Help- Electronic cross-matching

[jcdayaz]

Hi thanks for that information,

jcdayaz - no I wont use that incident as a negative - have had a very positive response from those who are currently using electronic issue, i would just use it to highlight that as with so many things in life - you have to expect the unexpected!

thanks!

YES! There are many "unexpected" things that occur in Blood Bank. Electronic crossmatching works...go for it!

If your original antibody screen is negative, your manual crossmatch (9 times out of 10) would be compatible also. So it is just wasted time, resources, etc. to crossmatch these particular patients.

I won't lie.....Electronic Crossmatching was VERY scary to me at first. Now I LOVE IT!!

[Brenda K Hutson]

Two things:

1. First, without that history of clinically significant antibodies in your Blood Bank, if you didn't perform Electronic XM,

you would most likely only be performing an Immediate Spin XM. So, the "scary" scenario is always a possibility;

whether performing an electronic XM, or an I.S. XM; either way, you probably would not pick up the antibodies

(unless IgM).

2. And I agree with Malcolm; I too have seen plenty of Rh Antibodies disappear.

You are lucky that this patient spoke up. One night while working the MN shift at a large Medical Center with a Trauma Center, the ER requested 2 units of uncrossmatched blood. I threw the Antibody Screen in just as quickly as we got the specimen. When the screen was positive, I called the ER and told them to stop transfusing; that the patient had antibodies. The MD said it was too late; they were already on the 2nd unit and the patient needed the blood. I then asked the MD to ask the patient (she was coherent; but that is another thing that could trip you up) her transfusion history. Just as I finished the work-up (anti-E and anti-c), the MD called back and said "the patient said something about having an antibody card; would that be helpful?! Yes, like about an hour ago!! Since the units were O NEG, they were (as is most likely) E-c+. Had we known about the card from the start, we actually kept 2 shelves of historically antigen negative RBCs and could have at least given E-c- units (though still uncrossmatched). That particular Medical Center had it's own Donor Center. When the Reference Lab in the Blood Bank performed Antigen Typing on units, they would send a copy of the results to the Donor Center. The Donor Center then plugged the results into the computer under that donor. So, when the donor came back, a white tag on the top of the unit would give all historical typing results (if there were any).

I think that the letters that usually accompany those cards, need to be written in terms that the public can understand; as well as emphasizing the importantce of telling Hospital staff immediately! What I have seen happen frequently is that all of the patient has to do is see the word "antibodies" on a letter and card and they immediately panic; thinking of things like HIV.......but at least then they call for clarification; providing an opportunity to explain it better. But the reality is, not all places send out antibody cards; in fact, my guess would be that most Transfusion Services do not send out cards.

Brenda

Responding to my own e-mail again....sorry for not taking the time to look at the spelling and grammar again! I am usually in a hurry when I have a moment to come to the site. But I know it isn't easy to read e-mails when you are stumbling over the writing....

Brenda Hutson