NAN47

That's a great response thanks Malcolm, and I look forward to reading the updated guidelines, many thanks Tricia

Hi there I am interested in hearing people's opinions on which antibodies required to be titred during pregnancy, and Also any other info which is considered to be important in the antibody titre process, ie running against a standard or previous sample , and also any important points which should be considered in the reporting of titres. Many thanks Tricia

Thanks Malcolm, I completely agree that assumptions should never be made on such things and I will be sure to raise this issue, so basically what is being said is that if a positive antibody screen is detected at the 28 week screen for anti-D that this should be sent for quantification even if the patient has recently received Anti-D Ig for a sensitising event earlier in the pregnancy? Thanks for your thoughts

Hi all, I have been reading over these new guidelines and am interested in people's thoughts on the following paragraph There have been several cases in the UK where immune anti-D has been mistakenly assumed to be prophylactic without a validated method of measuring the strength of serological reaction or taking into account an accurate history (2010 SHOT Annual Report). It is important therefore that regardless of any prior administration of anti-D Ig, any anti-D detected at 28 weeks should be quantified and the results made available in the woman’s hand-held and hospital records. At present we do not send patients sample away for quantitation if they have been recently given anti-D and presume that it is prophylactic anti-D that we are detecting, is this a common practice in other hospital blood banks? Thanks

Hi , We currently use the XN series, we have the XN9000, which is a track made up of 9 modules, and include 4XN analysers. We have been using them for around 8 months, and I have found them to be reliable with a good throughput of samples. We previously had the XE series and they are as good as them but with added improvements.

Thanks, We are now being asked to process every sample received into the department even if we receive multiple requests for the same patient on the same day and I am struggling to see the logic in this.

Thanks for that, We are being asked now to process every sample received into the department, even if we have multiple requests for the same patient on the same day....I am struggling to see the logic in this...!

Hi , I am interested to know how other blood banks deal with duplicate requests being received into the lab. For instance if there is a valid group & screen or cross- match sample in the lab and a further sample is received , how would the second sample be dealt with? Many thanks

Hi , I am interested to know how other blood banks deal with duplicate requests being received into the lab. For instance if there is a valid group & screen or cross- match sample in the lab and a further sample is received , how would the second sample be dealt with? Many thanks

hi could anyone tell me whether it is a requirement by law/ or in national guidelines that blood transfusion samples require to be signed ( on the bottle) thanks

could anyone tell me whether it is a requirement by law or guidelines for blood transfusion samples to have a signature on the bottle thanks

Hi everyone I am currently providing some input into a new training manual which is being prepared for the blood transfusion laboratory. Basically this manual involves lots of theory questions and then the assessment of the individuals ability to perform a task and achieve a level of competency suitable to working unsupervised during the out of hours service. I would be interested to know how other laboratories achieve such an aim, in terms of what methods are used to demonstrate a persons competency...ie witness statements, reflective learning statements . My thinking is that instead of lots of theory questions, to produce worksheets such as identification of blood groups from serological reactions etc Basically I am looking for interesting ways to provide documentary evidence of an individuals knowledge, but which is also achievable within a busy laboratory environment. Grateful for any thoughts Thanks

Hi everyone I am currently providing some input into a new training manual which is being prepared for the blood transfusion laboratory. Basically this manual involves lots of theory questions and then the assessment of the individuals ability to perform a task and achieve a level of competency suitable to working unsupervised during the out of hours service. I would be interested to know how other laboratories achieve such an aim, in terms of what methods are used to demonstrate a persons competency...ie witness statements, reflective learning statements . My thinking is that instead of lots of theory questions, to produce worksheets such as identification of blood groups from serological reactions etc Basically I am looking for interesting ways to provide documentary evidence of an individuals knowledge, but which is also achievable within a busy laboratory environment. Grateful for any thoughts Thanks

Thanks guys for that info - will have a look at those articles, any other scenarios will also be gratefully received. Thanks Tricia:)

Hi Everyone, I am giving a presentation on Haemolytic disease of the newborn - i will be presenting a case study in which i was involved, which looks at when the management of pregnant ladies with antibodies goes wrong. ie my patient case involved a woman with an anti-D being induced during the out of hours service on a sunday afternoon when no blood provision had been put in place for the baby -who had a hb of around 60 at birth, trying to illustrate how communication is vital in the management of pregnant woman with antibodies. I was wondering if any of you guys out there have any interesting experiences of patient cases where something has went wrong due to lack of communication etc surrounding patients with maternal antibodies which i could incorporate into my presentation. Many Thanks Patricia Bradley:)

