OkayestSBB

We do provide the units to the air ambulance.  Patients transfused with those units can either get transferred to our facility, or another trauma center in the area.  We keep segments aside of the units we give out and if they come to us we crossmatch but there is talk of removing that from the SOP.  We feel uncomfortable with that because we cant find much information other than the FDA wants traceability and trackability of the unit.   I feel like this situation is a black hole for units, not much information in the regulations/standards. 

We accept them back and use them.  We put Safe-T-Vue indicators on them, control the refrigerators at some hangars, validate their transport containers and have reviewed the procedures and documentation for storage at the other company's hangar.

We have a contract to provide blood to our air ambulances, but they charge the patient if they transfuse it (well, it's wrapped into their total charges for the flight, but we don't charge the patient).  If the patient comes to us, we do the XM like we would for our own UNXM units but if the patient is transported elsewhere, we maintain final disposition of the unit in our computer but don't do the XM (yes, we give the patient a fake account in the BB computer using a specific format).  It is just easier for us to maintain the record of the unit's final disposition for if there is a market withdrawal etc.  We would notify the air transport company to do the patient or next of kin notifications if that were ever needed. It hasn't happened yet so it isn't a big problem.

We do provide the units to the air ambulance.  Patients transfused with those units can either get transferred to our facility, or another trauma center in the area.  We keep segments aside of the units we give out and if they come to us we crossmatch but there is talk of removing that from the SOP.  We feel uncomfortable with that because we cant find much information other than the FDA wants traceability and trackability of the unit.   I feel like this situation is a black hole for units, not much information in the regulations/standards. 

We do provide the units to the air ambulance.  Patients transfused with those units can either get transferred to our facility, or another trauma center in the area.  We keep segments aside of the units we give out and if they come to us we crossmatch but there is talk of removing that from the SOP.  We feel uncomfortable with that because we cant find much information other than the FDA wants traceability and trackability of the unit.   I feel like this situation is a black hole for units, not much information in the regulations/standards. 

We do provide the units to the air ambulance.  Patients transfused with those units can either get transferred to our facility, or another trauma center in the area.  We keep segments aside of the units we give out and if they come to us we crossmatch but there is talk of removing that from the SOP.  We feel uncomfortable with that because we cant find much information other than the FDA wants traceability and trackability of the unit.   I feel like this situation is a black hole for units, not much information in the regulations/standards. 

I just answered this question.

My Score PASS  

Do you have a custom script in Cerner for tag printing?  When we were on Cerner the script would occasionally lose the setting for lines per page, resulting in the situation you described.  It wasn't a printer problem at all, in our case. 

In my experience with HTLA like antibodies you usually have a feeling to go that route by the way they shake off, they are generally weaker reactions and sometimes hard to reproduce.  As Malcom has stated, I have heard strong Ch/Rg antibodies that need to be diluted out to neutralize.  I personally like to do a titer, and I find that antibodies to Ch/Rg usually like gel.  But that's when they place nice... 
Hope that was helpful

Thanks Malcom! I know A1 lectins need to be diluted properly but didn’t think it all the way through to that’s why A2 cells are a necessary negative control. 

I attach a hybrid of my lectures on the differences between the A1 and the A2 ABO type, together with a very few slides from my lecture on lectins, and I hope that this will serve to be of some use to you.
It is hugely important to remember that many lectins, including Dolichos biflorus, are not specific unless they are diluted to ensure that they only react as desired.  For example, this particular lectin (Dol b) will react quite strongly with A2 red cells unless suitably diluted so that it only reacts with A1 red cells.  It is because of this that group B red cells are totally unsuitable to be used as the negative control for the Dol b lectin, and the same applies for group O and other group A subtypes.  Group B red cells will not tell you whether or not your grouping reagent is "specific" for the A1 antigen, or will still react with the A2 antigen.  In addition, the lectin will also react with red cells expressing the rare polyagglutination antigens Cad and Tn, and so, in the true meaning of the word, it is not "specific" anyway.
What is the difference between A1 and A2.pptx

In my experience with HTLA like antibodies you usually have a feeling to go that route by the way they shake off, they are generally weaker reactions and sometimes hard to reproduce.  As Malcom has stated, I have heard strong Ch/Rg antibodies that need to be diluted out to neutralize.  I personally like to do a titer, and I find that antibodies to Ch/Rg usually like gel.  But that's when they place nice... 
Hope that was helpful

I just answered this question.

My Score PASS  

In my experience with HTLA like antibodies you usually have a feeling to go that route by the way they shake off, they are generally weaker reactions and sometimes hard to reproduce.  As Malcom has stated, I have heard strong Ch/Rg antibodies that need to be diluted out to neutralize.  I personally like to do a titer, and I find that antibodies to Ch/Rg usually like gel.  But that's when they place nice... 
Hope that was helpful

In my experience with HTLA like antibodies you usually have a feeling to go that route by the way they shake off, they are generally weaker reactions and sometimes hard to reproduce.  As Malcom has stated, I have heard strong Ch/Rg antibodies that need to be diluted out to neutralize.  I personally like to do a titer, and I find that antibodies to Ch/Rg usually like gel.  But that's when they place nice... 
Hope that was helpful

Maybe anti-P1, rather than anti-P.

Thank you Malcolm.  Our prenatal titer procedure calls for reading microscopic solely for the purpose of scoring, but I guess there isn't an associated score .  Looks like the procedure should be updated 

Thank you Malcolm.  Our prenatal titer procedure calls for reading microscopic solely for the purpose of scoring, but I guess there isn't an associated score .  Looks like the procedure should be updated 

Thank you Malcolm.  Our prenatal titer procedure calls for reading microscopic solely for the purpose of scoring, but I guess there isn't an associated score .  Looks like the procedure should be updated 

Macroscopic every time.

When I first joined the wonderful world of blood transfusion, with particular reference to blood group serology, at the International Blood Group Reference Laboratory, when it was in London, my mentors were Dr Carolyn Giles and Joyce Poole.  In those days, yes, we did use microscopes (albeit with very little magnification) and, given that we were using human-derived antisera, and the fact that I was anxious not to miss anything, I often got Joyce to check my sightings down the microscope.  These were invariably "kissing cells", as you suggest, and Joyce christened them "Malcolm weaks", a term which, I understand, is still used in the Red Cell Reference Department, when there is actually no agglutination present at all!
By the time I retired, I NEVER used a microscope for red cell reactions (of course, for Kleihauers and the like), but not for agglutination, unless I was training someone, and showed them the typical "mixed-field" agglutination seen with anti-Sda (I hate not being able to use subscript and superscript on herre any more) and Lutheran antibodies.

I just answered this question.

My Score PASS  

Do you use Rhophylac? In the package insert it says, "Rhophylac® can contain antibodies to other Rh antigens (e.g., anti-C antibodies), which might be detected by sensitive serological tests following administration"

But we sooooooooooooo rely on your infinite wealth of knowledge.

Thanks everyone! Im actually relieved bc I can just tell them not to wash and it'll be an easy fix.
We do use that calculation to make the 0.8% from packed cells, the problem is that people are washing the cord blood four times in the cell washer and it doesn't leave enough red cells to get 10 microliters of true packed cells.
 
Anorris, page 377 last paragraph.