A Laboratory Director's Question?

[Dansket]

This is a question posed by my Laboratory director:

 

Given this scenario, "Patient with a history of anti-Jka whose current antibody screen is negative.  Two units of RBCs are ordered for transfusion tomorrow evening." 

 

1. Does your blood bank crossmatch random donor units and issue crossmatch-compatible donor units?

 

    or

 

2. Crossmatch Jka- donor units  and issue crossmatch-compatible Jka- donor units?

 

    or

 

3.  Do you think this is a trick question?

 

I'd appreciate as many responses as possible.

 

Thanks,

 

Dan

[tbostock]

We do #2. We find antigen negative units for Jka first, then would perform the AHG crossmatch.

[EDibble]

Number 2 for sure. Why could it be considered a trick question?

[R1R2]

#2

[Eagle Eye]

# 2 ...there is no doubt #1 is no no.

 

& not a trick question.

[Malcolm Needs ☆]

Number 2 without doubt.

 

Anti-Jka is renowned for causing anamnestic haemolytic transfusion reactions and is implicated in many, many cases in the UK's SHOT Haemovigilence Scheme every year.

[David Saikin]

#2

[Justina]

#2 only

[KAPMT]

We also do the #2 scenario.

[dalene]

Number 2 definitely

[John C. Staley]

I have a question for you. What is your lab director's blood bank back ground? I had a lab director once and his only qualifications for the job was a BS in business (long story). He would ask these kinds of questions. 

[bmarotto]

No trick or treat....#2 is the only answer.   

[Dansket]

I have a question for you. What is your lab director's blood bank back ground? I had a lab director once and his only qualifications for the job was a BS in business (long story). He would ask these kinds of questions. 

He is a CLS

[Justina]

He is a CLS

  A bit scary, but I guess if you don't have a blood banking background it's an understandable question right.

Edited October 28, 2013 by Justina

[SMILLER]

Why did he ask the question?

 

Scott

[JoyG]

#2

[MAGNUM]

That should go without saying, if you have a history of ab then you would give Ag negative units.

[DOGLOVER]

#2. Why would he even be asking?  

[tricore]

2. Crossmatch Jka- donor units  and issue crossmatch-compatible Jka- donor units.

[Hans]

Number 1 is WRONG as following this procedure will lead to possible anamnestic response*. 

 

Number 2 is the RIGHT PROCEDURE to follow to prevent possible anamnestic response*. 

 

Number 3: This is definitely NOT A TRICKY QUESTION. 

 

Anamnestic Response: An accentuated antibody response following a secondary exposure to an antigen. Antibody levels from the initial exposure may not be be detectable in the patient's plama until the secondary exposure, when a rapid rinse in antibody titre may occur. This may lead to haemolytic transfusion reaction. 

[goodchild]

#3.

 

The fact that the question is being asked is the trick.

[Likewine99]

#2. 

[Abdulhameed Al-Attas]

_{Number 2 for sure.}  

[Pavel Dmitrievich]

As bloodbanks become increasingly digitized, less and less qualified people become associated with them. We withdraw in horror at the prospect of choice number one  being even a choice on the table.

However, we must get accept the fact that as experienced blood bank staff retires and replacements are chosen in "cost-efficient" manners, as one would chose a nut or a bolt, the consequences of

inappropriate choices will become more frequent. Smaller hospitals and rural hospitals which cannot

compete for the needed staff will evince the most errors. I can't speculate on the number of errors, but

my feeling is that percentages are now rising.

[R1R2]

As bloodbanks become increasingly digitized, less and less qualified people become associated with them. We withdraw in horror at the prospect of choice number one  being even a choice on the table.

However, we must get accept the fact that as experienced blood bank staff retires and replacements are chosen in "cost-efficient" manners, as one would chose a nut or a bolt, the consequences of

inappropriate choices will become more frequent. Smaller hospitals and rural hospitals which cannot

compete for the needed staff will evince the most errors. I can't speculate on the number of errors, but

my feeling is that percentages are now rising.

I agree with Pavel and thank goodness most of us have computer systems that would not allow #1. 

Edited October 30, 2013 by R1R2