Just For Fun

[Malcolm Needs ☆]

I'll bet all of us have been bitten on the posterior by anti-H. I tell my techs that cold reactive antibodies were put on earth to keep us blood bankers humble. Just when you think you've got them all figured out, one of them will sneak up and get you! :mad:

Thanks for the sympathy (I need it), but I don't feel so much humbled as totally crushed.

What an idiot I am!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

:surrender:surrender

[adiescast]

We had a similar incident here. There was an ABO discrepancy detected by a tech (who felt quite clever about it). The patient has been reported as an O at least three times in the past. The clever tech noticed that the back type was not quite right - the A1 cells reacted only W+ while the B cells were 4+. When the patient cells were tested with A,B they were 1+. Obviously the patient is not an O! So the record was corrected to indicate that the patient was an A.

Some days later, the doctor's office reported that the patient had a bone marrow transplant in the 1990s, but they had no more information than that. When the patient was finally available for questioning (you can see this coming, right?), she reported that she was type A before the transplant. Now we have to correct the corrected record...

You are definitely not alone, Malcolm.

[adiescast]

At Malcolm's request, I am reporting this from another section:

We had a real surprise one time when we found out about a lawsuit that a family filed against the hospital. When we read the chart, the physician had written a note that he suspected the platelet unit the patient was given was contaminated. There was never a report of this suspicion to the blood bank at all! I still shake my head over that one.

:disbelief

[Dr. Pepper]

This was not a scary quote but perhaps a scarier action: We just received a specimen from an outreach site for a culture and other tests. It was in a syringe with the needle still attached. The needle had no cap, but was "sealed" with a gauze pad and tape! That'll keep that sharp from sticking someone!

[Malcolm Needs ☆]

We had a similar incident here. There was an ABO discrepancy detected by a tech (who felt quite clever about it). The patient has been reported as an O at least three times in the past. The clever tech noticed that the back type was not quite right - the A1 cells reacted only W+ while the B cells were 4+. When the patient cells were tested with A,B they were 1+. Obviously the patient is not an O! So the record was corrected to indicate that the patient was an A.

Some days later, the doctor's office reported that the patient had a bone marrow transplant in the 1990s, but they had no more information than that. When the patient was finally available for questioning (you can see this coming, right?), she reported that she was type A before the transplant. Now we have to correct the corrected record...

You are definitely not alone, Malcolm.

One of our hospitals had a similar incident some years ago.

A baby was born to a group O mum and a group B dad. The baby was group A!

They repeated on a fresh sample and the baby was A again.

They did all sorts of things, suspecting a baby swap in the Delivery Suite. They even suspected that they could no longer do ABO grouping.

It turned out that the mum had received a BMT and that the baby was the result of a GIFT ovum from her (group A) sister, but nobody had bothered to tell anyone else, let alone the Blood Bank.

:eek:

[AMcCord]

One of our near (hospital) neighbors had a Group O mom and an AB dad. Baby turned out to be AB. They also suspected all kinds of dumb things happening in delivery, they asked about a GIFT ovum (nurses didn't have a clue why they would ask), retyped and retyped and retyped. Redrew mom and dad, then collected a cap sample on baby. The doctor thought the lab had a major problem with their ability to determine a simple blood type. Finally sent it out to the ARC reference lab in Philadelphia to see what kind of weirdness was going on. The reference folks requested some family study samples from dad's family. Lo and Behold!, dad was sharing cis-AB, not A or B, with his child, just as his daddy had shared with him. Dad's family members, in the relative few they tested, had several instances of cis-AB, but it was not discovered until this cord blood sample was typed. The funny part was that the story ended up on the front page of the local newspaper - the story was actually pretty accurate, though how the editor or reporter (non-science people) grasped enough to find it interesting enough to publish, is a mystery. That's a patient that will be talked about for years in that lab.

[Barb Thompson]

This reminds me of an OB patient who was AB neg, delivering an O Pos baby. My first thought was "Uh Oh!". Tested, retested, grabbed the hemo tube and tested again.....still O pos! Then I noticed the mom's age....49. I called OB and asked if it was a donor egg; sure was! The mom came in 2 years later and did it again.

[PammyDQ]

OMG I've heard much of the same in my career...asking for washed blood or Oneg when a patient had antibodies and they couldn't wait, being argumentative when we report clots because they'd already removed them. Once a nurse called me for the 2nd unit of blood on "Patient A" and I tell her it was dispensed already, she argues and said no the only other unit they got was for "Patient B" whom we never sent any blood up on...turns out the unit was hung on the wrong patient because...and I kid you not...when checking the blood they checked the BED NUMBER on the compatibility slip...which was printed before they moved the patient to another bed! How often I would get calls with staff referring to patients as their bed number..."Can we have a unit for Bed 3?" I will reply, we transfuse patients, not beds...can you give me a NAME??? I mean really!