I am not sure what the general rule about haematology patients but i do know that patients with auto-immune haemolytic anaemia are excluded due to the presence of auto-antibodies, patients with a positive DAT are also usually excluded and due to the fact that many haematological conditions can affect serological testing ( ie myeloma patients and weakened blood group expression etc) this would require manual input into the process and would therefore result in these patients being excluded also.

Hi guys thanks for the posts can i ask a specific question with regards to pregnant patients - are these patients still eligible for electronic issue? in addition i appear to have come across conflicting data with regards to the eclusion time of post transplant/stem cell transplant patients receiving an ABO incompatible transplant. - have come across a source stating an exclusion period of 3 months and another which states an exclusion time of 1 year for these patients - could anyone clarify this for me? thanks

Hi everyone, I am giving a presentation on Electronic Issue next week to my peers and was just looking for any suggestions, advice or ideas on any issues which arises from using electronic issue. My presentation involves looking at the risk assessment of the process, positives and negatives of electronic issue/retaining IAT crossmatching, MHRA's stance on E-XM, and how electronic issue works in hospitals which currently use it. Following the presentation there will be a question and answer session and if there are elements of the process etc which I may not have considered and may be questioned on. Thanks in advance

Hi Malcolm, thanks for that - on our chart 1st choice is group B, second choice is AB and third choice is group A, our chart doesnt give the option for group O, thankfully my gut instinct was not to give the group A cryo and I called my lab manager to confirm what the other peer suggested and she agreed with me that it wasnt the best option - so I ordered down some group B paediatric cryo from our regional transfusion centre and special care was happy to wait for the product coming over!. Was just one of those situations which can only happen at 3am!! however i have learned from it!! thanks again Malcolm! tricia

Hi All, I have a question regarding something which occurred on my nightshift last week - there was a premature baby who required blood products, the baby was a B positive , however we only had group A and group O paediatric cryoprecipitate in stock. The baby had had a pulmonary haemorrhage, on advice from a peer i thawed a group A unit of cryo, however when i tried to issue it through our computer system it wouldnt allow me to due to ABO incomaptibility. From the guidelines i noted that group A was third choice and was really for emergency use in adults. Therefore my question is, is it safe to issue group A cryo to a group B premature neonate? thanks in advance for any advice Tricia:confused:

Hi everyone, I just wanted to share with you all the good news that I was successful in my higher Specialist Diploma in Transfusion Science! I wanted to take this opportunity to thank everyone for the help and support which I received from you all whilst undertaking my examinations. This site has been an invaluable source of information and support and most definitely helped me through my course. I would like to say a special thankyou in particular to Malcolm Needs and "fluffy agglutinates" - your advice has been much appreciated. I will continue to recommend this website to my fellow colleagues, and will continue to make use of the website myself, as i continue to gain more knowledge in Blood Transfusion. Many Thanks Patricia:)

thanks for that Malcolm, Glad it wasnt something that I was missing. helpful as always! tricia

thanks for that Malcolm - hope If it is a typo that I get extra marks for noticing it ( every little helps!!!) ha, ha. kind regards Tricia

Hi there, I have previously mentioned that I sat the IBMS higher specialist exams this year and had a query with regards to one of the case studies ( case study 2) . In the case study donor 2's phenotype appears to be negative for both C and c, the past papers have now been published and I have attached a copy, just in case there is something more complex going on that I have missed. Any comments appreciated. many thanks Patricia CH] HSD-Trans-2010-papers-3-4.pdf

hi fluffy, Am really not sure how I got on - I didnt run screaming from the exam hall when I looked at any of the papers so I am hoping that is a positive!. It was a really good learning experience to go and sit the exams and even if I am unsuccessful this year I will definitely do them again next year. I feel that there is so much to learn and that I have gained alot of knowledge which I will hopefully continue to build on. Only 3 of us sat the Transfusion exam this year!! This site has been an invaluable resource of information and advice and i enjoy reading all the interesting posts. kind regards Tricia