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labguru

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    Blood Bank Supervisor

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  1. When we switched to the Ortho workstation, I asked CAP what to do about the temperature and this was there response: Taking daily temperatures on the Ortho workstation which contains an indicator light can be satisfied by having the techs record that the green light is lit and is "acceptable". Prior to allowing the techs perform this task, best practice would to verify initially that the temperature in the incubator is accurate against a certified NIST traceable thermometer. If you are unable to verify that prior to installation, that the temperature is accurate, then the manufacturer would need to provide to you that the internal temperature has been calibrated by the company. The process that other labs are doing that you described would also be acceptable. Thank you for your inquiry, Ljiljana Petkovic, MT(ASCP)SBB Laboratory Accreditation Program
  2. We use Ortho Gel for the Blood Group, and tube for the weak D.
  3. According to the limitations of the FMH screen, if you have a weak d (which we don't know if it is or isn't because of the positive DAT) you must use a test to detect feto-maternal hemorrhage other than the screen. You only know if it is a weak D if you do the weak D testing on an Rh Negative specimen and when you add the Anti-IGG it will show up in this patient as positive due to the DAT. I think the positive DAT was due to the ABO incompatibility. We perform a weak D on all our Rh negative cord bloods to determine if the mother needs RHIG.
  4. Over 100 views and no comments? Is it safe to say I'm the only one with this issue?
  5. CAP standard TRM.40130 is a new standard that deals with alternative control procedures. It states "If the laboratory performs test procedures for which control materials are not commercially available, there are written procedures for an alternative mechanism to detect immediate errors and monitor test system performance over time. The performance of alternative control procedures must be recorded." We use the Ortho Confidence system for gel. We also use AB Plasma (we aliquot one unit of expired FFP and use it until gone) for our reverse type in confidence cell 1, to test the buffer part of the card and also to test our screening cells in the IGG card to make sure they come up negative. If you use the Ortho system, do you test your buffer cards (or last 2 cells in the ABO RH Reverse card) and IGG cards in the same way? It sounds like this new standard applies to what we are doing, correct? We don't have a procedure, but we do monitor and review. We even do a 20 sample crossover before it is put in use.
  6. Mother is O negative, baby is A negative. The DAT on the baby is positive, so the Weak D is inconclusive. According to the limitations of the FMH screen, if you have a weak d (which we don't know if it is or isn't because of the positive DAT) you must use a test to detect feto-maternal hemorrhage other than the screen. We send out a KB for this determination. However, the limitations also state that "in cases of ABO incompatibility between mother and child, the mother's natural ABO antibodies may destroy any fetal cells in the maternal blood specimen before testing is performed. This is true for any method of detecting fetal cells in the maternal blood." So my question is would you send this ABO incompatible specimen out for a KB or would you just issue the mother one vial of Rhogam and not worry about the KB since nothing may be detected? This was an uncomplicated vaginal delivery.
  7. We run the current positive and negative controls (before they expire) with the new lot of Indicator cells and D reagent. We are not comparing results, we are just making sure our new reagents are giving us a positive and negative result. This was under direction from a call to CAP. I guess it could depend on who you talk to there as to what answer you get though.
  8. My Ortho rep informed me that for a patient with an antibody the immediate spin in a buffer card still needs to be done because the IGG card does not pick up the ABO incompatibility. So we have both crossmatches in our result field. We will put the immediate spin results in first, then we will replace the IS XM with the extended XM (AHG).
  9. We have Meditech also, and once the doctor orders additional product, Meditech will attach it to a viable sample if there is one through a Daemon. If the current sample is due to expire shortly, it will order a new TS and XM which will need to be collected.
  10. I was wondering how other labs handle a unit of PRBC that you have to antigen type before a cross match. We edit the unit in Meditech and put in the positive or negative result in for the antigen. We only have a worksheet though for our reaction data. Is that worksheet something that needs to be kept for 10 years per CAP (Donor Blood Testing) or since we changed the unit and it is saved in our LIS we are ok not to save the paper worksheet?
  11. That is the direction I was thinking of going, but as you said, there are a few that will protest because of their level of paranoia. I'm not saying that it's a bad thing. Thank you for your input!
  12. Is there a requirement to have a secondary or back up method to your primary method? We use gel for type and screen and ab id. We have the reagents for the tube method for these, but rarely ever use them. I've been in the Blood Bank for almost a year so I'm a newb and the one time I used them I ended up sending the sample to a reference lab anyway.
  13. Can someone help me out with the term "child bearing potential"? I am revising a "Emergency Release of Blood Product" procedure and it states that a Female of child bearing age should get O negative blood. Of course this is a patient with unknown ABORH and in an immediate need of transfusion. My thought is any female under 50 years old should fall under this category. Do you have a policy that states a specific age "range" for these females? Is there going to be a difference in a 6 year old and a 12 year old in terms of creating an anti-D? I guess I'm getting hung up on the term "child bearing potential" and I don't want to think of a child as having child bearing potential- but I guess they have the potential until they hit menopause. Or do I have this wrong?
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