slsmith

I would read the book, "Modern Blood Banking and Transfusion Practices" by Harmening.  It is pretty easy read unlike the Technical manual. Plus it has short quizzes at the end of the chapter.
As far as workflow you probably need to wait to see how your BB does things. Only thing I tell Techs that I train on the simple things such as loading the centrifuge or setting up their tubes for testing is to  be consistent in how you do that task, don't flip back and forth.

As David said there isn't a BB standard for time frame a transfusion needs to be started but for some reason this time frame is in the nursing policy, theirs is 20 minutes. Where they got this information I don't know. Anyway if blood is sent to the floor and it isn't going to be started in 20 minutes and the floor asked calls the BB (before they actually return it) we tell them if they are going to transfuse and it is will be completed within the 4 hours that it was issued to the floor keep it, otherwise it will be discarded (if temp is greater than 10 degrees)

We use it when working with a patient with a warm antibody that has had all significant antibodies ruled out by the reference lab. The gel screen is still performed each time to make sure reactions are not getting stronger or no longer demonstrating. Then the saline panel is performed. We also transfuse with phenotypical matched blood for Kell, C, E  and c . This procedure is usually being performed on the frequent fliers that we know are only coming to our hospital.
We also use it when a gel shows no pattern, all cells positive or negative and we have gone to PEG and all cells are positive. The saline panel has to have at least 8 cells and ran with an auto control. If the panel is negative including the auto control it called a NSF and saline tech is use for the xm. IF the auto control is positive it is called a warm auto. If it is positive the work up is sent to the reference lab.
The principle behind this I can't explain it is just what we do.

shipping documents/ transfers: 10 years

From the  hospitals in the system since we follow the same procedures , perform the same competencies and share the same data base we accept the results. Although we do perform another ABORH (not a standard just our process).
From another hospital system we will honor any antibody that is reported, just to be safe( never the ABORH). We have a test that we can order that allows us to entered it into computer without charging the patient for a test we didn't do but stops someone from issuing blood not antigen negative for that antibody.

The hematology department does the KB. There is a built in table when the KB is resulted that states how many vials of rhogam is indicated, which is doted out by pharmacy. Only BB involvement is if they did a fetal screen which turns out positive they give hematology the sample, the KB is automatically reflexed based on a positive result.
Hem and BB share the PT testing. The leads work together on who is assign the samples , review the results and submit to CAP. The only "trouble" we ever got in was on what medical director signed the attestation form. The site medical director was signing it but according to CAP it should of been the BB medical director.  Not an issue anymore as now it is the same person.

We crossmatch the A or B cells(the red cell itself) to the babies plasma, using the IgG gel card. 

As David said there isn't a BB standard for time frame a transfusion needs to be started but for some reason this time frame is in the nursing policy, theirs is 20 minutes. Where they got this information I don't know. Anyway if blood is sent to the floor and it isn't going to be started in 20 minutes and the floor asked calls the BB (before they actually return it) we tell them if they are going to transfuse and it is will be completed within the 4 hours that it was issued to the floor keep it, otherwise it will be discarded (if temp is greater than 10 degrees)

Here is our aliquoting procedure, hope it opens okay. I may be a good Banker but when it comes to computer uploads, downloads or whatever not so much.
Sheri
SKM_C55821040507520.pdf

Here is our aliquoting procedure, hope it opens okay. I may be a good Banker but when it comes to computer uploads, downloads or whatever not so much.
Sheri
SKM_C55821040507520.pdf

Only thing read Microscopically is the fetal screen which is the procedure for that test. According to the literature out there (see Issett) no other tests should be read microscopically 

BPAM

We crossmatch the A or B cells(the red cell itself) to the babies plasma, using the IgG gel card. 

Change things as in?
From my experience, a persons understanding, willing to learn, and pro-activeness is dependent on the person and not whether they are a MLT or MT.

Only thing read Microscopically is the fetal screen which is the procedure for that test. According to the literature out there (see Issett) no other tests should be read microscopically 

My scary story is the time a nurse who transfused the wrong patient because she not only didn't compare the unit to the arm band but did not read the the unit off with another nurse. It was caught because the nurse of the patient that unit was meant for called the BB asking where her blood was. The transfusion was stopped before the whole   red cell could be given.  Fortunately for the patient the unit was O pos (his type) and antibody screen was negative.  Unfortunately for the  nurse she no longer has a job.

