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Posts posted by Dansket
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9 minutes ago, Likewine99 said:
Two cell screen for as long as I can remember. It saved the organization quite a bit of money and we keep 2 panels in stock.
Have been on gel since 1994 and automated BB analyzer for almost 13 years.
Did you attend ORTHO's very first ProVue training session?
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The was a white paper written by John Judd many years ago regarding 2 versus 3 cell screens. In this study, he observed that technique (tube testing) was a far greater variable affecting test tube reaction strength than the number of cells in the antibody screen. Since 3 cell screens are configured with more double-dose cells than 2-cell screens, it might mitigate the weaker reactions found by some individuals.
- John C. Staley and AuntiS
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3-cell screen might mitigate the poor technique of non-blood bankers who do tube testing, but not necessary for manual or automated gel testing. All our testing is done on ProVue with 2-cell screen.
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On 3/23/2017 at 8:27 AM, BldBnker said:
According to AABB Standard 5.30.2 part 2; "the woman is not known to be actively immunized to the D antigen." We perform an antibody screen, along with an ABO/Rh on a current sample before issuing a Rhogam. This is for ED patients and LD patients.
I'm not understanding how performing an antibody screen determines whether or not "the woman is not known to be actively immunized to the D antigen" meets the AABB requirement. If I understand correctly you perform and antibody screen and do antibody identification, and if anti-D is identified (in the absence of a record of recent RhIG injection) you ignore that finding and give RhoGAM.
In our process, we do an Rh type only and if patient is Rh negative and in the absence of a record of recent RhIG injection, we issue RhoGAM. So for this hypothetical patient, we both come the same conclusion and issue RhoGAM.
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39 minutes ago, BldBnker said:
Dansket, I am not sure I understand your question. That is the standard AABB protocol. You perform an antibody screen to determine if the woman has already been immunized to the D antigen (ab screen neg for Anti-D).
If a positive antibody screen is detected per your protocol and anti-D is identified in the "pre-partum" blood sample, how do you determine if the anti-D identified represents "active immunization to the D antigen" or "passive immunization due to a recent RhIg injection" in the absence of any record of recent RhIg injection.
I'm not aware of any serological test that all experts agree will definitively differentiate between active and passive immunization in all situations. If there is such a publication I would like the reference. Malcolm please advise.
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Do all feel that performing/charging for an ABO type on the mother as part of an antepartum or postpartum RhoGAM work-up is pertinent information and justifiable?
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27 minutes ago, BldBnker said:
According to AABB Standard 5.30.2 part 2; "the woman is not known to be actively immunized to the D antigen." We perform an antibody screen, along with an ABO/Rh on a current sample before issuing a Rhogam. This is for ED patients and LD patients.
AABB Standards only apply to AABB accredited facilities. Is there a standardized protocol provided by the AABB to determine whether or not a woman is actively immunized to the D antigen then anti-D is identified in her blood sample?
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3 hours ago, bowerj1 said:
Thank you. I see what you mean about a current type. Myoriginal question was do you require an antibody screen prior to issuing RhoGam?
Thanks,
Jesse
We don't require an antibody screen test result prior to or after issuing RhoGAM.
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We don't perform an antibody screen for either the Antepartum RhoGAM protocol or the Postpartum RhoGAM protocol. We don't issue RhoGAM without an Rh type done on a current blood sample for either protocol.
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1 hour ago, Brenda Hutson said:
Ah, so give up trying to "receive" non-clotted specimens.....just have to create them on our own. Either of you have issues because not all clots were removed sufficiently?
Thanks,
Brenda
Rarely
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Our cord blood samples are collected in red tops. They arrive in BBK usually with one giant clot. We remove the clot, centrifuge and test on ProVue. We stopped using EDTA samples because they usually had numerous small clots that were very time consuming to remove.
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32 minutes ago, R1R2 said:
Not to hijack the topic but does your label print after you issue in the computer or before?
The Report of Blood Transfusion form (with detachable labels) is printed immediately after crossmatch results entry. Blood components (Report of Blood Transfusion form is attached prior to storage) are retrieved from storage when RN arrives with Request for Blood Component form.
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On 3/11/2017 at 3:25 PM, David Saikin said:
WE use a compatibility label: Patient Name, MR#, birthdate, ABORh. Unit Nmber, ABORh, Product code and compatibility statement. Label can be stuck on or attached.
We stick a label on the donor tubing (permanent) and also attach the form (temporary) from which the label was detached.
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I would change the process. I don't see any reason to leave any refrigerator door opened for an extended period of time (over one minute) to the extent it causes an over-temp in the storage unit. Load the shipment into the refrigerator in batches so that it can recover between each batch.
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Try www.helmerinc.com. They have solutions for both refrigerator and freezer.
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- What automation platform do you use? ProVue
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What LIS? Meditech C/S version 5.67
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Do you use middleware? No, ProVue is not interfaced to Meditech
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Do you use positive patient identification? Yes, Typenex Blood Recipient Identification System
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To get a second blood group, by retesting the sample (i.e. PPI) do you:
- Generate a new specimen number and re-label or aliquot? No, a new specimen number is generated and a new blood sample is collected if original blood sample was agglutinated by anti-A,B (manual tube test).
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Generate new tests for the same specimen number. If so, will the analyzer retest that same sample with the new tests and generate a second ABO/Rh? No
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Do you use history from another site (like Clinical Connect here in Southern Ontario or other Electronic Health Record) as a historical result? No
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If so, have you created a new test that your LIS will use as a second group to use for Computer XM? Yes, depending on results of testing with anti-A,B, CONFIRM or CONFIRMO.
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Do all your samples expire after 96 hours? Or do you have a pre-op policy that allows for more time as long as the patient has not been transfused/pregnant. We have a 28 day policy. All samples expire at 2359 on the third calendar day (day sample collected counted as day zero)
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Any other brilliant ideas or thoughts? By retesting the same blood sample, you won't detect specimen collection errors.
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The US military has been a constant practitioner of the use of whole blood in trauma.
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No adverse reactions to blood transfusion due to ABO mismatch or unexpected antibody undetected since implementation of electronic crossmatch in 1997.
- MaryPDX and Carrie Easley
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Using the Meditech Emergency Release of Units routine will automatically issue the unit and automatically order a Type and Screen for whomever blood is issued.
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Did you use Meditech's Emergency Release routine to issue these units?
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See attached showing page 5 of product dictionary in Meditech 5.67. See sections titled Subsitute Prod and Subst Prod Grp. You can use these so that RN/MD can order general product but you can substitute any product based on you entries in these fields.
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2 hours ago, Malcolm Needs said:
Looks excellent Dansket.
I wouldn't necessarily agree that anti-A1 and, in particular, anti-Yka are clinically significant and require antigen negative blood - but hey!
Thanks, I'll update the chart.
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This flow chart is not dedicated to electronic crossmatch but does address it in section B.
Weak D testing
in Transfusion Services
Posted
We have been doing Weak D testing on ProVue for over 10 years using ORTHO BioClone Anti-D (vialed liquid antiserum).