adiescast

Ouch! It is scary that there are people out there who don't know what they are doing. I don't know how to prevent it except vigilance and knowledge sharing on the part of those who do know. I've seen people just ignore reactions because they did not fit their preconceived idea. I did on one occasion refuse to have a second shift generalist in blood bank because he was not capable of interpreting antibody identification panels. He was a nice guy, but he was completely incapable as a blood banker.

Congratulations Malcolm! You have every right to be excited about this honor. Thanks for letting us know about it!

If you are CAP accredited, the following applies:
TRM.50000
Phase II
N/A YES NO

Does the person in charge of the technical operations of the transfusion medicine section of the laboratory have education or experience equivalent to an MT(ASCP) and at least 4 years experience (one of which is in transfusion medicine) under a qualified laboratory director?

Attached is the "pick up" slip I designed for sending blood in the tube system. I stole from many sources, so I won't try to give credit here...
Our process is the floor sends the pick up slip through the tube. We send the blood and the slip to them (we use the secure feature in the tube system). They sign the slip and return it to us. If we don't get the signed slip back in 10 minutes, we call to find out what happened to the blood.
This is a very new process for us and we are only using it in a very low volume area right now, so I won't make any claims about its success rate.
Pick up forms 090110.xls

Even though Kell is considered to be highly immunogenic, it is nowhere near 100% likely to cause antibody production. Removal of the 9% of the donor population that is positive for the antigen is very inefficient use of our donors, who are rare enough as it is!
Even if a woman develops anti-Kell from a blood transfusion during her childbearing years, the father of any child she carries would have to be in that 9% of the population in order to cause a problem pregnancy. If he is K+/K-, it is only a 50% chance that a pregnancy he engenders will produce a Kell positive child.
Given that we do not Kell type our blood on a routine basis, we see very few instances of anti-Kell. We have had no instances of HDN due to anti-Kell from transfusion (that I know of) in any facility I worked in during my 20 year career. Maybe it is luck...or maybe the chances are low enough to take the risk. Just my opinion!

Even though Kell is considered to be highly immunogenic, it is nowhere near 100% likely to cause antibody production. Removal of the 9% of the donor population that is positive for the antigen is very inefficient use of our donors, who are rare enough as it is!
Even if a woman develops anti-Kell from a blood transfusion during her childbearing years, the father of any child she carries would have to be in that 9% of the population in order to cause a problem pregnancy. If he is K+/K-, it is only a 50% chance that a pregnancy he engenders will produce a Kell positive child.
Given that we do not Kell type our blood on a routine basis, we see very few instances of anti-Kell. We have had no instances of HDN due to anti-Kell from transfusion (that I know of) in any facility I worked in during my 20 year career. Maybe it is luck...or maybe the chances are low enough to take the risk. Just my opinion!

Here is the quick and dirty for the stroma preparation procedure:
We used three units of red cells (R1R1, R2R2, rr; one homozygous for Jka, one for Jkb, one for S, one for s; not more than one unit positive for K). Each unit was treated with 10 cc of 1% ficin (freshly prepared) in a waterbath for 15 minutes. Test after incubation with glycine soya to ensure 2+ reaction. Incubate longer if needed. Wash 3 times in a Cobe 2991 with no red cell override. Add 75 cc of digitonin, mix, and incubate in the processor for 5 to 15 minutes. Do three manual washes with superout set to 300cc. Add 75 cc of digitonin, mix, and incubate in the processor for 5 to 15 minutes. Wash until stroma is white (a minimum of 2 liters saline - watch the waste bag, it can't take this much!) Spin times at least 3 minutes gradually increase the superout as the hemolysis is reduced. Additional digitonin may be added if the stroma is not the desired whiteness. Be sure to wash thoroughly afterwards.
Test the supernatant with red cells to see if all the digitonin was removed. The stroma may require extra washing before it is used if these cells hemolyze.
After wash is completed, add about 200 cc saline.
Aliquot into tubes and freeze at -70C Use within 6 months.
Credit the staff at Florida's Blood Centers Reference Lab for this procedure.

Here is our procedure. I hope this helps.
EXCHANGE 6.1.doc

They apply it before leaving the surgery room. Our reasoning is that as long as there is only one patient in the room and neither the patient nor the bracelet leaves the room until they are connected that the possibilities for error are small.

Here is our procedure. I hope this helps.
EXCHANGE 6.1.doc

macarton, if you have any more information about your tornadoes it would be great if you added to the thread "Disaster Experiences Shared" in Hot Topics from January. Maybe we can all be better prepared for an influx of patients or a lack of resources by learning from others' experiences.
And Marilyn, isn't it amazing that an entire treatment option (and our profession) exists simply due to the altruism of blood donors. Makes you feel better about the human race.

The point is to check for new antibodies, not to reidentify the one you already know about, as gkloc says. I do usually include one cell for the known antibody (or separate cells for multiples) just to see which ones are still demonstrating. It may be overkill, but I don't like to report out "Anti-X present" on an antibody identification if I haven't demonstrated it currently.

Where does the line form?

As far as the background colors of a field, you set that by going to Format then Conditional Formating. I make two columns- one is the date of the last review. The column next to it is the due date for the next review, which is a formula such as =B12+365 where B12 is the field with the date of the last review. I then go to Conditional Formating and select the condition "Less than" and put "=TODAY()", then format the background to be pink if the statement is true (in other words, the review date has passed); I add another condition "Greater than" and "=TODAY()" and format the background to be green if the statement is true (in other words, you still haven't passed the review date yet).
I have attached an Excel sheet with an example of the formatting (click on New Sheet attachment).
I hope this helps.
BC
New Sheet.xls