RL0121

Hello, If a lab is doing manual ELISA and ANA IFA and using previously ran patient as external controls, are they required to perform new lot verification? They are using FDA cleared, CE marked ANA kit. The lab is not CAP accredited. Thank you.

Hello, I’m in the autoimmune sector and would like to found out from anyone who can share their Proficiency Testing Policy that includes providing evidence of compliance in reviewing Ungraded PT results . Since we perform specialized testing , we don’t have enough labs to compare our answers with. I’m updating our PT policy to address this requirement. I appreciate any assistance I can get. Thank you . Stay safe everyone 😷

Hi there, I recently transitioned from a Blood Bank Supervisor position from a hospital to a promising Biotech career in Rheumatology/CTD as a Chem Lab Supervisor. It's been 3 weeks and I'm loving the transition. I was wondering if there's anyone out here who ho has experience with Quantalysers and Nova View. My department runs ANA, DsDNA, Hep2 , Anti C1Q, Ribo P , PSPT IGG/IGM ( PROGNOSTICS). All Elisa based assay. Our lab specializes in SLE Assessment , RA, Fibromyalgia and other CTD Diseases. Hope to hear from the experts here.Thanks.

He realized that afterwards but suggested hopefully in the future leukofree and not lekoreduced only rbc will be available .

Patient had multiple transfusions 2 mos ago (open heart) but had a reaction (febrile) last night after second RBC transfusion. I'm reviewing the path report, our doc recommended use of washed RBC's. We only use leureduced RBC . I'm not sure if the patient can actually benefit from washed RBC's other than leukopoor RBC's shes getting from us. Patient is not know to be Ig A deficient. This patient also has strong rouleaux at IS and at 37 C. Saline replacement was recommended by our Ref. lab. If a patient developed an HLA type antibody, is washing of red cells going to eliminate the problem? Like in the case of Bga antibody? He also asked if short date units would be beneficial for our patient ??

Do u recommend a 3 min spin time at 5964 rpm for trop testing using Access?

I'm in the process of developing a competency testing/evaluation for the Emergency Release of Blood Products. This is supposed to be a 6 month goal I need to accomplish. I have to perform a mock drill for all our BB'ers and evaluate all of them as to how they respond to the situation. We don't do this often and I want them to be comfortable if they have to deal with the real situation. Do you have any scenarios and evaluation tool I can use that you would like to share? or anyone? Thanks.

Sorry for the type o's from my previous post. I was posting on my break yesterday morning and typing on the phone is such a difficult task :-( In addition to my post, if OR can verify hospital band but not the blood bank number, can they use the patient chart to verify the Blood bank number instead? Normally, after a BB sample is collected, they attached the BB armband sticker to the patient chart?

We have a case last week, OR called requesting for units but told BB they cant verify the Blood Bank armband number becauses the patient was tucked in and cant be reposititioned (spine surgery). I was pulling my hair because I have to issue emergency O neg units (PT is B+, no antibody). OR surgeon signed the waiver without a fight. I was told that there are hospitals practice this system: OR nurse verifies the blood band number with anesthesia or another nurse. Then the OR the nurse writes the blood band number on their white board and verifies this with anesthesia prior to patient going to sleep and of course prior to positioning. That way everybody has seen the blood band and has documented so once the patient is positioned there is no need to “search” for the band. Staff also know that once you cut the band off you have to retype and cross match. I'm curious to know whether this practice is aceptable. I am not sure this practice will pass AABB, our BB accreditation policy, because there is a real flaw with this practice. If someone does not erase this number and you don’t empty the blood out of the OR BB refrigerator, you have the potential to give the wrong blood to next patient in that room. Any ideas?

Scenario :Missed Anti Fya during initial compatibility testing. No previous antibody hx. Received 1 U (Fya Ag unk at this time). If unit transfused is Fya+ is it FDA reportable or if its neg and patient not transfused with fya+ is it still reportable?

I have seen a 45 min cold screen and was reported as CA. I want to !!! After 6 weeks as a supervisor, ahhh..i'm about to lose my hair Thank you for all your useful inputs. I'm learning from everyone here. What am I supposed to do without BB talk?. Please keep on talking:-)

Hi David, So your facility wont allow to give "gel crossmatch " compatible units when all C.S AB are r/o in gel? Gel xmatch is more sensitive than a tube LISS xmatch right? Some techs can miss a macroscopic agglutination but you cant ignore minute speckles on gel. Our current approach is like you mentioned. Cold screen in addition to tube LISS AB screen. If LISS neg, cold screen pos, a LISS xmatch is recommended. My procedure will probably still include LISS AB screen if gel screen is pos and ELIMINATE cold screen work up. Report it as "non specific" and comment: "Antibodies to the routinely encountered blood group systems are not demonstrated". Give gel xmatch compatible units. Your thoughts David?

