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Everything posted by Dansket
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Has anyone used this solution, that is used for clearing lipemic blood samples in Chemistry, in Blood Bank? LipoBrochure.pdf
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Do you do tube or gel testing? If tube, refer to manufacturer's direction insert. Doing Weak D testing only on newborns is a policy decision that is consistent with what we do using Gel and back in the old days when I did tube test with an anti-D monoclonal blend reagent.
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Test volume is just one element, not the sole element, that can be used to justify automation. Patient safety, due to elimination of the endless variety of errors associated with manual testing, is an overwhelming reason to justify automation. With automation you gain standardization. I'm in a small facility, less than 10 type and screens per day, with two ProVue instruments. We have two (look in your core lab, do you backup your automated testing with manual testing) so that we never have to resort to manual testing. I believe that transfusion services that perform tube testing in 2015 do so, because that want to, not because they can't acquire automation.
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"How do you make sure that happens?". This is a quality control function. We monitor this on a monthly basis and report deviations to the Blood Utilization Committee quarterly. Nursing Directors sit on this committee. It is there job to report to their staffs regarding compliance with BBK policies and procedures.
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Your procedures are outdated and I agree with your pathologist. Once an RBC unit exceeds 10C, it should be discarded per AABB, CAP, FDA. We discard any returned units that have been spiked or if the outlet port covers have been opened, to that they may not be reissued... There have been extensive discussions on this website regarding this very issue.
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I use Microsoft Visio.
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AHG crossmatch for "rhogam" antibody?
Dansket replied to mollyredone's topic in Transfusion Services
We do all our testing on ProVue. I have standardized this process so that whenever crossmatching is done on ProVue, users are required to do both Buffered Gel crossmatch and Anti-IgG Gel crossmatch for patients with a positive antibody screen, regardless of patient history. We are a small facility. -
AHG crossmatch for "rhogam" antibody?
Dansket replied to mollyredone's topic in Transfusion Services
If the current antibody screen is negative, patients with a history of anti-D due to Rh Immune Globulin injection qualify for electronic crossmatch in our computer system. We use the term "RhIG" to designate passively-acquired anti-D that is configured as "not clinically significant". -
Tube testing is a 40+ year old dinosaur! It has 10x the potential points of error compared to manual gel testing and even more compared to automated testing.
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Would you issue Type-Specific blood to a patient based solely on patient history without any testing on a current blood sample? We require an Rh type done on a current blood sample prior to issue of Rh Immune Globulin.
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AABB requires both ABO red cell grouping and ABO plasma grouping (ABO Determination) be done on second blood sample. Not AABB, so we do ABO red cell typing only (ABO confirmation).
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Be advised that glass specimen tubes, CAP Survey JAT and ALBA-QCheck, will break in these high speed centrifuges. I'll bet PammyDQ meant 8000 not 80000 RPM.
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Scott, I think it is a risk management calculation. Transfusing ABO incompatible red cells far outweighs the risk of transfusing ABO incompatible plasma. Trauma centers are now using group A plasma for untyped recipients. It is acceptable to give group O platelet pheresis units to non-group O recipients. We eliminated the minor crossmatch in US decades ago!
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I don't know, not being required to do ABO/Rh confirmation on donor tubing segments would significantly and positively impact workflow in most if not all transfusion services in the US.
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I posted this question in UK Guidelines forum and Malcolm responded that isn't a requirement in UK. UK donor centers guarantee that what is in the bag matches the label. It is not an FDA requirement for transfusion services to serologically confirm the ABO/Rh type of red cell components using rbcs from a donor tubing segment, it's the CAP, AABB, etc. I'm trying to drum-up interest in the transfusion services community to push their donor centers to implement the same practice in the US that UK donor centers do! Please don't tell me they can't do it! This is 2015, not 1980...
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We do Buffered Gel crossmatch on ProVue. I would expect it can be done on VISION as well. You will have to validate the Buffered Gel crossmatch before you implement it. I would conclude that the anti-A and/or anti-B that is expected to be detected in adult blood samples meets the criteria of a direct agglutinating cold antibody.
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Get the vendor's name and rapid infuser model number and google it! Don't run platelets through a rapid infuser (one that also functions as a blood warmer).
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We do the same.
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They did not use anti-D antisera manufactured for Rh typing in test tube in this study, by that I mean ORTHO anti-D, Immucor Anti-D, BioTest Anti-D, etc. At this point, we do not know if txlabguy82's anti-D typing antiserum contained the cell lines mentioned in your references.
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After reading Malcolm's reference #2, I don't see any mention of the use of manufactured reagent anti-D in this study. My impression is that all the hemagglutination testing in this study was done at 4C. Given that US anti-D antisera for tube test contains both IgG anti-D and IgM anti-D components, it seems a stretch to attribute the 3+ reaction in the Weak D test to the use of cold antiserum. Has txlabguy82 contacted the vendor of his anti-D antiserum? What do they say?
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Malcolm, Are you suggesting that failure to allow an anti-D reagent antiserum to warm to room temperature prior to testing could result in a false-positive (3+ reaction) in the Weak D test done by the indirect antiglobulin test method?
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But the repeat testing by other techs using same reagents was negative in both D and Weak D testing? I believe monoclonal anti-D in US contain both IgM and IgG components.
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There seems to be intense focus on explaining the W1+ reaction on immediate-spin with monoclonal anti-D while ignoring the original Weak D test result of 3+. Given that repeat testing produced no agglutination in the immediate-spin test and in the Weak D test, I have to wonder if something other than anti-D was added to the D tube?
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Was your initial observation W1+ a macroscopic or microscopic reading? Your reading of 3+ for the Weak D (Du) test is not ambiguous. Is it usual to immediately put the anti-D and D control tubes into 37C incubator for the Weak D test, or are there other steps taken first? I am also wondering about the anti-D manufacturers direction insert indications for performing a Weak D test and for microscopic readings?
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ABO/Rh and Platelet, Plasma Transfusions
Dansket replied to B Postive's topic in Transfusion Services
We require a 2nd ABO for all specimens collected for pretransfusion compatibility testing regardless of the blood component requested and whether or not patient qualifies for electronic crossmatch. We do this for standardization to eliminate complexity and decision making in a small facility staffed with generalists.
