Mabel Adams

Will you also get the BloodTrack software and interface to your BBIS?

I just answered this question. My Score PASS  

Does the access code change every day or hour or...?

Thanks for the offer. We have a meeting with Biolog ID soon. Are the units emergency issued in your BBIS, or do they get assigned to the patient somehow with the RFID system? Or is documentation all on paper?

It looks like we may begin to use normosol-R which I think may be plasmalyte from a different vendor.

Resurrecting this old thread to ask what problems you all find with either a simple blood fridge in ED or with a Haemobank. We plan to get a Haemobank eventually but if we would just have the same problems with it that we would have with a simple fridge in ED with a few units in it, then the cost benefit ratio is poor. I am most concerned with keeping nurses trained to use it in a not terribly busy level 2 trauma center. We have an MTP that uses over 6 RBC units about once every 3 months. I worry that they will take out O neg for males, take units out for too long then put them back or waste them, not label the units for the patient (with Haemobank) and that it will keep the units far from us so we can't use them up on other patients (mostly 5-day plasma for this concern) without a trek to the ED to swap them.

I just answered this question. My Score PASS  

Yes, this again. OR wants to use it; the circular still says not to. Does anyone have any definitive data that allows the use of Lactated Ringers solution in blood infusions? I see one small study out of Canada in 2009. I'm not sure how it could be allowed when the Circular of Information specifically says never to use it.

We had to purchase a set of screening cells from a different vendor for DTT treating cells for Darzalex patients because when we validated it, the Duffy antigen we were testing didn't survive the process consistently. It was fine on Alba cells but not on Immucor cells.

Because Knops antibodies usually behave as HTLA-like, I would have expected it to react in PEG as well as gel, but the antibodies do whatever they want!

Some of you more "experienced" people will remember the little saws that we used to score the microhematocrit tubes so we could break off the part with the immature red cells for antigen typing someone who had been recently transfused. What the heck were those saws meant for originally? I feel like they came with something else in the lab. Were they for general chemistry glass tubing? Also, what tool works well now for scoring the plastic-coated glass microhematocrit tubes since those little saws aren't available? I found a few centimeters of staples (ready to be put in a stapler) could work. Hack saw blade?

Maybe it is a cold but the diluent 2 was colder for the first run but had warmed up by the second run of 2 additional cells?

What's a high frequency antigen that might be weakened on expired reagent cells, reacts in Ortho MTS gel testing (about 1+), including when 3% cells are converted to 0.8% to run in gel but not in PEG? It does not react in MTS gel on 2 expired 3% reagent cells converted and run in gel but did react with 3 in-date cells converted to 0.8%. It does not react using 30-minute PEG with any cells in a 16-cell panel. DAT is neg. No recent transfusions; 51 y.o. fe with a lacerated spleen from being thrown from a white-water raft onto a rock. Hgb staying stable enough. O pos. "Race: Other White" and she is from Arizona. I would think it was antibody to the gel diluent in prediluted reagent cells but then the converted cells using diluent 2 should not react. I am tempted to trust the PEG results but thought I would ask.

Giving O units (or A2) keeps our computer happier on patients with documented anti-A1. Of course, that is the prime objective these days, right? We bow to our computers!

With the Supreme Court decision is all of this moot? Is the FDA still able to regulate LDTs since congress didn't specifically address this?

Someone online said that anything not in an FDA-approved kit or reagent system purchased from a vendor is a lab developed test and thus subject to the new FDA rules, including all those ancient procedures that are in the methods section of the Technical Manual. I could argue that the titer procedure is really just specimen treatment, not a test different from any other tube AHG test. Generally, the tube AHG tests are defined in the manufacturer's instructions. Is saline replacement a test? I wonder what the Lab regulatory bodies will say about the new rule in regard to BB tests. Anyone have any extra knowledge about this for BB?

If the Kleihauer calculations are for seven (or more) 300 mcg vials of RhIG (assuming persistent fetal Hgb and weak D have been ruled out), are there precautions for giving that much? Is it effective? Is there a number of vials that is just too many? I have heard of concerns for hemolysis, which are sometimes mitigated by spreading out the IV doses and by giving steroids. I vaguely remember the idea that over a certain number of doses it may be hopeless. Is the approach different if due to transfusion rather than a FMH? Does anyone have any actual guidelines or evidence?

ALLOHOPEfoundation.org I just learned of this organization so wanted to share their name.

ALLOHOPEfoundation.org I just learned of this organization so wanted to share their name.

If they are so strong that we must use the pre-warmed technique to resolve them, and/or the patient is significantly hemolyzing from CAD, we would recommend using a blood warmer.

Can not even Weak D type 1 patients be consistent in their ability to make anti-D?!??! I still don't know why we got such different results than previously in gel. I verified that Ortho didn't change the anti-D clone in their gel cards between November and now. I guess this patient just wanted to mess with us.

These experiences are very useful for anyone considering this as a possible deviation from normal processes in a dire emergency.

Has anyone used this book from AABB: ON-CALL MANUAL: A SYSTEMATIC APPROACH TO SOLVING COMMON ISSUES IN TRANSFUSION MEDICINE? Is it good for a new BB supervisor or generalist pathologist?

Maybe some of these references are helpful. 7. Selleng K, Jenichen G, Denker K, et al. Emergency transfusion of patients with unknown blood type with blood group O Rhesus D positive red blood cell concentrates: A prospective, single-centre, observational study. Lancet Haematol 2017;4:e218-24. 8. Frohn C, Dümbgen L, Brand JM, et al. Probability of anti-D development in D– patients receiving D+ RBCs. Transfusion 2003;43:893-8. 9. Gonzalez-Porras JR, Graciani IF, Perez-Simon JA, et al. Prospective evaluation of a transfusion policy of D+ red blood cells into D– patients. Transfusion 2008;48:1318-24. 10. Tchakarov A, Hobbs R, Bai Y. Transfusion of D+ red blood cells to D– individuals in trauma situations. Immunohematology 2014;30:149-52. 11. Yazer MH, Triulzi DJ. Detection of anti-D in D– recipients transfused with D+ red blood cells. Transfusion 2007;47:2197-201. 12. Burin des Roziers N, Ibanez C, Samuel D, et al. Rare and transient anti-D antibody response in D(–) liver transplant recipients transfused with D(+) red blood cells. Vox Sang 2016;111:107-10. 13. Yuan S, Davis R, Lu Q, et al. Low risk of alloimmunization to the D antigen in D– orthotopic liver transplant recipients receiving D+ RBCs perioperatively. Transfusion 2008;48:2653-5. 14. Schonewille H, Haak HL, van Zijl AM. Alloimmunization after blood transfusion in patients with hematologic and oncologic diseases. Transfusion 1999;39:763-71. 15. Goodell PP, Uhl L, Mohammed M, Powers AA. Risk of hemolytic transfusion reactions following emergency-release RBC transfusion. Am J Clin Pathol 2010;134:202-6. From this: Association Bulletin #19-02 - Recommendations on the Use of Group O Red Blood Cells (Revised) (aabb.org)

This is from our SOP: