Bill Sinn

this is a late reply... for units issued routinely to a med/surg ward, we check a returned unit with an infra red (validated) scanning thermometer.. range is 1-10 deg C. These units are considered to be in transit. We have found that most units out of the BB for 15 minutes will be warmer than 10 deg C. when returned. Units in a validated cooler have irreversible Temp indicators attached (6 deg C). They can be in cooler for 8 hours and are considered to be in storage.

Hi, I came to this thread late! Our Ortho polyspecific AHG contains Anti C3: both anti C3d and Anti C3b. Our monospecific anti complement contains only anti C3d.... so it is possible to get stronger reactions on complement coated cells with our poly reagent vs the monospecific. Bill

Similar to cthherbal's response, we also have designed the EPIC electronic blood ordering to ask the question 'Does patient have Sickle Cell Anemia?" when blood is ordered. the quesion and answer appear on the blood orders in blood bank. Rh, Kell matching for unsensitzed patients Add Jka, Jkb, Fya, S, s matching for a patient with any clin. significant Ab. Add Fyb only for known Anti Fyb or Anti Fy3

from medium size hospital.. Vitals: pre transfusion, 15 min, 30 min, post tranfusuion, Compliance: somewhat spotty

I have seen this "resting" period in other hospital's SOP's from time to time. It says that platelets should be agitated for 10 minutes after transport or upon receipt back in the blood bank after issuing. I have never found a reference for this- not in AABB,CAP, Circ of Information-- nowhere. One hospital that had this requirement could not provide a reference for me, either.

My experience with the SafTVue 10: Make sure both the RBC unit and the indicator are COLD when applying indicator. Work quickly. Apply in the middle of the unit (the fat part). Don't hold the RBC unit in your warm paw, especially the are where the indicator is. Don't know what "inside appropriate porter" is.. We have had very good experience with SafTVue 10 on RBC units inside a validated cooler with cold refrigerant packs.. up to 8 hours. If RBC is left at room temperature, the indicator will turn to red within 10 to 15 minutes. Bill

For SunQuest 7.1, we are using Print Tek PrintMaster 862. This is for a 2 part form, regular paper (not card stock). Works great. .Bill

Oh, Most Knowledgable Blood Bankers.... Is there a reference for the answer to this question? A unit of frozen plasma (FFP or FP24HR) expires at midnight. It is thawed at 2200 hours on the day it would expire. Usually, thawed FFP or FP24 is good for 24 hours from the time of thawing. Is the expiration of the thawed product 2400 (midnight) or 2200, the next day (24 hours)? This is NOT a 5 day plasma question ;-). Thanks in advance, Bill

We only QC the new lot with the new controls that come with the kit. I don't think there is any requirement to do this crosschecking with controls from the old kit. In any case CAP TRM.31350 states "If there are multiple components of a reagent kit, the laboratory uses componenets of reagent kits only within the kit lot unless otherwise specified by the manufacturer." Bill

Mabel, Cells 8 and 10 on that lot of Panel A are the only cells having homozygous expression of N. Bill

Getting back to the original post.. for a cold agglutinin reacting in a gel Ab screen, we have had some success in "prewarming" the test system--the patient's plama, the gel card, and the screening cells pipeted into the gel card-- and then pipeting the plasma into the card. I know the card will cool down to room temp. during centrifugation , but sometimes this will work, and you can demonstrate a negatvie Ab screen. Bill

Laura, You do not need to perform a full panel. You need to test sufficient cells to rule out other clinically significant antibodies. For instance, if patient has anti Fya, we would probably test all the Fya negative cells on a panel, and see what still needed to be ruled out. Usually, on a well designed panel, other antibodies would be ruled out by testing the Fya negative cells. You may need to run just 2 or 3 cells in addition to your negative Ab screening cells to rule out "others" when the antibody is Anti K or Anti E. Bill