Hi Barbara, Although Inconclusive and non specific antibody translates same interpretation, my pathologist and CLS's suggested they'd rather report non specific . Can I take a peek at your facility's ABID procedure portion where non specific antibody reporting is mentioned when all C.S. AB was r/o.? Thanks in advance.

Pos Antibody Screen gel method ABID panel all neg next step: report Antibody as Inconclusive and give gel(IGG) crossmatch compatible units or perform cold screen at 4 deg 15-30 mins. If pos, report Cold Agg reacting at 4 deg. Perform LISS tube Antibody screen and recommend LISS crossmatch compatible units. I'm seeing a lot of Cold Agg in our facility since majority of our patients are elderly. Inconclusive reporting is not routinely practice . Has anyone wrote a procedure suggesting "if all clinically significant antibodies are ruled out", report the Antibody as Inconclusive?. The previous facility I work has this practice but theres no written procedure thats directive to the process. I would like to eliminate unnecessary work but still provide a safe practice.

Our facility uses Knowledge trak cGMP training for the last 3 years. Our techs claim only 2/3 of the questions can be applied to our current practice. The rest is non applicable. We are not a donor center and I was hoping to initiate another compliance training other than cGMP which offers more relevance to our facility. Any suggestions?

Thanks for the input folks. C/T ratio is included in our monthly report but I think I will revised the policy and will include RBC wastage. 100% RBC utilization is ideal but our current policy don't reflect the wastage portion.

I hate to post this question but its bugging me for the last 2 weeks In my monthly usage report, I have to calculate % RBC utilization. I look at our existing policy which was originally written in 1992 and was revised in 2004. According to the policy; % utilization of RBC is calculated by dividing the number of RBC transfused for the month by the number of RBC transfused. The total should be 100%. That don't make any sense to me. If we transfused 263 and wasted 6 for the month, I guess my calculation should be 263/269 X100=97.77%. The policy should say; % utilization of RBC is calculated by dividing the total number of RBC transfused for the month by the number of RBC transfused + total number of wasted RBC x 100. Inputs are greatly appreciated. Thank you.

Hi Dona, Oftentimes we have 2 Blood Bankers on the evening shift. One works primarily in BB then one back up who works in the main lab. On rare occassion, if the back up tech calls out, the primary BBer is left with a non BB tech. A request to train non BB personnel to dispense/issue unit came from one of the evening shift tech. She suggested that all per diem techs should be trained to issue regardless of their shift. I opted not to do approve the request for many reasons: 1.) resistance from our casual CLS's 2.) keeping up with competency will be difficult. 3.) the previous supervisor didnt approve it... and we both probably feels the same way . it's just too scary!

This is going to be very interesting. It's actually up to me to decide whether that process will be allowed. The higher ups asked me if im comfortable to have it going. Not everyone of course is on board but we'll see. Thanks for the input.

(pardon my type os... I'm on my phone and at the gym on a bike) One of our full time staff insisted that a non bb staff should be trained to dispense a unit in order for a BBer to go to break peacefully during break time and without no interruption and for extra coverage if it's busy. I know about our staffing issue particularly evening shift but it worries me a lot to have a non bb worker to issue a unit. I'm curious if there's any facility who allow this practice.

Agree 100%. In Blood Bank, uniformity/consistency is followed. When I was just a new BB CLS, someone took over the department in the facility I work. She changed the way things are done. Its a whole BB make over and those changes are very good although not everyone's on board at first, eventually the process took place and the rules are followed.

Your feedback was very helpful Barbara. I know I have a lot to learn since this is my first time to supervise a blood bank facility . I'm very confident as a BB Tech but since im evaluating their current workflow process, there are of course gray areas that needs attention. Im mentally challenged because I don't have anyone training me for the job. Although the previous supervisor is just a phone call away I don't want to annoy her. The senior tech that was supposed to train me is on vacation for 3 weeks. When she comes back she also work in different areas in the lab. Without BB Talk I will be lost .

Yes. 2 out of 3 of 1+ reaction. They're not allowed to report inconclusive. If everything is ruled out and a gel xmatch Unit is compatible why spend more time with extra work? Cold Screen seems the preffered method . Can someone validate this with me so I can work on changing our process. Antibody screen pos , selected panel ID neg , auto neg, all clinically significant antibodies were ruled out. Back where I came from this will be reported as INCONCLUSIVE and gel xmatch compatible units is recommended. I'm curious about what other blood bankers will say.

It's only my 3rd week in the facility and in the process of getting to know everyone. I know what you mean about developing a system how to work up an antibody. Majority of the techs know their BB by heart. Thanks for your input mhc .