Dansket

This was a hot topic about 2 yrs ago.  The FDA came out and said that storage in blood boxes/coolers is considered storage NOT transport.  AABB/CAP might be mollified, I don't think the feds will think twice about a 483.  Unless you are putting the product in a BB refrig.
Check out posts from Feb, 2016

No!

When user enters Type and Screen results into computer, are intermediate results entered (anti-A, anti-B, etc) or only the interpretations, e.g. APOS, BNEG etc.?  Are results of Antibody screen for Cell1 and Cell2 entered or just interpretation, e.g. Positive or Negative?  

No!

Assuming that most patient samples are tested against screening cells that do not have a K+k- cell,  is the exclusion of anti-K1 using a screening cell with heterozygous expression allowable if the antibody screen result is negative but not allowable if the antibody screen result is positive?  
If the facility endorses a computer "crossmatch" with a negative antibody screen (using a K+k+ cell) do you require additional testing with a K+k- cell to exclude anti-K1?  Ours does not - but we also allow exclusion of anti-K1 with a K+k+ cell for any patient.

Testing the same blood sample twice will not detect WBIT.  That is why we draw a second blood sample from a different venipuncture from patients who initially type not group O.  We are not AABB accredited.

Testing the same blood sample twice will not detect WBIT.  That is why we draw a second blood sample from a different venipuncture from patients who initially type not group O.  We are not AABB accredited.

For those who routinely do eluates, what evidence/data have you to support such a policy?  Whether an eluate is positive or negative, when have eluate results changed the physician's decision to do or not to do?

Can you imagine what a nightmare of logistics it would be if we had to be concerned about that?   As long as you issued your product on that good specimen before it expired, you are fine.  We have the same practice.  Our day of draw is day 0 and then our specimens expire at midnight on day 3.  We could issue products on that specimen up to the minute before it expired. 

If the current antibody screen is negative we issue electronically crossmatched units untested for Lea. If the current antibody screen is positive, we issue IgG-crossmatch compatible units untested for Lea

If the current antibody screen is negative we issue electronically crossmatched units untested for Lea. If the current antibody screen is positive, we issue IgG-crossmatch compatible units untested for Lea

I believe there is a field for Visual Inspection on page 1 of the product dictionary.  If you enter Y, users are prompted during product login.

We transfuse febrile patients regularly. The nurses look for an elevation in temperature (1.5 C) above the starting temp to call a febrile reaction. I don't feel that we are doing a large number of workups simply because the patient transfusion started with an elevated temp.

In Meditech, user can designate whether an antibody is/is not clinically significant and can also designate corresponding antigen-negatives.  In the case of anti-A1,  you could create two 'anti-A1' entries in the 'antibody file'.  One would be designated "clinically-significant' and that A2 cells were 'antigen-negative'.  The second entry in the antibody file would not be designated 'clinically-significant' and the 'antigen-negative' field left blank.  For patients with an anti-A1 that reacts as 37C, computer would require A2 red cells for crossmatch.  Patients with anti-A1 that does not react at 37C would not require A2 cells.

In Meditech, user can designate whether an antibody is/is not clinically significant and can also designate corresponding antigen-negatives.  In the case of anti-A1,  you could create two 'anti-A1' entries in the 'antibody file'.  One would be designated "clinically-significant' and that A2 cells were 'antigen-negative'.  The second entry in the antibody file would not be designated 'clinically-significant' and the 'antigen-negative' field left blank.  For patients with an anti-A1 that reacts as 37C, computer would require A2 red cells for crossmatch.  Patients with anti-A1 that does not react at 37C would not require A2 cells.

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.
substitute products.docx

Meditech users:
 
We have just installed a custom (not a rule but custom hard code) in C/S version 5.66 that causes all specimens to expire at 2359 regardless of the time of specimen collection.  It will not be generally available as a DTS.
 
If you want this feature, you will have to press Meditech for it.

Let me spin this differently.  I'm unlikely to detect an anti-A1 or any other weakly reactive (1-2+) IgM antibody in routine room-temperature gel testing.  Secondly, I have eliminated the immediate-spin crossmatch in favor of an electronic crossmatch to detect ABO incompatibility between donor and recipient. Lastly, by adopting the electronic crossmatch, I have accepted that any reactivity (limited to room-temperature) between donor and recipient (not demonstrated to be due to anti-A and/or anti-B) is rendered clinically irrelevant!
 

Let me spin this differently.  I'm unlikely to detect an anti-A1 or any other weakly reactive (1-2+) IgM antibody in routine room-temperature gel testing.  Secondly, I have eliminated the immediate-spin crossmatch in favor of an electronic crossmatch to detect ABO incompatibility between donor and recipient. Lastly, by adopting the electronic crossmatch, I have accepted that any reactivity (limited to room-temperature) between donor and recipient (not demonstrated to be due to anti-A and/or anti-B) is rendered clinically irrelevant!
 

In Meditech, user can designate whether an antibody is/is not clinically significant and can also designate corresponding antigen-negatives.  In the case of anti-A1,  you could create two 'anti-A1' entries in the 'antibody file'.  One would be designated "clinically-significant' and that A2 cells were 'antigen-negative'.  The second entry in the antibody file would not be designated 'clinically-significant' and the 'antigen-negative' field left blank.  For patients with an anti-A1 that reacts as 37C, computer would require A2 red cells for crossmatch.  Patients with anti-A1 that does not react at 37C would not require A2 cells.

In Meditech, user can designate whether an antibody is/is not clinically significant and can also designate corresponding antigen-negatives.  In the case of anti-A1,  you could create two 'anti-A1' entries in the 'antibody file'.  One would be designated "clinically-significant' and that A2 cells were 'antigen-negative'.  The second entry in the antibody file would not be designated 'clinically-significant' and the 'antigen-negative' field left blank.  For patients with an anti-A1 that reacts as 37C, computer would require A2 red cells for crossmatch.  Patients with anti-A1 that does not react at 37C would not require A2 cells.

My opinion:  Why are we recording vital signs?  The person recording them has to be able to interpret them in regards to the transfusion taking place.  They must be trained to recognize changes that are indicative of a reaction regardless if they are an RN or not.

I agree that looking into software programs to build in rules and help would be good for a lab without a dedicated blood banker.  AntigenPlus is another good option

An auto-control and a DAT have not always given the same result in my experience!

An autocontrol is an indirect antiglobulin test that includes both patient serum/plasma and patient rbc incubated together at 37C and subsequently tested with antihuman globulin reagent.  Methodology includes the standard tube test, Gel test, PEG test etc.