My scary story is the time a nurse who transfused the wrong patient because she not only didn't compare the unit to the arm band but did not read the the unit off with another nurse. It was caught because the nurse of the patient that unit was meant for called the BB asking where her blood was. The transfusion was stopped before the whole   red cell could be given.  Fortunately for the patient the unit was O pos (his type) and antibody screen was negative.  Unfortunately for the  nurse she no longer has a job.

Only thing read Microscopically is the fetal screen which is the procedure for that test. According to the literature out there (see Issett) no other tests should be read microscopically 

Only thing read Microscopically is the fetal screen which is the procedure for that test. According to the literature out there (see Issett) no other tests should be read microscopically 

My scary story is the time a nurse who transfused the wrong patient because she not only didn't compare the unit to the arm band but did not read the the unit off with another nurse. It was caught because the nurse of the patient that unit was meant for called the BB asking where her blood was. The transfusion was stopped before the whole   red cell could be given.  Fortunately for the patient the unit was O pos (his type) and antibody screen was negative.  Unfortunately for the  nurse she no longer has a job.

That is what my former supervisor used to say (he was a tech for over 50 years)!  Get the titer up where you can work with it!  God rest him!

Very proud to have received this through the post earlier this week, to go with being elected to Fellowship of the British Blood Transfusion Society earlier this year.

I was immensely honoured to receive this through the post today (with a lapel badge).

Malcolm Needs - Thanks so much for the quick response.  There's no ethnicity on the patient yet but I doubt she is Japanese by her last names (very Hispanic).  We are not planning on antigen typing the red cells for M at this point since it only showed up at immediate spin.  We didn't do the workup on the mom so although the other BB said they ruled M out we don't know for sure if they use the 3/3 homozygous rule that we use.  You are definitely correct about the M still possibly being IgG, I do realize, thanks for correcting me.  It's been a very weird year, since last July when we had our first true anti-U, then an huge increase in the number of extremely strong WAA, an anti-hrB at Christmas, and now this newborn.  I hope this doesn't become standard for us but with our Hematology/Oncology clinic growing each year and all the solid organ and HPC transplants I'm sure we're only touching the surface.  I miss the days when a children's hospital blood bank worried more about making smaller aliquots than dealing with rare antibodies.

The British Society for Haematology (BSH) have just issued an updated version of their "Guidelines on the use of irradiated blood components" (actually on 9th October 2020).

The recommendations for patients who have received allogeneic haematopoietic stem cell transplantation (HSCT) is as follows.
"All recipients (adult and paediatric) of allogeneic HSCT should receive irradiated blood components from the time of initiation of conditioning chemo/radiotherapy.  The recommendation applies for all conditions where HSCT is indicated regardless of the underlying diagnosis.
Irradiated components should be continued until all of the following criteria are met:
1.  >6 months have elapsed since the transplant date.
2. The lymphocyte count is .1.0 x109/L.
3. The patient is free of active chronic GvHD.
4. The patient is off all immunosuppression.
If chronic GvHD is present or continued immunosuppression treatment is required, irradiated blood components should be given indefinitely.
Treatment with irradiated blood components should continue indefinitely if this is required based on transplant conditioning, underlying disease or previous treatment, e.g. previous diagnosis of Hodgkin's Lymphoma (HL) or previous purine analogue treatment.
As far as patients who have undergone an autologous stem cell transplantation (ASCT) are concerned, all patients undergoing ASCT irrespective of underlying diagnosis or indication for this treatment should receive irradiated cellular blood components from initiation of conditioning chemo/radiotherapy until 3 months post-transplant (6 months if total body irradiation was used in conditioning) unless conditioning, disease or previous treatment determine indefinite duration, for example previous diagnosis of HL, or previous purine analogue treatment."
The Guideline is actually quite lengthy (and, of course, is for use in the UK, and not the USA), but can be found (for free) on the BSH website.
I hope this helps.