CMCDCHI

We visually interpret the equivocal results here too. It took some coaching for our staff to get comfortable. Last year our equivocal rate kept increasing. Our instrument was 7 or 8 years old and it eventually died. When we replaced the instrument, the Immucor technical specialists spent a lot of time with our techs explaining the technology and what causes the instrument to throw up a "?" Take advantage of having those resources- it is what finally got our techs comfortable.

We are working with our HIS team to get pharmacy orders for DARA to print in the blood bank as well as a "heads up" that there is a new patient on the drug. So far, oncology has been great about communicating with us.

AABB just release a statement supporting genotyping on patients with "weak D" phenotypes to determine if they need RhIg and/or Rh negative units. Now just try to convince anyone that it's worth the cost....

There was a session at AABB that was somewhat contentious regarding storage/transport temps, validations, etc. One of the presenters said that they do the exact thing described by NewBBSup. If I can ever figure out how to retrieve my Sync-to-Slide, I'll verify! I managed to scribble the session number down: 9108-QE.

thank you all for your replies. We are planning on keeping it. Isn't budget time fun?

My facility is currently AABB accredited. In this environment of everything being scrutinized for expense, I've been asked to justify AABB accreditation. I think the inspections are much more rigorous than CAP, but otherwise, I can't put into words why we should continue. If we did not continue our accreditation, we would still buy the standards and follow them, we just wouldn't have the inspections and stamp of approval from AABB. Give me your best argument! Thanks.

We had a pretty massive downtime last week (about 15 hours!). We completed the recovery and everything was entered into the LIS and double checked. How long do I need to keep the original paper test records, if at all?

We got some insulated lunch bags and pack the units between room temperature gel packs that we keep on the platelet rotator. We validated that they keep platelets at the correct temperature in both warmer and cooler environments. We also do all of the checks that Goodchild talks about when they return. In the 29th ed. of AABB standards, the wording for transportation temperature was changed to "As close as possible" to 20-24C. I know the argument... that this is really storage... but at least there is some room for common sense.

I always love an article that talks about blood banking, but since when is anti-D rare? http://www.npr.org/2015/06/14/414397424/man-with-the-golden-arm-donates-blood-thats-saved-2-million-babies?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20150614

The only time I have ever known of A subgroups to matter is when they cause a type discrepancy or in the case of kidney transfusion. I remember doing anti-A1 titers on a potential kidney recipient to see if the subgroup recipient could tolerate an A1 donor.

Same as David.

Sounds like you did well in the middle of a very trying situation. I always try to remember that the people actually in the room with the patient are in the midst of crisis and doing their best. After a massive transfusion situation recently, the OR returned some unused products. The platelet was returned on ice, and our brand new (expensive) cooler was broken. It can be so frustrating. We just lost a mother in L&D last week. Most likely blood products would not have helped, but the emergency issue blood sat down in the lab for longer than it should have because they were expecting us to bring it to them, when it is the policy that someone from the unit comes to pick it up. Hopefully some important lessons will be passed on in the spirit of continuous improvement.

We do a "short panel" (the @ on Ortho panels or [ ] on Immucor panels), call it passive anti-D probably from RhIG. We do not require AHG XM.

We create our own baby aliquots with syringes, fully labeled, in the blood bank. BUT we also have a policy that says when the NICU comes in breaking down the door, just give them a unit and a syringe and what they do is up to them. We provide the syringe because it has the in-line filter. I had never even considered the labeling of the syringe once nursing has it. This is an interesting discussion!

We kind of skirted it by saying our policy is to contact our reference lab for guidance. We'll see what they think on our next AABB inspection!

We charge both.

We have our pathologist give approval.

RaeRae251, I would also say it depends on what your reference lab is going to do. Not all RLs are created equal. I would not send the sample in your example. Our local RL doesn't use gel or solid phase, so it's not uncommon to get a response of "we couldn't replicate your reactions."

I always read that standard that panels needed to be kept forever, but someone just pointed out to me that you have to keep the results of antibody ID indefinitely, but not necessarily the work it took to get there. So, if you have a record that says "anti-Fya", that needs to stay indefinitely, but the panel that led you there only needs to be kept for 10 years.

When I worked in a reference lab, we had certain patients that we just always tested using LISS rather than PEG for exactly the reason you mentioned. The PEG seems to cause precipitates.

Gel is currently our back-up and we see this occasionally. If we get a negative gel screen and panel, we call it negative.

We also have Translogic/Swisslog and have an auto-return feature we are going to use with the secure send feature. The nurses must scan their badge to get the carrier to release. If no one scans their badge in 10 minutes, the carrier will return to the blood bank. Of course this all sounds great but we have not been able to use it yet. We moved into our new hospital over a month ago and Swisslog is still unable to work out all of the bugs. Until it is smooth sailing we are afraid to put blood products in the system.

We are about to go live with a new p-tube system and we have done temperature studies to all of the stations to show that there are no hotspots. Is there anything else you are concerned about as a "safe product"?

We have sent blood via helicopter/ambulance as well. My only follow up is to be sure that the authorization for uncrossmatched blood is clearly documented.

I've wondered about this myself, especially when we are thawing for a massive protocol and have 20 other things to do at the same time. I would agree that 30 minutes is too long. We usually do about 16.