Julie Anderson

Just finished writing these- Not sure if it is enough- we rarely have a positive so External QC will have to suffice
TRM 299 Parallel Testing.doc
TRM 299A Lot-to-Lot Verification.doc

According to AABB Standard 5.30.2 part 2; "the woman is not known to be actively immunized to the D antigen."  We perform an antibody screen, along with an  ABO/Rh on a current sample before issuing a Rhogam. This is for ED patients and LD patients.

I stopped requiring microscopic examination of AHG testing many years ago but we kept the microscope for KB testing.  Consequently I had a few "more experienced" techs who refused to stop using the scope routinely for AHG testing.  The battle was not worth the effort to try to get them to stop.  Most of the "less experienced" techs had no problem with not using the scope.  As is the way of nature I'm pretty sure none of the "more experienced" folks are still testing patients, especially since they were more experienced than I and I am long gone as well.  
Wow, I'm getting far to diplomatic for my own good!  

The only caveat I would add...consider your staff. I have all generalists. I require them to use a microscope because they are not all equally skilled with shaking off and seeing weak reactions in the mirror. Without the scope, we would miss some things we need to see. If I had a dedicated blood bank staff, I would give you a different answer.

Have you run a cold panel? I like to run my screening cells, auto ct, and 2 group O cord bloods at IS, 5'@rt and 5' @4C. This way I can see if there is something that reacts at these temps. I don't believe you can say there is a cold ab unless you have proved it.

Sorry for the late post (years later) but I was browsing and saw this question. Mable our late pathologist used to do as yours. It was always beautifully written. Full of great information that only a true blood banker could appreciate. Our 'new' pathologists are way too busy for that but will answer any questions that any physician has about an antibody identification but boy I miss those Path reviews .... just reminiscing about the good ol' days!

Thank you all.  Your responses are greatly appreciated!

I agree with the previous responses. I would cease and desist with routine microscopic reading - you don't read the gel tests microscopically. Perhaps keep the microscope around just in case there's an odd case where it MIGHT be useful, but I suspect that it will just collect dust.

The use of the term "Optical aids", in this sense, is almost certainly referring you to an agglutination viewer.
The only time we use a scope is to verify the presence of that pesky rouleaux.
Scott

Many years ago, Peter Issitt stated that microscopes should be banned from Transfusion Laboratories (I think it was in the orange edition of his book) except for such tests where cells are being counted (such as the Kleihauer).
Many years after his wise words, I still follow his advice, and have not (yet) been involved in a missed weak antibody that has caused a clinically significant haemolytic transfusion reaction (43 years in the job), and many of those tests were performed in opaque tiles and then, as we "modernised", tube techniques.

We used the AABB publication as a guideline. When validating we sent a tech to the floor to time how it took & the unit's temperature.  We required a request/order and the floor had to sign an area that said unit appeared acceptable and information checked, time it, and return when they received the blood. We called when we tubed it & followed up if the form was not returned in a few minutes. We kept the completed form with our transfuse orders.  We only tubed to two locations.  That said, the blood bank has no control over the blood once it leaves.   One day we issued a unit, got a request for another patient, waited until we got the completed form for first unit back, and issued, called & tubed the unit for the next patient. A few minutes later, the first nurse called wanting to know where her blood was.  She had delayed getting her unit & the second nurse had grabbed it & completed the form. Two people had signed the bedside check area, but the first unit was hanging on the second patient.  Thankfully, it was group O & the patient had no antibodies.