macarton

We are one of the first BB's to go with gel in 1995. We had issues as you described on all cells for a spell and started storing our gel cards in the refrigerator and eased the problem. We keep cards at RT that we are testing with. We are also seeing occassional cell 2 haziness that most of the time if you run a tube cold screen will explain the issue. We also do antibody screens on all OB's coming in L&D.

Welcome to you both.

I would have given E negative cells. I would take the gel results over the tube. We have gotten where we run a ficin treated set of cells on all of our panels. We see the type of reaction you are describing on the untreated panel requently and the heterozygous cells will be a strong positive on the ficin. We use the panel C using gel for our panels.

We have a box back in our walkin, not in BB that we keep our expired antisera and panels in. It has a big label that says for student use.

We use a postive and negative control cell when ever running outdated panels

We keep our old panels for ruling out also. We also have students that we will give or make up a multiple antiobody samples, so they can go through them & rule out.

We do the same, offer a urine protocol. If the UA has mod to large epi's, a new UA is ordered and the culture rejected on the first specimen even if the WBC, Nit, bacteria pos. It took a while to work that out in Meditech.

We run the 5-8 cells indicated on the Ortho panel on all Rh negative OB's coming into L&D with a comment, not screened for D. If the infant has a positve DAT, we do an elution and report the antibody if eluted.

1. OR has runners who pick up the blood in coolers. We don't require RN's to pick up, nor for floors. 2 RN's/docs have to verify blood before given. 2. We have a phlebotomy team that does all draws. Lab draws any outpatients. 3. RN's do line draws. 4. Nursery draws 5. We have a survey form & if patient has a history of antibodies comes w/i days of surgery & gets collected & we do 2 units antigen negative. If a new patient w antibodies, we find units & either have patient come back in w/i 3 days or day of surgery depending on distance they live from hospital & crossmatch them.

We switched from the Vitek Legacy to the Microscan 96 about 3 years ago and have been happy with it. We have a lot of non-fermenters and had about a 30% repeats before going to the Microscan.

We've used the Meridian STEC for a while. We test from the GN broth. We've had a few positives, most have been non-0157 lately.

just a thought on this, I had a high school friend who started chemotherapy. She had a history of a low HCT to the point she was rejected as a blood donor. A few weeks after the chemo was started we started transfusing her with leukodepleted red cells. Shortly after her 3rd transfusion visit, she became gravely ill and died from a CMV infection. The question at that time was did she have a previous infection to come back or was it from the blood?

The 4+ reactions on all screening cells seem to be more prominant since an update a few months back. One of the selling points used by the sales rep was that it didn't pick up colds. Like Tony, we've checked some of those with a negative gel at 4 degree and are finding colds. Mary

We do the same as Cathy. I have the procedure in my manual as we have MT & MLT students. We occassionally, really rarely have to use it.

We have a Sanyo refrig and freezer and have been very pleased with them. We have a couple of Revco and FTR (also made by same company) and have issues with them. Only complaint I have about our Sanyo refrig is that the small finger holes on the inside door will almost break your fingers sometimes.

We started using individual coolers several years ago kept in the room which surgery returns after the case. We had one of the docs in OR who grabbed a unit out of the refrig and gave it to the wrong patient and they now use the refrigerator for tissue transplant. CV post surgery has a refrig that the blood goes to after the case and one of the personnel brings the leftover blood down the next day.

After 9-11 our former blood supplier was constantly on the news here in Alabama asking for donors, esp O negative & O positive. I was getting calls from the public and I asked them to wait a couple of weeks and go to our LifeSouth center in the hospital and that we will really need the blood later as there won't be donors available during the shortage that will follow.

We use coolers for all our surgery cases and will send up red cells and FFP at the same time for our CV cases. We keep a thermometer bag in the cooler and we have a time or temp at which we will change out the ice in the cooler. Pheresis will be sent up in another container.

Our supplier is wanting to increase our supply to cover the NW corner of Alabama in an emergency. Right now we keep 100 O pos, 30 O neg, 80 Apos, 24 Anegs and B pos, 8 AB pos, neg and B neg. We are a 400 bed facility and the blood for our other hospital comes to us and we supply and rotate them out as needed. All retypes are done by us when units logged in. Right before the tornadoes hit south of us, there were some TVA transmission towers knocked down in the early morning that cut off electricity to Huntsville and Decatur areas. Lifesouth called and sent us a large shipment. When the tornadoes hit that afternoon, we were glad to have the extra as we still had to place an order the next day.

We had a similar case. Turns out the patient was given Rh positive cells at another hospital a few weeks earlier.

We see this type of reaction frequently with the Echo. We repeat the screen by gel and report the reaction we get with it and do workups by gel if indicated.

Our policy in a shortage is all males and females over 55 will get Rh pos of their ABO group. We use a rating system in trauma cases. We are level 2, UAB and Huntsville Level 1, so the worst cases went there. LifeSouth our blood supplier was on a generator plus had refrigerator problems for 6 days that started in the AM. The worst tornado's occurred that afternoon. Thy had divided up a lot of their blood between the hospitals in North Alabama which came in handy later after the victims started in. A code D was called the night of April 27 with the media and we had several employees which came in to help. I was on vacation getting ready for my high school reunion that Saturday, part of it was a visit to my house before the main dinner for lemonade and cookies. What could go wrong did during the entire week. I have 2 stories about that on GRIT magazine at GRIT.com, blogs, look for Rosedale Garden. I have several links to stories about the tornado's there and also on my Mother's Day post. One link I have here is that some of the first responders went through: http://www.timesdaily.com/article/20110509/NEWS/110509796/1011/NEWS?Title=Doctors-set-up-makeshift-morgue-after-tornado-strikes-Franklin-County-town

We have given a large number of Rh positive units to Rh neg over the years due to emergencies or shortages. I can only remember 1 coming back in with an Anti D. We had a series of tornados to wipe out a couple of towns in NW Alabama on the 27th of April. We are the largest hospital in this part of the state. Several trauma cases came into the small hospital nearest the area and the critical patients were shipped to us, Huntsville Hosp and UAB. Our smaller sister hospital was scolded because they refused to send their 6 O neg's to the hospital nearest the destruction. They were also transferred patients. The local command center said that they should be the ones to make a call when our O neg's & our sister hospital would be sent. Our administration has nixed that.

We have LifeSouth as our primary and United Blood Services as our secondary. We find UBS very helpful through the years even though we are not a full time customer.

Our refrigerator in OR is now being used for tissues for transplanting. We stopped using it after one of the docs got a unit out and transfused it without looking at the patient information and gave the unit to the wrong patient. Mary