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Posts posted by Auntie-D
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On 1/29/2016 at 1:09 PM, DeeMc said:
We provide Rh and K antigen matched, Hgb S-neg for PRBC transfusion to all our sickle cell patients. Exchange transfusions also require units < 14 days old.
We do the same for phenoypically matched blood but our policy is <14 days for top up (we always give fresh blood to transfusion dependent patients) and <5 days for exchange transfusion.
Pbaker - we phenotype any patient that is transfusion dependent for two reason. 1) so they don't develop a Rh/K antibody and 2) so that if they do develop an antibody it makes finding suitable blood a lot easier when you already know their phenotype.
On 1/29/2016 at 1:09 PM, DeeMc said: -
On 2/3/2016 at 8:38 PM, NewBBSup said:
Auntie-D-
Do you use the 5 ml or 7.5 ml EDTA tubes? Right now we use 6 ml BD tubes. I don't know if I want to go to 5 ml or not. I'm afraid of running out of sample. Have you had problems?
We use the 7.5ml. We will accept the 4ml on children and 1.2ml on neonates. All the tubes are fine on our analysers for automation. We are the local centre for haemoglobinopathies so most samples are 7.5ml due to some patients having complex needs.
The nurses prefer them too as they are easier to write on.
On good point is that you can put a barcode label on without obsuring any patient details or the cells - handy for manual testing.
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On 2/3/2016 at 8:40 PM, bxcall1 said:
The nurse doing the line draw hemolyzed it! Happens all the time around here. They don't understand that you have to pull the plunger back gently and they just pull it all the way back even when the blood flow is not good.
Or leave the tourniquet on for ages whilst they get themselves organised and the patient's arm is going blue...
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We've been using them for years (over a decade) without issue - 5th largest hospital in the UK
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If we can't identify the antibodies off the panel and enzyme, we have a 2nd panel with a further 11 cells. Occasionally we have used the 3 cell D-neg screen too. Usually these 28 cells (plus 11 enzymes) will give us the answer. But then we send all of ours away to our reference centre for confirmation, so it doesn't really matter...
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18 hours ago, tricore said:
Now you just have to make sure that no one stores their lunch in the BB refrigerators.
Don't laugh, I found a copy of a very old inspection and it was written up that food was found in one of the BB refrigerators. I also found an apple in one of our reagent refrigerators.I know of one BBer who chills their Red Bull on a night shift in the ultra deep freeze.
ETA - it's not me and I no longer work there.
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My understanding is in the UK nothing should be stored in a fridge containing blood products. Any other fridge is fine but reagents must be stored above samples and there should be a dedicated quarantine area for unvalidated reagents.
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16 hours ago, rravkin@aol.com said:
Goodchild, when is the last time you ran out of group O Rh Pos red cells as compared to AB Pos red cells? And what about group B Rh Pos red cells? Does your blood bank reside in area where AB Rh Pos red cells is the predominant type and types O and B are scarce? If so then, by all means, give AB Rh Pos red cells; and does your blood bank have electricity and running water?
Sight in the absence of light leaves you blind.
You are aware that if you run out of B or AB units it is perfectly acceptable to give group O? You are competent enough to know that?
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My view is that the OP clearly doesn't understand transfusion science.
The worst that is going to happen is they might develop a clinical insignificant antibody - so what? So what if it is even clinical significant? If they ever come in needing blood again - then you worry about giving antigen negative blood. Hell - I've given O+ blood to an O- WOMAN of CHILD BEARING AGE in a massive haemorrhage situation. And do you know what? She didn't develop an anti-D!
The patient is group B - exactly how many units do you think you will have access to that are antigen negative for every antibody the patient has any possibility of developing? You are going to severely limit your donor pool.
The patient in question may not ever need a transfusion again - you are worrying about a miniscule maybe.
I seriously think you are overthinking this but not actually grasping the concept.
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We don't wash - I can't remember the last time we had an issue with a cord sample (other than mislabelling).
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We do the same as David
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20 hours ago, AMcCord said:
Auntie-D, it is common practice in the US to allocate a unit to an infant/child patient (or a few patients depending on anticipated need) to reduce donor exposure, but in some cases the patient(s) may receive only a very small volume of red cells prior to dismissal or transfer. In that circumstance it's a shame to waste the remainder of a unit of perfectly good red cells.
We wouldn't waste them - we would use them on a low need baby. We also transfer packs between the main, and satellite hospitals, to make sure they don't get wasted. We wouldn't use one on an adult though.
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On 12/31/2015 at 7:39 PM, John C. Staley said:
Another thought would be if you have an active pediatric unit that could possibly use a reduced volume unit on one of their kids. It would be a shame to discard perfectly good blood but I do agree that it would be unacceptable to issue it to an adult.
But it would be more of a shame to give a child an antibody due to unnecessary increased donor exposures. I'm not sure about in the US, but in the UK we allocate all 6 units to one baby so they are only exposed once. If the medics suspect only one unit is needed, then we will give the excess units from other babies if that makes any sense?
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If you fold up a piece of roll you can 'wipe' the top of the stain before staining to remove the gold top - it gives you cleaner slides.
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14 hours ago, R1R2 said:
I would discuss how much can be removed and still be considered a whole unit with your medical director. It seems a shame to waste a unit if just 25 mls were removed.
In the UK a paediatric unit is 45ml and we do a 6 unit split pack. If you are only doing a 4 unit split pack, then wouldn't the volume lost be more than that? (275ish/4 = 70ml ish)
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5 hours ago, Malcolm Needs said:
You may be able to get a copy via Amazon, or somewhere like that (but what state it would be in - slightly foxed as a minimum, I would say - I hesitate to think!).
My mind went haywire here and I started wondering why a blood bank book might have sticky pages?? Bad D!
- Malcolm Needs and pstruik
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What about case studies being posted (anonymised of course) with action took, outcome and follow up? To allow others to learn from procedures followed in real life.
The other thing I would like is for you to bring back the Zoo Keeper game!! I was at the top of the leaderboard...
- Malcolm Needs and Cliff
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I should imagine the wards wouldn't be happy about having to rehang part units too
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On 12/22/2015 at 8:00 PM, amym1586 said:
I just wonder if that will suffice to give one dose of RhIg to an Rh Neg Weak D pos mother of an Rh Pos baby. Or if more testing is required.
I guess we are getting by with our procedure of them not being a candidate but I don't like that.
I still don't understand why there is so much gray area in blood banking. I feel like there should be way to do it and that is the way to do it.
It can be, except when it isn't and without KB or flow you would never know - until the mother develops and antibody and you end up with HDN in the next pregnancy...
Don't laugh, I found a copy of a very old inspection and it was written up that food was found in one of the BB refrigerators. I also found an apple in one of our reagent refrigerators.
Gel antibody panel and tube antibody panels
in Transfusion Services
Posted
Absolutely! I sometimes feel a bit uncomfortable about doing groups on whole blood where the patient has a low Hb - and I know it will still react properly. I wouldn't risk it for anything that could result in prozone.