first batch of the day we set up a weak control, either D or K (we alternate each day) and challenge all grouping and screening cells and reagents. Just treat your whole blood control like a patient and it simplifies the whole thing
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We recently had a haematology proficiency here where a CLL patient had p.falcip. Nobody spotted the malaria because they were too busy looking at the high WCC.
So it WAS Falcip. ? Everyone took the Mick out of me for calling a dual pathology! I never did get round to looking at the results...
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How can a method be *too* sensitive. If they've got anti-c, surely you're best picking it up than ignoring it? I'd rather have a 3+ reaction than a 1+ reaction...
:)
Quantitative HCG testing methods?
in Equipment
Posted
We use Seimens Centaur CP and it's dreadful. Expensive technology, lots of dead space in the sampling (makes for lots of QC wastage), takes ages to initialise and you cannot do a dilute sample straight off (you have to do a neat and a dilute) which means that lots of reagent is wasted. The NEQAS isn't too hot either. Oh and did I mention the down time and the fact that it is super noisy? Don't go Seimens!!!!