Megan,

 

We also use Meditech C/S Ver 5.66 that is validated for electronic crossmatch.  If a patient does not qualify for the electronic crossmatch, we do a both buffered gel crossmatch and an IgG gel crossmatch.  This is our understanding of current FDA requirements. 

We are in the process of dropping the IS crossmatch when doing gel crossmatches. But we validated the procedure first. We tested A, B, AB and O plasma in Gel with A, B, AB and O cells to demonstrate that the gel technique will detect ABO incompatibilites.

 

The gel is aimed at detecting IgG incompatibilty. There is a strong probability (well strong for a 'never event) that  ABO incompatibility is missed. I have seen this on 2 occasions in my career so far and I have only been qualified for 13 years.

 

ETA - even if the computer crossmatch is OK, it stops the possibility that someone has inadvertently grabbed the wrong group of blood. Yes, the crossmatch may come up negative, but an IS XM will detect this within 5 minutes, instead of after 45 minutes. Nothing worse that having to delay the provision of blood because it wasn't noticed quickly that the wrong group was being crossmatched.

Edited September 25, 201410 yr by Auntie-D

Nothing stops the human from distributing the wrong unit of blood in any circumstance.  We had a saying that " if you have a system of multiple checks and balances, you'd better make sure that the first one works!"  'cuz invariably an error missed by the first line of defense will almost always get all the way through - people get complacent.  The EC should suffice for ABO incompatibility detection.

Nothing stops the human from distributing the wrong unit of blood in any circumstance.  We had a saying that " if you have a system of multiple checks and balances, you'd better make sure that the first one works!"  'cuz invariably an error missed by the first line of defense will almost always get all the way through - people get complacent.  The EC should suffice for ABO incompatibility detection.

 

Oh it will, but what use is that check if it isnt found until 40 minutes after the start of the XM? Yes it is found but the person then has to start again and the provision of blood has been delayed.

David is correct when the system depends on humans to detect discrepancies. The following is how I use the computer system to issue blood:

1. Patient case number (encounter, financial) barcoded label is scanned (barcode label is affixed to Request to Release Blood Component form presented by Nursing)

2. Scan bar coded (ISBT-128) Donor Identification number on label of blood container selected for issue. System will not allow scanned entry of Code 39 bar code.

3. Scan bar coded (code 39)Donor Identification number printed on crossmatch tag that is attached to the blood container. System will not allow scanned entry of an ISBT-128 bar code.

Step one establishes to whom blood will be released in the computer system.

Step two identifies the selected blood container to the computer which instantly determines if blood container is crossmatched/assigned to the patient.

Step three verifies that the donor identification number on crossmatch tag matches the donor identification number on the blood container label.

Edited September 26, 201410 yr by Dansket