CMCDCHI

Can anyone suggest a CPT for a prewarm screen/panel? Do you charge the same as a regular screen? Thanks!

We are in the process of evaluating new blood bank analyzers. It's been while since the last post comparing them. Can anyone provide updated information on working with Grifols Erytra or Ortho Vision? We currently have the Immucor Echo. Thank you!

Thanks for your responses! I asked at AABB and was told that the CFRs require a negative control.

CAP states: "There are records of acceptable reactivity and specificity of typing sera and reagent cells on each day of use, including a check against known positive and negative cells or antisera, or manufacturer's instructions for daily quality control are followed." Immucor package inserts for several reagents do not include instructions for a negative control. Do we follow what Immucor suggests or add in a negative control too? We currently test antisera against eachother for our daily QC, but are considering changing to Immucor corQC, but noticed there is no negative control for some reagents. For those of you using corQC, how do you address this? thanks!

Unfortunately, our LIS is set up to require a 3-cell screen. We do a select cell panel to rule everything else out. We perform titers if requested by the physician, but they are not automatically reflexed.

We have a patient who is 29 weeks pregnant with placental previa and anti-E. She is expected to remain as an inpatient until delivery. We have been doing T&S every three days, which requires an antibody ID with it. Is there any info to support extending the T&S timing? My thought is no, given her pregnancy status, but I'm hoping there's something out there that I don't know about that will eliminate some of this extra testing!

For our patient, her hemoglobin studies were normal.

We have a case that has me totally puzzled. A woman was admitted to L&D for a fetal demise at 38 weeks. She is D negative and was sent for a RhIG evaluation. The baby's blood type was unknown and they were unable to get a decent sample from the fetus after delivery. Since I learned my lesson from this forum that we cannot do a fetal screen (rosette test) if the baby's blood type is unknown, we gave it to the main lab for a Kleihauer-Betke. It came back at ~10% fetal cells. We treated the patient using this information, giving her LOTS of WinRho to save her from multiple injections of Rhogam. Knowing that the fetal blood volume from this calculation seemed unlikely, we sent a specimen out for fetal bleed detection by flow cytometry. Unfortunately, we did not get the results back until she had already received her WinRho. The flow cytometry showed a bleed of 0.1% fetal cells. I suspected that mom might have Hgb F in her circulation, but hemoglobin studies show normal results (mostly A1 and A2). We have repeated the KB using different specimens and different KB kits and continue to get at least 3% fetal cells on the slide. Any idea what else may cause false positive KB tests?

Yes! The paperwork for the J survey is always a nightmare! If I could look at one "patient" at a time, that would be great!

I could've sworn CAP said that the data entry was better this year. It is still taking me 30 minutes to enter results for the DAT survey. {Rant over}

We may be going in this direction as well. BPELZEL have you made the conversion? What Blood Bank system did you choose?

We currently have an Echo and are looking at the Erytra and Vision. I will have to double check the decontamination on the Vision.

We are evaluating several systems right now too and I'm not excited that the Erytra uses bleach to clean. I just removed all bleach from the blood bank not too long ago!

We also use secure send on our tube system. It returns to us if not picked up in 10 minutes. We also have a form that accompanies the unit that nursing fills out and returns to us after a clerical check. I hadn't thought about revalidation.

I am trying to move my department's procedure towards using the mother's antibody screen (and ID) results rather than the baby's. The question that I am getting hung up on is the timing of that screen since there can be multiple screens during pregnancy. My feeling is that it should be at the time of admission for delivery or after, but I can't find guidance. Help please!