Dansket

No additional testing required. We would electronic crossmatch this patient with random units

Provue requires concentrated red cells for sampling, e.g., a centrifuged whole blood sample (real or simulated). CAP supplies vials with 3% red cells for the DAT survey. We transfer 2mL to a 12x75 tube, centrifuge it for 15 seconds and then run it (without re-mixing) successfully on ProVue.

AABB Technical Manual defines "titer" as the reciprocal of the dilution of test serum that causes 1+ agglutination with the test cells. Thus, anti-D antibody that gives 1+ agglutination at a dilution of 1:64 is reported as a titer of "64" not "1:64". How does your facility report titer values?

We add 30uL of ORTHO BioClone Anti-D to newly-opened AlbaQ-Chek vial #4. ProVue reports 2-3+ positive DAT for one week as well as a 2-3+ positive Rh control.

Currently, we screen for HDN/F only in newborns delivered of group O moms and Rh-Negative moms. What is the incidence of ABO-HDF/N in newborns of group A or group B mothers? Malcolm?

Have never tested for Weak D to confirm the Rh type of donor units labeled Rh negative in over 40 years in US. The only reason we test with anti-D today is to detect donor center labeling errors.

Using a term other than "Incompatible", comforts you and your staff and is misleading. It is the patient who makes the final decision.

Don't use the Rhophylac/RhoGAM manufacturer's forms. Also keep panel antigrams only with patient workup. Blood Bankers should be thinking "digital storage" and optical archiving for the future!

What would you do today for a patient with a positive antibody screen and anti-e is identified, but cannot rule-out C and K? I think you have to select e-neg, K-neg and C-neg red cells for crossmatch/transfusion regardless of the results of the antibody screen.

Kathy,Could you provide more detail as to how you convert an Rh positive AlbaQ-Chek vial to give it a positive DAT? I've tried adding as little as 5ul of ORTHO BioClone anti-D to vial 2 or vial 4. When testing on ProVue, this results in an "unwanted positive Rh control" when tested with the A/B/D Reverse Grouping gel card as well as a positive DAT with the anti-IgG gel card.

We use a 2-bag Helmer that is set at 36.5C. Our timer is set for 18 minutes. All our units are flat-frozen (200-300mL). If there is an urgent need, I check after 10 minutes and crush large chunks by hand. We temp every thawed unit and the average temp of a non-urgent unit is 15-20C. Urgent units are less than 15C and even less than 10C.

Have you seen the "NEAT" scanning system advertised on TV?

Are these units labeled according to ISBT-128?

Delivery provides a red-top and a lavender-top plastic vacutainer tube, not sterilized. We previously used the lavender-tops on ProVue but have switched to the red-tops. The lavender-tops were full of clots and many,many fishing expeditions required to remove them. The red tube has just one large clot that is easily removed.

A small facility doing a lot of blood banking by generalists should seriously consider an automated testing platform. Automated testing eliminates a wide range of errors associated with specimen identification, test tube labeling/handling, results entry, results interpretation and transcription. Our platform prints a report with results and results interpretation. We affix a barcoded sample label to the report (one patient per sheet of paper). The barcode on the report is scanned into the LIS result entry routine and results are transcribed. This system works 24/7/365 with a single individual wholly responsible for results entry. I have used this system successfully over the past 10 years, both in a 525 bed Level II trauma center (>10000 rbcs transfused annually) and a 100 bed (<50% occupancy) community hospital(<1100 rbcs transfused annually). I believe that any strategy that relies on double-checking a process by multiple individuals will fail. If an individual cannot accurately transcribe results in the system described above, they should not be working in a transfusion service. Blood bankers need to embrace automation in the 21st century and discard 20th century manual processes. Whew!!, I feel so much better now. Thanks.

The ORTHO Confidence Antibody contains anti-D and anti-c. So it will test all the cells in a panel. We use it to QC the panels on ProVue.

Were these ABO reporting errors, transcription errors or testing errors? Are your current test results (anti-A, anti-B, anti-D, etc.) entered into a computer, written on a paper worksheet or both? Need more information from you to be helpful.

I don't use history inquiry routinely, because we print the historical blood type and antibody history on the specimen collection label using Meditech C/S 5.66. Saves a lot of time!

What brand/model of Cell Washer are you using? I would replace/clean/bleach all the tubing from the saline container to the dispense nozzles in the cell washer. I would clean/bleach all the nozzles in the washer.

Will you have full administrative access to either system, Meditech or Softbank? I've used both systems, most recently Meditech (past 6 years). Based on your scenario, Meditech would be my choice.

We are less than 100 beds and have 2 ProVues, We do not do any manual testing, gel or tube. Transfuse 100-130 RBC/month. ORTHO will be replacing the ProVue with the VISION in April 2015.

With implementation of an automated testing instrument, I am no longer concerned with use of expired reagents. Using a blood bank computer system, issue of uncrossmatched blood puts the specimen on the pending list which is required to be checked by staff begin/end of each work shift.

Forward and reverse only required by AABB, not by CAP.

I believe that collecting a second blood sample is the gold standard for preventing WBIT. It is CAP's first recommendation for the Transfusion Medicine Checklist item TRM.30575 Misidentification Risk. The request to collect a second blood sample is generated internally (given a unique specimen number in Meditech) by our Blood Bank staff and only for selected patients (Non-group O patients with no blood type on file). We do not accept/test unsolicited blood samples. Dan

Scott, We use a secondary blood band that has a unique identifier(ABC1234). Our phlebotomists are required to document that code on the specimen container label of the specimen collected with the second venipuncture. On receipt, we enter that code into the computer system. Computer system checks that entry with the blood band code that was entered for the initial Type and Screen specimen. If the codes don't match, red flag on the play! Dan