[Malcolm Needs ☆]

I'm in two minds whether to post this one, as I have just told the person concerned to join BloodBankTalk, but the person concerned has a superb sense of humour and is an excellent serologist, so I'll keep it strictly anonymous.

We had a sample in some time ago on a pregnant lady with a high titre anti-S (or anti-s, I can't remember her details).

Anyway, my colleague came to me a bit perplexed, because the follow-up sample was completely clear of atypical antibodies. My colleague had gone back to the original follow-up sample and repeated the tests (in case my colleague had taken plasma from the wrong sample) and it was still negative. Could I come up with an explanation?

Well, the answer was yes. This sample was not from the lady with the antibody, but from her partner. The hospital had sent it in for Ss typing!

Whoops (but I bet we've all done something similar - I know I have - see post 149)!

:D

[BankerGirl]

I just got done working up a new patient crossmatch where the patient forward typed an O neg and backtyped an A neg. I got a w+ reaction with anti-A,B, but could not get anything to come down with anti-A, even after refrigeration. I called the doctor's office to ask for a patient history and the nurse said his history was unremarkable. After further investigation she found a note that he had received some sort of transplant and prefered to have his care done at another facility. I called the other facility for their help. It turns out he had a BMT a year ago and his type went from A pos to O neg. Well, this explains everything! Apparently a bone marrow transplant is "unremarkable" now.

[VACASE]

We had a physician call and ask when the sensitivity results would be ready on a sample that had a parasite.

[cooltech]

Just overnight.......

Our micro tech was communicating some positive blood cultures to a patient's nurse and the nurse replies: "But........(insert long pause here) his flu test was negative!!!

I:faint:

[adiescast]

Quite some time ago we were working with our trauma team on process improvements for turn around time in these very urgent cases. At one point after the physician had complained yet again that we were too slow, I said that we had talked extensively about the blood bank process for producing the blood units, perhaps we needed to look at the ordering end to see if things could improve there. I asked him to tell me about the ordering process. He looked at me and said (completely seriously) "I call into the air and blood shows up."

:disbelief

[Malcolm Needs ☆]

Quite some time ago we were working with our trauma team on process improvements for turn around time in these very urgent cases. At one point after the physician had complained yet again that we were too slow, I said that we had talked extensively about the blood bank process for producing the blood units, perhaps we needed to look at the ordering end to see if things could improve there. I asked him to tell me about the ordering process. He looked at me and said (completely seriously) "I call into the air and blood shows up."

:disbelief

They're Gods aren't they!!!!!!!!!!!!!!!!!

:sarcasm:

[L106]

No, some of them only think they are!

[adiescast]

I actually suggested that maybe we needed to put a microphone in his surgery suite to expedite the process. Since they are only one floor below us, I suggested we could put in a trap door to lower the blood through. He had the grace to be sheepish when he made his comment, but to him it was true. He had two hands in the patient and pretty much called out for whatever he needed. He just never bothered to look into what happened after his vocalization.

[Malcolm Needs ☆]

No, some of them only think they are!

True, very true.

[Fizzbin]

Back in the days when we used to have to call all stat results, I once had a nurse ask me how to spell MCV!

Along the same line, I don't know which one is better: being asked to spell BUN, or when someone wants the "bun" result.

[kdal]

This just in.... today my supervisor received an incident report where our labor and delivery unit complained that we called them with a hemolyzed type and screen that needed to be redrawn. They further complained that the patient could bleed at any time and that multiple needle sticks could open her to infection and loss of access. The nurses suggested solution for this problem???

Get ready, here it comes...

And I quote "Hemolyzed specimens should not be a visual test"

Uh, WHAT?? And how much more do you make per year than we do????

Edited October 7, 2009 by kdal
Wanted to emphasize that it was the nurses solution and not the supervisors

[Pailloz]

In a large urban hospital, I had a nurse franticly call and tell me she needed blood on a code and somone was coming forpatient : Betty Levin.

We looked her up..no patient , no specimen, as we preped uncrossmatched for pickup, the nurse swore she had sent specimens. Look under Elizabeth, Liz, a variation of Spelling in so many ways.(of course she had not other identifiers)

When nurse arrived: pickup slip stated

BED 11

not

Betty Levin!!!

Since my name is Elizabeth I always got a kick out of that one!!

[Mary**]

That is a good one!

[vav5325]

A funny misspelling on Dr. orders that i see all the time : instead of platelet pheresis I see alot of plt foreece's.

I've also seen a Dr request for eradicated blood instead of irradiated blood. Too funny.

[NedB]

One more for not knowing the subject. An RN just refused to pick up a unit of blood after finding out it was irradiated. She is 3 months pregnant anf that is the most critical trimester for avoiding radiation sources. Had heard that one before, but not in a long time.

[AMcCord]

We get requests for 'irritated blood'.

[Malcolm Needs ☆]

We get requests for 'irritated blood'.

We get irritated when they ask for blood!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

:D:D