Kellimq

Sonya Martinez,
Where are you going to get the COVID-19 convalescent plasma?  I had a physician inquire about that this morning.  I don't think our normal providers will have that as it is still considered "experimental."  
Thanks!

Blood shortages are a big problem in parts of the US. Donors are not presenting, drives are being cancelled. Those patients who normally need blood products will be affected by that. I can't speak to Covid19 patients specifically...yet. We have been asked to reduce our stock by 25% and cut usage by 25% so that blood products will be available for those who need it most.

My best guess and it is nothing more than a guess, is that if these patient's require any support from the transfusion service it will be due to a preexisting condition and not the direct result of the corona virus.  I don't recall in all my years, of any patients with pneumonia requiring a transfusion due to having pneumonia and I understand that pneumonia is the primary reason for hospitalization here.  Now I may be way out there on this but only time and experience will tell.    

I'm currently working on building the convalescent plasma product codes into our computer system in case it is needed/wanted.  But I'm in a children's only hospital so the only thing we're seeing right now is the normal stuff like urgent heart, spine, cranio and orthopedic surgeries plus our chronic transfusions for the rare anemia patients.  We are no longer doing non-urgent surgeries and I anticipate to slow down further but according to the news California had the first death of a child (person under 18 yo) with COVID-19 but I haven't see if that's why the patient died.  It would be nice if anyone knew lab personnel in Italy, Spain, etc but I think they may be a bit busy right now!!  Unfortunately for us the flu is still going strong and we have had HUS and CAHA cases from it.

Really sick patients needing ECMO will use blood. I don’t have a way to gauge the utilization at this time though. 
All the best. 
 

I believe that once ventilated, due to the risk of DIC, some COVID19 patients are requiring extensive platelet support. Thank fully not seeing this at present in Scotland, however numbers of patients testing positive are increasing daily.
 

Hi, We recently also had a B (A) phenotype detected by the Ortho reagents.  Our reactions were similar to yours. We are fortunate to have a R&D Rh gentoyping facility at our Reference Lab here in Brisbane, Australia who confirmed the B (A) phenotype. I confirmed with Ortho they are using the clone which detects this.  We transfuse Group B where possible. 

Hi, We recently also had a B (A) phenotype detected by the Ortho reagents.  Our reactions were similar to yours. We are fortunate to have a R&D Rh gentoyping facility at our Reference Lab here in Brisbane, Australia who confirmed the B (A) phenotype. I confirmed with Ortho they are using the clone which detects this.  We transfuse Group B where possible. 

GD-CLN-900100.pdf
Hi, We are a multidis non-trauma hospital, with a large (10,000 births/year) maternity hospital. We have found the use of Cryo in the first MTP pack to be advantageous in getting obstetric bleeds under control more quickly. 

Thanks all. Don't worry, I am certainly here to learn from this process, and am happy to receive all constructive criticism. Will let you know if and when the article gets accepted! and p.s.you're right Pony, finding the time to write for a 24hr shift worker is extremely challenging! 

I have been a peer reviewer for Transfusion (amongst a few other journals) and Pony is absolutely correct in saying that we are there to help, rather than criticise, so, once again, good luck!

Hi Kelli,
I'm so excited to hear you are writing an article for Transfusion. Finding time to write is a challenge. I wouldn't worry about a professional reviewer as the Transfusion staff will edit your article to comply with the Transfusion Style Guide. As one of the former Technical Editors for Transfusion, I'm very familliar with the process. The journal's website which you can access through AABB.org, has instructions for authors that will cover how they would like you to organize your paper (Case Review or original work, etc) and the steps for electronic submission of the file once you are ready for the peer review process to start. The peer reviewers are only supposed to look at content and how you drew conclusions from your results. They will submit questions back to you if it is felt there is more explanation or data needed. This is meant to be a supportive, collaborative process so please do not take any of the comments personally. They are meant to help you look good as an author.
When content is settled, the technical editing staff for the journal will will work on your paper to make it comply with the Transfusion Style Guide and send you proofs before anything is printed. They do all the heavy work as far as grammar and formatting are concerned. They will make sure your data is presented in the clearest way possible and  that your intended message is delivered correctly. You will be involved in the process but not completely responsible for it so don't worry!
Any questions or concerns, I'm happy to help.

I don't, but I wish you all the very best for your first article; it is always an exciting step forward in one's career.

GD-CLN-900100.pdf
Hi, We are a multidis non-trauma hospital, with a large (10,000 births/year) maternity hospital. We have found the use of Cryo in the first MTP pack to be advantageous in getting obstetric bleeds under control more quickly. 

GD-CLN-900100.pdf
Hi, We are a multidis non-trauma hospital, with a large (10,000 births/year) maternity hospital. We have found the use of Cryo in the first MTP pack to be advantageous in getting obstetric bleeds under control more quickly. 

Hi GoodChild, in my previous life I was Process Control Manager for the Australian Red Cross Blood Service...I hear you
 

GD-CLN-900100.pdf
Hi, We are a multidis non-trauma hospital, with a large (10,000 births/year) maternity hospital. We have found the use of Cryo in the first MTP pack to be advantageous in getting obstetric bleeds under control more quickly. 

GD-CLN-900100.pdf
Hi, We are a multidis non-trauma hospital, with a large (10,000 births/year) maternity hospital. We have found the use of Cryo in the first MTP pack to be advantageous in getting obstetric bleeds under control more quickly. 

@Kellimq As a sincere appreciator of process control and flowcharts, whoever designed that document is a genius and has my praise.

GD-CLN-900100.pdf
Hi, We are a multidis non-trauma hospital, with a large (10,000 births/year) maternity hospital. We have found the use of Cryo in the first MTP pack to be advantageous in getting obstetric bleeds under control more quickly. 

The patient has had a mitral valve repair and then CABG (now post-op day 5). Day 53 in ICU.  The hb now appears to be stabilising. They are still monitoring her, but are hopeful they have found the cause of the hemolysis.
 

Thank you so much Malcolm. The intensivist was also querying mechinical destruction by the heart, so now that they know the anti-Ytb is unlikely to be the cause of the low grade hemolysis, they are going to do some cardiac investigations. Excellent references and once again Malcolm is the veritable font of information. 

The patient has had a mitral valve repair and then CABG (now post-op day 5). Day 53 in ICU.  The hb now appears to be stabilising. They are still monitoring her, but are hopeful they have found the cause of the hemolysis.
 

You may not get much info from A subtyping, esp if the pt is actually a group O.  I think the only way to be sure of a group A status would be to try and absorb/elute anti-A from the pts rbcs.

What was the outcome Kellimq?  Was it mechanical destruction, or do they still not know?