ejsommers

Annadele I am going to assume that your question is more than the answer I am going to give but here goes: "Passive" simply means that the Anti-D present in the Mother is due to the injection of RhIG rather than the Mother having a "real" Anti-D due to Rh sensitization.

Malcom - good point but we still do ot work up PLT or FFP products - just RBCs

Our policy is "two sides must agree within 4 cells if the count is <50 or within 10% if > 50." At 50 cell 10% is 5 cells, if less than 50 we revert to agreement +/- 4 cells.

Same as Deny above...Docs order the work-up and BB takes it from there. If testing does not show the need for RhIG we footnote the work-up that the "RhIg is not indicated for this patient."

Same as Bill. We have RN's, LPN's, PCA's, and ward clerks checking out blood - with training. Docs never come...but could.

If multiple products are hanging we would only work-up a transfusion reaction for RBC's. We do not work-up PLTs or FFP.

Hey group - I am curious if CLIA dictates WHO that second draw person should be - i.e. does it have to be a different person than the person first drawing??

Liz - our confirmation is a non-charge test and it is forward grouping only - ABD. The Rh control is only run on AB+ patients.

The majority of our cord bloods are Rh- Moms also. We may get the occasional cord blood work-up (AboRh/Dat) from an Rh+ mom if the baby's Bili is on the rise.

Mabel - I think Dee said the assistant was retyping patients w/o a hx and not retyping units.

Hmmmm - our procedure doesn't specify a post-partum collection time - only that the specimen is stable 24hrs if refrigerated. I think my BB super is going to ban me from this site!!! I keep questioning things (yes, a GOOD thing). Adding THIS issue to my list!!!! We use the Immucor FMS...

Same as many above. We only do Du testing on cord bloods and RhIG moms.

We only report smudge cells if the dx or other clinical indicators point to CLL

We only do Du testing on cord bloods and babies

Regular antibody panel here.

We validated our method with the Igloo Cooler packed as follows: 2 frozen bottles along both sides, 1 refrigerated bottle along the back panel. The rbc's - up to 6 - are contained in a plastic container in the middle of the three bottles with a refrigerated soft gel pack on top of them. This set-up will maintain an acceptable BB temp range for 6 hrs. Of course, we use the Hemo-Temp sticker on each unit to verify they never went out of range.

We send a Lab Assistant to all traumas with a cooler of 4 type O RBC's and 2 AB plasmas - to start with. That lab assistant stays with that trauma - all the way thru surgery if required - until released by the attending doc. We have the RBC units labeled as "uncrossmatched." We do not have any patient labels tagged directly to the unit. There is an emergency release form pre-labeled with the unit numbers and then labeled with the patient ID - either the name or ECC UNK + a rolling number if not ID'd. The Lab Assistant coordinates the distribution and documentation of the products and calls down for more products to be sent up if needed. The emergency release paperwork is signed by the doc and brought back to the lab where the usage of the products for that patient is updated in the LIS.

We will issue multiple products in an emergent situation with the same monitoring and restrictions as folks have described above. In a non-emergent situation will will issue multiple products only if there are two lines that are going to be used and both products will be hung at the same time. We would issue 1 FFP and 1 PLT but not 2 and 2.

We draw up to 14 days in advance if not preg or transfused in last 90 days AND no known Ab Hx. If any one is a 'yes' then we draw no more than 72 hrs in advance (prefereably the day before). If an unexpected Ab is found in someone drawn more than 72hrs in advance we ID the Ab on that specimen and set antigen-typed units aside. That patient would be redrawn and repeated the day of surgery using those Ag-typed units.

We do the same....we keep TWO AB plasmas thawed at all times for emergency release situations. Two plasma and four Rbc's are initially sent up to a trauma when we get the page. We are usually waiting there with the products in a cooler when the trauma patient hits the door. If the plasma has not been used and it getting close to the 5 day expiration we give it to the first plasma order that comes down and re-thaw two more AB's. Occasionally we get caught with expired AB's (like we did this morning) but not very often. ANY waste is a shame but it is worth it to have the pre-thawed product on-hand and ready to fly out the door when needed. We have emergency release paperwork for the physician to sign in the emergency situation so the product can leave the BB almost immediately after the call comes in for a trauma. The floors can typically wait the couple minutes it takes to "assign" the plasma which can usually be completed before they can get to the BB if they call ahead and let us know.

Our cord bloods come down labeled with a nursing unit patient label. In addition to all the identification info for the baby this label has the Mom's first name and FIN on it to use as a tie back to the Mom.

I wouldn't want to be that patient that came in the door WITH the Anti-D

I understand the theory behind the O Pos for males and females 55+ but I don't like it. We have the same policy here. I have had 3 instances of patients with Anti-D where we sent up O pos blood. Luckily, I was able to intercede before any units were transfused. I think you should switch over the heavy users to O pos but O neg should be initially sent to the ER until a negative screen can be determined. Just my opinion but I know it's not the official standard.

Our method states a type has to have been done within the past 30 days

We also use 72hrs for inpatients and 14 days if no pregnancy or transfusion in last 3 months OR any known antibody hx. If any one requirement is not met we draw "no more than 72 hrs before surgery."