EDibble

This reminds me of a case many years ago, when an Rh pos patient with ITP needed a rbc transfusion. Hmm, strongly positive Autocontrol and then DAT. Eluate was anti-D. Even after several phone calls no one in the office saw fit to mention that the patient was being treated with WinRho. Beth

Agreed, and then, because we are a curious bunch, do our best to identify the antibody(ies).

I believe it is the Brigham. They got a lot of the victims. I knew a few people in town Monday, thank God all are OK. There was some potential for us (in New Hampshire) to get some cases if the thing had been a much larger event. Glad that did not have to happen.

I agree with AMcCord. Just how we do it here.

We use an Echo for our primary method. If we get a positive screen, depending on any initial suspicions we can glean from patient history and or the screen results, we run at least one Echo panel. (The D negative panel is a godsend to rule out everything but D in a prenatal Rh neg patient who got Rhogam!) Depending on the results of the first panel we either run another full Echo panel, or selected cells. We may use our backup method, tubes with PEG, if we need ruleout cells. As long as each methodology is QC'd appropriately, you can use the results from each. Just remember, of course, that reaction strength will probably vary. Apples and oranges indeed. :confused:

Malcolm, I have tried to come up with a way to explain the phrase, but words that will not get me in trouble elude me.

May I just add how much I *love* being in this group! :D

We do our cord testing in tubes. I wash once, just to make sure all clots etc are out (nurses are notorious for not inverting the EDTA tubes). This initial suspension is used for ABO and Rh testing. If the Rh needs to be taken to IgG, I then wash a drop of the suspension 4 times, decanting to the "dry button" each time. The same is done for the DAT.

Ah, an antibody on a trauma patient. Always fun! :cries:

Malcolm, If I ever develop a BB antibody, I am getting a medical alert tag!!

Interesting and upsetting at the same time! Is it IgG alone or AHG?

Agreed, that is quite a "responder" you have there!

Mabel, were you getting false positives with the previous version of the Immucor kit as recently as the fourth quarter of 2012? We found we had a problem with only one lot over one year ago. We were doing KB's on the positives, only to see no fetal cells on the KB. That is when we contacted Immucor. It has been fine since. Also, as others have pointed out, the test is *very* sensitive to pH.

Did you check the AABB website to see if the presentation is available? If you attended the session you should be able to access it at no charge. Beth

This year, as always, our hospital provided a holiday meal, gifts, and basic foods and household supplies for over 70 families in need. Talk about a good feeling! It is so sad that little kids ask Santa for sheets and blankets! Our lab is known as being extra generous, and we did an outstanding job this year. :clap::clap: :clap:

:eek::o absofraginlutely true!

We actually got the manual station before the ECHO and got quite used to reading reactions by eye, which has been a great asset when a specimen is running low, and we want to run just selected cells for rule out / rule in.

Same here regarding the DAT, but we also perform one on the pretransfusion sample, as well as repeat Type, Rh, and IAT on post specimen.

Like Kate and David, we are using MediaLab.

When we barcode our units into inventory (our supplier is ARC), we barcode the ABO Rh that is on the bag. When we retype the units, and put the results in the computer, if the tested result(s) do not match what they should be according to original labelling, it flags us and we have to resolve the discrepancy. For most patients, we perform electronic crossmatches, but the computer system will not let us choose ABO incompatible blood.

Our software, HCLL, will print out a sticker with patient info (as much as we have) on the label, and no indication that it is crossmatched. As a matter of fact, we have a stamp that prints "UNCROSSMATCHED" in caps and in red, so it is obvious that it is emergency released blood, either O neg or type specific.

Jumping on the bandwagon with everyone else. BTW, we also have a pick up slip with check offs for "Patient consent" etc, so it prompts the nurses to double check this before they come down to pick up the unit.

Liz, if it is like our own, the fetal screen is a test performed on a post partum , Rh negative mom's blood to screen for the presence of Rh pos cells. This is done when the baby is Rh pos of course. If the screen is positive, the quantative Kleihauer-betke is done. (I wish we had flow cytometry!)

We do the same, but with a 14 day out date. Again, they have to say they have not been transfused or pregnant within 3 months. We have a standard form, the patient answers, is witnessed by an RN, and both sign. We get this form in the BB

I agree.