TreeMoss

I would suspect so -- if agglutination is happening at lower temperatures in a test tube, I would expect the agglutination to be occurring in the cooled down patient.

So excited that you are being recognized for your contributions to our field. This is well-deserved.

I'm sure that would only be in cases where the patient was cooled down. I'm sure there have been times when a blood warmer was used in surgery just as it can be on the floors.

They usually are, so I'm sure that is the case in heart surgeries, as well.

The physicians would use cold cardioplegic solution -- 4 degrees - when putting the patient on bypass.

We simply used a beaker with water and ice and maintained the temperature during the 15 minute incubation period. This procedure was brought to us by a perfusionist who had been an MLS prior to becoming a perfusionist. She developed these procedures as part of a project when she was in perfusionist school.

We used to use that same procedure when we were doing open heart surgeries and the patient was on bypass. If our antibody screen was positive at 4 degrees, we would test at 10, 15, and 20 degrees - maybe even 30 degrees if the room temperature incubation was positive. Whatever the thermal range was, we would then do an antibody ID (who cares) and titer at that temperature. We would also include a test at 4 degrees using a 20% suspension of the patient cells to see if there was agglutination after 30 minutes. We in the blood bank were very happy when new surgeons were brought in who no longer wanted that testing -- working on beating hearts and doing mini valve replacements, etc. has helped us immensely.

We do the same. We also offer to do a blood type at no charge if the parent(s) want to bring the baby in to the lab in 6 months or so in order to get an accurate blood type.

I have attached the screen shots of the set up of the Order Group and Test in Meditech. Type Reflex.docx

We use MobiLab and do not have a separate Blood Bank wristband. We love MobiLab! We are able to use hematology specimens if they are labeled with a patient wristband label at the time of collection. Our specimens are collected by phlebs, ER folks, and L&D nurses. If the patient ID band is removed and not immediately replaced in a different location, we require a new specimen to be collected and tested. We also have Temporary ID bands (TID) from Biologics that we use in times of computer downtime.

We actually have two history questions on the result screen. The original Type History question is the one that a "No" reflexes the re-type specimen. There is also a "Previous History Check" that was added when we went up on BCTA (Bar-code Transfusion Administration). The We have four possible answers for the previous history check question -- No history, Yes hemolytic reaction, Yes non-hemolytic reaction, and Yes no reaction. There is no reflex order from this question.

We do perform in parallel if we have a previous specimen from the same pregnancy.

We have a "History" (Y or N) question on our result screen. If there is no history, a patient retype (forward type only) reflex orders on a new requisition, so the specimen can be collected. You just need to set it up like any other reflex order. Our L&D nurses draw most of the specimens from their patients. They also draw the extra tube for our retypes, but we often wonder when the labels are printed just 1-2 minutes apart. Everyone we ask verifies that the specimens were collected at separate times. I see that we're not the only ones with that concern.

We accept specimens drawn at the oncologists' office and labeled with Temporary ID band labels with the TID band placed on the patient's limb. Otherwise, all patient specimens are collected at our facility with the armband being placed on the patient at the time of specimen collection.

We follow the AABB guideline and test only in tube method.