We do as Dr Pepper, above. The original CAP requirement from about 8 years ago allowed performing rechecks for non Group O patients only, and this would satisfy the requirement. The CAP wording has since changed, but we are still doing rechecks (2nd stick) on NEW non Gp O patients only. Again, this is to prevent major ABO mismatch. Bill

There are probably several differences. For instance; Issuing blood products.. CAP "the procedure for signing blood.. out.. provides adequate protection for the potential recipient." TRM.40900 AABB "there shall be a check of..(lists several separate items)" 5.18.2 limiting ABO incompatible plasma including platelets: CAP: for infants only TRM.40740 AABB "shall have a policy concerning transfusion of components containing significant amounts of incompatible ABO antibodies." --implied for all patients. and so on... Bill

We use SafTVue 10 for units going to surgery in an ice chest. If you want to monitor units issued to nursing floors, you would probably want to use STV 10, because the standard is 1 to 10 degrees (transport). My personal experience with STV 10 is that the indicator will change on an RBC unit much sooner than 30 minutes at room temperature. Again, this would be an expensive proposition for each RBC issued routinely from the transfusion service.

OK, but what about this scenario (and it has happened). Patient has been inpatient for some while, crossmatches done every 3 days.. patient is A Pos. Early AM, after previous crossmatch sample has expired, patient needs blood emergently. Issue uncrossed O neg or uncrossed A pos that a few hours earlier was completely acceptable for this patient?

Brenda, We use the SafTVue 10 for RBC's issued to surgery in ice chest. We do not use them for FFP. The plasma units are usually close to room temperature by the time they are thawed, and would have to be cooled down below 6 degrees C before applying SafTVue. I would be cautious in switching to SafTVue 6 for blood products. I find the SafTVue 10 to be fairly sensitive. In reading between the lines of the product info for the SafTVue 6, I think they would be very sensitive and would change to red much more readily than the "10". We are already quarantining some units each month with SafTVue 10, and I would think this would increase if we switched to "6" For platelets.. if we are can make a reasonable assumption that they were at room temp after issue, we will acept them back, even more than 30 minutes out of department. Bill Sinn

We do AHG crossmatches in gel for patients with Anti M. We do not screen units for M antigen. It helps to find compatible units if you prewarm the gel card, the donor RBC suspensions in MTS Diluent, and the patient's plasma before combining in the gel card. Some of these compatible units may have heterozygous expression of the M antigen, but we don't care. Bill Sinn

This has probably been discussed before, but once again... Transfusion of a blood product must be completed before the expiration time of that product. Agreed? Do you have policies about how close to the expiration time blood products can be issued from the transfusion service? Plasma can usually be infused within 30-45 minutes. Would you issue a unit of thawed plasma 25 minutes before expiration? RBC's one hour before expiration? Do you instruct nursing staff to infuse until the expiration time, then stop the transfusion whether the unit is completed or not? Just seeking ideas...

TRM. 30575 was still on the checklist with which we were recently inspected. We were cited as deficient because, while we were doing a 2nd ABO/Rh on a 2nd sample (separate phlebotomy), we did NOT do this for Group O patients. We would transfuse Group O's with group O blood anyway! In answer to the original survey question ofthis thread, #4, 2nd sample does NOT need to satisfy all blood bank criteria for ID, labeling, ets.

This is a new item, and we will have to change our SOP's. We have not been doing an actual crossmatch of auto units. It has not been previously required by AABB or CAP, to my knowledge. We were doing type and screen of patient, confirming all ID on patient sample and auto labeling agreed, and doing the ABO ang Rh of the unit.. making sure they agree, of course. I wonder what the CAP's concern is?

this is an interesting discussion of an interesting new CAP item. The item trm.42110 asks about a "plan to reduce the risk of" TRALI.. not recognition or reporting of. I think we will emphasize whatever our blood supplier is doing in this regard AND emphasize proper usage and indications for plasma, platelets, etc.