Sandy Jo

That is great! I think I am a retired SBB, but not quite certain. Still maintaining my licenses but no longer working. Hmmm... just in case.

Here is another generic template we use with Avery Business card stock... genericANTIBODY CARD TEMPLATE-BLOOD BANK.doc

Basically there is a bias with the selected samples. I would not be picking a patient with a SPD (Solid Phase Dependent) antibody to compare with manual tube methods. We pull samples that have already been run on the Echo and repeat them in tube testing. I also include a "disclaimer" of sorts in the SOP by stating that the methods may not compare 100% due to the sensitivity and specificity of each test method. The goal is not to achieve perfect correlation, but to document comparable results given the difference in sensitivities, specificities and general limitations between the methods. As we all know and love - no one method will always detect all clinically significant antibodies!

That is the quantity we use in other areas of the lab and it is also the quantity used in other facilities in our division. We are standardizing many of the processes so that is what I am using. Sandy

Quick! Does anyone have a form they are willing to share (or post in the Library) for method comparison of Blood Bank assays? I would like to include a minimum of 10 patient samples and correlate between Solid Phase (Echo) and tube testing for ABO/Rh and Antibody Screen. Thanks so much! Sandy

For our Helmer Cellwasher I obtained a letter from the company verifying that the RelyOn Disinfectant tabs we use for the Immucor Galileo Echo is acceptable for the cellwaher as well. That also allows use to use the tabs up before they expire. Win-win!

I am interested in more input from those that use Echo for automation: We currently use API for our proficiency testing and have had questionable or inconclusive results several times over the past several years. We are considering going back to CAP. It just isn't worth the cost savings if you have to waste Tech time and/or risk failure due to sample issues beyond your control. Are there many others using API that are seeing results such as this and/or have switched back to CAP because of it? Thanks! Sandy

If you have a flowchart or something visual for one or more procedures (AB ID, DATs, eluates, ABO discrepencies, etc) and would like to share these, please send me a PM. I would dearly love some examples as well. I am a working BB Supervisor and with loss of several staff members in the lab I find myself covering BB as well as helping to cover Chemistry as well. Unfortunately the "off bench" tasks get left behind. If anyone can send some examples please PM me. It would be so VERY MUCH appreciated! Sandy

We result the positive antibody screen on the Echo and then perform an antibody panel on the Echo. We add an IAT using manual tube method. If all cells are positive in Capture, with negative results in tubes, we result it as a Solid Phase Dependent antibody and use full coombs crossmatch. I have concerns with techs calling results "junk." I have seen what looks like a WAA show up in the more sensitive methods, like the Echo, and later have found a specific alloantibody. IMO we should be performing a full coombs crossmatch (just in case) whenever a method gives positive results for an antibody screen, not just ignoring the results. Obviously we all know with increased sensitivity there is decreased specificity. But I would not want to be responsible for treating something as insignificant and having a delayed hemolytic reaction come back to bite us!

Thermco...Tempcheck...Laser thermometer device, etc., What are pro's, con's, recommendations from actual users of these devices? I am trying to research and not finding a lot of user reviews. I have a big concern over anything that is too complicated or lacks consistency. We are a small facility with a lot of generalists. I want to adapt a process to check temps on returned products, but I also want to avoid loss of product for a device that has questionable accuracy. Thanks for input!

I also like to have a textbook on hand for the generalists that get crosstrained to work in the Transfusion Service. Actually it is good for anyone to go back and review and helps with questions for competencies. I recommend Denise Harmening "Modern Blood Banking and Transfusion Practices."

Our Medical Director is looking for some examples of a form letter to use when blood product usage is not in compliance with our established criteria. Does anyone have some standard form letters for this topic that they would be willing to share with me? Also - for the moderators - what is the best way to give an email or fax number for contacts to send me the requested information?

Hey Regina - how's it going? We generally give type O units. We also perform an AHG crossmatch, although perhaps not required, it helps maintain consistency when you have generalists rotating into Blood Bank. Sandy

For our confirmatory hgb (for out-patients or someone that does not have a CBC or H&H done at our facility) we DO charge for just a hgb. We sent it through an approval committee (MEC) at the hospital and require at least a hgb - it is on record and considered a reflex test for the out-patients so the lab has approval to order it, and charge for it. In essence, if we transfused the patient and sent them into circulatory overload, we would be liable, not the outside lab. We do not accept the results of outside labs for this protocol. But I am still wondering about billing issues with confirmatory blood types, especially from other HCA facilities. Sandy BB Supervisor MT SBB

Just wondering with all the interest in performing retypes on samples - if you can bill for this testing? We retype a specimen (quick forward Anti-A, Anti-B, Anti-D) each time the sample (previously T&S'd) is pulled out to add more crossmatches. Does anyone know if it is acceptable practice to bill for this testing? CPT codes? Also, if we were to adopt a protocol to require a repeat ABO/Rh on another lab sample drawn at a different time, would we be able to perform a billable ABO/Rh. What CPT codes? It seems as if the testing is performed, it should be billable. Although I do understand re-imbursement is a whole different ballgame! Thanks for the response, Sandy