Female patient unknown transfusion history with mycoplasma pneumoniae what exclusions and further testing would you perform ?
When would you perform a titre ? Reactions greater than 3+. If emergency units required with titre greater than 64 what is your protocol ?
As I'm sure everyone else is doing, we are trying to find ways to cut costs. We are a medium sized hospital (<400 beds) in a rural setting without a trauma designation. Annually, I look at supplier contracts including reference lab testing. We currently do our own antigen typing and primary and secondary antibody ID panels but do not keep an enzyme panel nor do we do adsorptions, although we do perform elutions. Most of my staff are generalists and at least half of them are MLT's.
I am curious to know the size of your institution and how much, if any, of your serology you send to a reference lab. We are seeing more complex patients (in volume, not necessarily complexity) and I am considering bringing in enzymes and adsorptions. Please give me your thoughts. Thanks!
What is your procedure for a random cell that is reacting and not accoutanted for? Our testing capablity is limited with simple ABID. I am still trying to figure out a happy balance for us for sending things and not sending things to a reference lab. I know at where I used to work we didnt sent a lot of those one random cells for further investigation. Would just assume low incidence or HLA(if postitive on the extended) and be done giving IgG XM. But I did not know what I know now and knowing what I know now...makes things harder sometimes!! haha
Is it more important with the pregnancy patients. How about with patients who have been transfused ever?
Talking with red cross they would confirm the HLA by treating with something that destoys the antigen to show no more reactivity
So wondering if write the procedure say:
1. any unexplanable cell and patient pregnant and or transfused hx must go to reference lab even if all commonly encountered are ruled out
2. any unexplanable cell and pt not pregnant or transfused and all commonly encoutered are ruled out give IgG xm
Thoughts, ideas appreciated, thank you!!
Does anyone know of any standards that require repeat of special antigen typing that was performed by a reference lab. At this time, the facility I work at will repeat any special antigen typing that was performed by the ARC and then documents this information in the computer system (and on paper) and places their own special antigen stickers on the units in addition to the tag attached by the ARC. Any info would be greatly appreciated! Thanks!