BldBnker

John C. Staley, in my 30+ years also, we have never QC'd panels and have never been cited )we are AABB, CAP and FDA inspected).

Sonya Martinez, it is an old COBE 2991 (I think they are now made by Terumo). It is programmed to wash a whole unit, a pedi/quad unit, or do a 2-L wash for IgA deficient patients. Our machine is probably at least 30 years old. We just spike the unit and spike a 1 L bag of injectable saline using the wash bags that are used on the machine. The machine takes care of it! Here's the link: https://www.terumobct.com/2991

To clarify, we sterile dock a packed cell into quads and wash one quad at a time when a transfusion is needed. We try to dedicate one packed cell to an infant (which decreases exposure) but will use a unit for more than one infant if needed. This helps prevent wastage. Our overall wastage is very low here. Also, we don't transfuse too many infants at our facility (maybe 1 baby per month). Really premature/sick infants are transferred to a local children's hospital for a higher level of care.

We use O Neg, CMV neg, irradiated units for our babies but we wash them with a blood washer (an old COBE 2991). I know...we are dinosaurs and yes, I am FDA inspected because of it. Washing removes the potassium and anticoagulant (which can cause citrate toxicity in small premature infants).

So sorry to hear this. My condolences.

I have used Immucor Echo instruments since 2008. I love them! There are still some issues with cold antibodies and weakly positive DAT's causing positive screens, as with any newer methodology. Unfortunately, we are going to be going to the Ortho Visions due to corporate decisions. I'm trying to be optimistic but am thankful to be in the latter part of my career (3 years to go!).

Sonya Martinez, Where are you going to get the COVID-19 convalescent plasma? I had a physician inquire about that this morning. I don't think our normal providers will have that as it is still considered "experimental." Thanks!

I would appreciate you sharing with me also! I am not fond of our form we use now. Thanks!

There have been many improvements over my career. Now, of course, we have barcode scanners being used by our phlebotomists which have greatly decreased the number of mislabeled samples. We also have Epic BPAM for transfusions. However, we are all human and we still have the rare specimen error, usually in a hurried/emergent situation (when SOP's sometime go out the window, unfortunately). A bedside ABO slide type would have saved the patient in Texas that recently passed from an ABO HTR.

That was my point. Yes, if the sample is the same type as the patient in the bed but wrong patient's sample, it won't catch WBIT. However, it has saved us several ABO HTR's in my career (30+ years). I call that a good catch!

We perform at bedside slide blood type for confirmation before starting blood at the hospital where I work. A Blood Bank employee (Blood Bank Assistant/Transfusionist) takes the issued blood to the patient's bedside and participates in the starting of the transfusion with nursing personnel. The slide type is an extra layer of patient safety. Pre-transfusion testing is only as good as the quality of sample! We have caught wrong-blood-in-tube (mislabeled) samples this way. We also have computer confirmation with barcoding of units but that doesn't always catch WBIT samples.

Me too! Epic and Softbank!

The patient's DAT is positive, right? Has the patient received ABO incompatible platelets lately? Or received Immunoglobulin therapy (gamma globulins)? I have seen both of those scenarios cause incompatibilities with the patient's own type. Could be either Anti-A or Anti-A,B from O platelets or the gamma globulin therapy.

We have the ability to program our system to accept "untested" units for selection for antigens that do not have available anti-sera, like Cob, Bga, or Vell etc. We use SoftBank.

What other compatible IV solutions? I think 0.9% saline is the only one.