I was wondering how most of you QC your blood bank saline? We are a small hospital and typically only use gel testing. The only time we use our saline cube is when we wash cord blood, when we re-type our blood upon arrival, and then occassional antibody workups/problem crossmatches. Our daily QC for tube testing currently only includes testing of Anti-A,-B,-D,-Rh control, and AHG. The only procedure I can find for testing the saline is to test it against screening cells, incubate, wash, so on and so forth. It just seems to be a pain to have to carry that out when the other tube testing is done in a minute or two. Does anyone have a better procedure to QC the saline? Thanks.

Don't you perform Weak D testing with your tube controls? That should include your saline.

:handshake

Edited March 29, 201015 yr by KKidd
misspelling

We actually QC the saline when we QC the check cells. Because our QC reagent is positive for all cells screened, we QC the check cells in a separate step. One tube has check cells and AHG (positive control) the other has check cells and saline (negative control). The only thing we check for is hemolysis in the negative control, which is not a very sensitive test. The main things you would be concerned about with saline is pH and contamination. It is hard to check directly for contamination. You would have to dispense some into a tube and look for floaties. We use ours quickly enough that I have not worried about it.

Our saline mfg recommends a daily check of saline for non-hemolysing and a negative DAT of cells washed with it, so that's what we do.

I never really thought about QC'ing saline, but as KKidd and Lscmrz stated in their posts, the saline is actually "accidently" QC'ed when we do the various testing in our daily QC of our routine reagents.

We never formally QC'd our saline each day until we realized the manufacturer states you should do it right on the outside of the cube of saline. Ours details what needs to be done. Also, ours states on the cube that it should be given a 30 day expiration from the date it is opened. I came up with a daily Saline QC sheet for each workstation. Kind of a pain, but you don't want to get cited for not following the manufacturer's instructions.

SHOULD doesn't mean you MUST.

Our cell washer maintenance includes a weekly check of saline pH after it's run through the device post disinfection. Here's another little back door saline QC.

We test our check cells against the saline as our check cell qc. Don't forget about your MTS diluent to, the package insert for that states it should be QC'd to.

Related question: we were nearly cited for not doing QC on saline this past CAP/AABB inspection. Our supervisor is considering switching over to buffered saline opposed to using the certified blood bank saline. Aside of the cost savings, is there any other benefit to this switch? How would this effect daily QC and would it still be required to be completed? Thanks in advance!

Immucor Fetal screen kit ---New lot just came/ requires the use of phosphate buffered saline.

That change has been in the works for over a year . . . it is about time it was formalized.

Oh, awesome...don't have any. Question: can you use phosphate buffered saline for any other testing, or will I now have to stock the two types of saline?

When Immucor sent out its letter stating it was going to require PBS for the fetal screen kit, we switched from the Blood Bank saline to PBS for everything. Some of the Immucor antisera inserts require a saline pH of 7 so I had been checking our saline's pH for a while and it wasn't consistent. It just seemed easier to switch to the PBS for everything.

Oh, awesome...don't have any. Question: can you use phosphate buffered saline for any other testing, or will I now have to stock the two types of saline?

would you validate all your procedure before switching?

I checked some inserts for immucor which says Isotonic saline/phosphate buffered saline

Hello,

For those who pH test their BB saline, what do you use? Our BB saline is from Cardinal health and is unbuffered.  We bleach the lines bimonthly, and after this maintenance, the pH of the saline is verified. We are using Hydrion pH test paper (Micro Essential Laboratory).   However this was on their web site. :(  (

Can I use Hydrion pH Paper to test the pH of NaCL solutions?

pH paper will not work well in NaCL solutions. The salt will "hold back" the pH indicator dyes and pH readings will most likely be inaccurate.

https://www.microessentiallab.com/help.aspx

Thanks so much for any responses.

Julie

When we were using gel, for the antibody screening negative controls we ran one with each diluent and the third with saline.  Now that we are automated, we use saline as the negative control for the Check Cells in tube.

We don't QC the saline we wash with, never thought about that.  Something to ponder.

We do QC the saline squirt bottles with the daily control as we still test ABORH and DAT using the tube method, thus saline suspensions.

To all Echo users...How are you handling daily QC of the saline?  We QC the saline when the cube is made but not daily.

2 hours ago, sqmier said:

To all Echo users...How are you handling daily QC of the saline?  We QC the saline when the cube is made but not daily.

Actually, I believe that the daily QC takes care of that, as the saline is used the same in patient specimens and QC material.

On 3/16/2020 at 10:14 AM, BankerGirl said:

When we were using gel, for the antibody screening negative controls we ran one with each diluent and the third with saline.  Now that we are automated, we use saline as the negative control for the Check Cells in tube.

Same as many above, also use saline as a neg. control for CC so it's "accidentally" QC'd.

The cubes are also inspected on a daily basis as part of the Cellwasher QC, which checks for valid expiration date of 30d on the cube and that there is sufficient volume.

Switched over to PBS somewhat recently, all the procedures were modified.