JOANBALONE

I agree with Rh Fan - If you use Elu Kit read the Limitations section (#9)of package insert. JB

We give them the band to take home with instructions to bring back. We draw up to 14 days in advance of surgery. JB

Our criteria for plasma is a return temp of 1-10 C, however I may obtain pathologist ok to return to inventory if return temp is >10 C. Criteria for returned cryo and platelets is based on time as long at the return temp of the product is 20-24 C.

We take the temps of all returned red cell units from all patient care areas that do not have approved storage devices and only return red cells to inventory if the temp is 1-10 C. We affix a Safe T Vue 10 indicator to all red cells if sending to patient care areas with approved storage devices and determine if red cells can be returned to inventory based on the indicator. We have different acceptance criteria for platelets, plasma and cryo.

No, it is not a requirement.

We discourage handwritten labels. Computer labels are OK! We also require a BBID number. JB

I agree with Galvania's answer in the light that the patient has never been transfused.

I agree with David, train them well and it will work. JB

I work in a large hospital system in the midwest USA. I have seen several severe HDFN cases due to anti-K in the last few years. Some physicians are beginning to request K negative blood for females of child bearing potential. Eventually, I think it will be routine to give K negative blood to females of child bearing potential. JB

Hi John, I don't consider this treating OB patient's any different than others. Anti-D is expected (and in my opinion, clinically insignificant) in these patients that have recently received RHIG. We just modify our antibody screen (using the cells designated by @) to rule out all other antibodies. JB

Perhaps you can add to your procedure that if patient has received RhIG in last 3 months that the cells indicated with @ may be used to rule out unexpected antibodies?

Hi Lisa, You routinely rule out on heterzygous cells all day if you use a 2 cell screen. If the patient has recently received RhIG it is expected to be in the plasma. I have no problem using the cells designated with @ to rule out any unexpected antibody even though some may have heterozygous expressions (just like the screening cells). I consider the cells designated with @ as an extended screen. What does your antibody identification procedure state? JB

Hi Lisa, Do you run a 2 or 3 cell screen? JB

And washing blood removes all antigens!

What is the age of the patient?

We will perform an antibody screen on baby (not mom) as part of the pretransfusion testing.

We see this several times a year. I agree with David, a lot has crossed the placenta. JB

I agree with jayinsat. I haven't labeled a retype tube in 20 years. I retype only the same blood type at one time. JB

You may also want to perform a complete panel.

I agree with David and Clarest and have recommended one vial of RhIG in such cases. JB

I agree with Shelby56 for the reasons she posted. JB

I agree with Lara.

I think it is the platelet. Ask the blood supplier to titer the isoagglutinins.

Hi Brenda, If patient qualifies for electronic crossmatch we wait to crossmatch until a unit is requested. If a type and screen is ordered and the screen is positive or there are other serological problems such as ABO discrepancy, we automatically set up 2 units of blood (we don't call the physician). I don't know if this was ever evaluated for cost effectiveness at my facility but I feel it is the right thing to do. Our C/T ratio is a little over 1. JB

I am with Brenda on this one. Don't assume anything.