R1R2

For a smaller hospital that does not "prepare" components this could apply to FFP that is thawed and a clot is present what steps do you take.

what is the standard?

I am curious about why the 30 minute gap between samples?

I was told that there are signatures of acceptability on the document.

Sounds like a leaky segment. Do you get the bag back so you could investigate? I would document this incident as a safety event.

Anytime you add humans to the process you will have manual result entry errors and WBITs. My suggestion is to document the errors and discuss with you one up and quality person. You are doing a lot of TASs to warrant an interface IMO.

These are just a couple of CAP requirements that deal with result review: GEN.43825 Result Verification - Manual and automated result entries are verified before final acceptance and reporting by the computer. An audit after the fact would not satisfy this requirement. COM.04100 Deals with Supervisory Result Review and all results need to be reviewed within 24 hours if high complexity testing is performed by trainined high school grads. It would also be a good idea to audit a percentage of results after the fact too if you are manually entering results into an LIS.

can we assume you are doing serological crossmatches on everyone (which would confirm your 1 and only blood type, sort of)?

I just answered this question. My Score FAIL

I am OK with ruling out the presence of anti K with single dose cells. I think I have seen anti K showing dosage only 1x in all m years of BB.

THANK YOU FOR THE INFORMATION

Stupid question - why is group O whole blood better than group O pack cells and group A thawed plasma?

sounds neat and tidy. No handwriting anything!

and a blood warmer would probably be over kill in this case

Does your laboratory staff have the necessary procedures to follow for this scenario? I think flow charts work very well for things like this.

HI Kathy, any follow up for this patient?

Am I the only one that thinks that performing lot to lot with ABLA Q is not required?

plain bags here.

I am not a BBer and don't have a policy to share but I am sure others here can share.

I would use plasma from patients that have produced those antibodies instead of antisera. The commercial antisera is usually not IgG.

I think because Rh antisera is usually not IgG and will agglutinate with cells in buffer cards so it is really not QCing the IgG activity in your IgG card.

In my experience I think a lot of Blood Banks don't know or know but continue to use fetal bleed screens on prenatal specimens. Big pet peeve of mine.

I remember seeing a blurb about QCing each methodoly in use but can't find it in CAP. It might have been somewhere else. But CAP does say that QC is required for only 1 vial reagent/lot in use TRM.31400 Antisera/Reagent Red Cell QC Phase II There are records of acceptable reactivity and specificity of typing sera and reagent cells on each day of use, including a check against known positive and negative cells or antisera, or manufacturer's instructions for daily quality control are followed. NOTE: Unless manufacturer's instructions state otherwise, the following apply: ■ Each cell used for antibody detection must be checked each day of use for reactivity of at least one antigen using antisera of 1+ or greater avidity. ■ Typing reagents such as anti-D, anti-K, anti-Fy(a), etc. must be checked each day of use. ■ Anti-IgG reactivity of antiglobulin reagents may be checked during antibody screening and crossmatching. ■ Typing sera and reagent cells must be checked for reactivity and specificity on each day of use, including a check against known positive and negative cells or antisera. This checklist requirement can be satisfied by testing one vial of each reagent lot each day of testing.

Below is the exact text from the guidelines. I agree that potentiators added to the reverse group may detect non ABO antibodies in addition to the ABO antibodies but who adds potentiators to reverse group routinely? One reason that anti c is mentioned may be that reverse group cells are usually Rh neg. I have seen strong IgG anti c react in reverse group with no potentiators. Other reverse grouping anomalies: Potentiators in the reverse grouping reagents may cause IgG antibodies such as anti-c to be detected in the reverse group.

keep us posted