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One of my larger projects for the last few weeks has been to update our procedure for antibody identification. Most of the individuals who have been involved in reviewing/validating the procedure seem pretty satisfied with it but some of the techs think it's too detailed in some regards and insufficiently detailed in others. I do have a habit of trying making very long procedures that cover as many bases as possible but at the same time I didn't want to make the procedure too rigid because antibodies don't always' follow the rules' and in some cases there's a lot of art and intuition to performing an antibody identification. The procedure includes: Notification of caregivers of delay in testing/rbc availabilityDocumentation requirementsAcquiring transfusion historyProcess for performing full/selected cell panelsProcess for performing exclusion analysis (rule outs)Algorithms with suggested methods to perform in the event that the basic rule outs aren't enough and/or the autocontrol is positive.ProbabilityWhat common antibodies should be ruled out with every AB ID and what to do if unable to rule something outHow antibodies to low incidence antigens are handledHow we handle antibody of undetermined specificityHow/when to use expired panel cellsDirections for IRL consultationHow to determine the clinical significance of usually insignificant antibodies (anti-M)And a chart demonstrating the likely clinical significance of antibodies in transfusion/pregnancyI'm curious if anyone would be willing to share their documented procedure. If anyone is interested in having a look at what we're working on, PM me. Thanks in advance and happy Friday!!