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Antibodies Identified at Another Facility

kmmoton
in Transfusion Services

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comment_53769

JUST CURIOUS; AFTER READING THESE POSTS, EXPERIENCING AND KNOWING THE IMPORTANCE OF PATIENT TRANSFUSION, AND ANTIBODY HISTORY; ARE WE ANY CLOSER TO SOME UNIVERSAL SYSTEM WHERE SUCH HISTORY WOULD BE READILY AVAILABLE TO THE MEDICAL COMMUNITY? WE HAVE ISBT AND NOW AN SDS (UNIVERSAL CHEMICAL ID SYSTEM REPLACING THE MSDS) SO IS IT POSSIBLE THAT A UNIVERSAL TRANSFUSION AND AB HISTORY IS IN THE MAKING?

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  • tbostock
    tbostock

    I would antigen type the patient. If K negative, we would transfuse with K neg units (easy enough to find them). We would probably add the Anti-K to his account with a note that it came from the patie

  • jayinsat
    jayinsat

    For reasons such as this, whenever I have a positive antibody screen on a new patient, I call the floor and ask if the patient has been transfused before and, if so, where.  I then call that facility

  • PAWHITTECAR
    PAWHITTECAR

    We had a case recently where a patient came in through the ER, she gave the nurse an Antibody card for a Jka that was identified years ago in Texas. When we called to get more info we were told that t

comment_53770

JUST CURIOUS; AFTER READING THESE POSTS, EXPERIENCING AND KNOWING THE IMPORTANCE OF PATIENT TRANSFUSION, AND ANTIBODY HISTORY; ARE WE ANY CLOSER TO SOME UNIVERSAL SYSTEM WHERE SUCH HISTORY WOULD BE READILY AVAILABLE TO THE MEDICAL COMMUNITY? WE HAVE ISBT AND NOW AN SDS (UNIVERSAL CHEMICAL ID SYSTEM REPLACING THE MSDS) SO IS IT POSSIBLE THAT A UNIVERSAL TRANSFUSION AND AB HISTORY IS IN THE MAKING?

Eek caps :(

In the UK there is now a national scheme using the NHS number - participation is voluntary though :(

comment_53774

JUST CURIOUS; AFTER READING THESE POSTS, EXPERIENCING AND KNOWING THE IMPORTANCE OF PATIENT TRANSFUSION, AND ANTIBODY HISTORY; ARE WE ANY CLOSER TO SOME UNIVERSAL SYSTEM WHERE SUCH HISTORY WOULD BE READILY AVAILABLE TO THE MEDICAL COMMUNITY? WE HAVE ISBT AND NOW AN SDS (UNIVERSAL CHEMICAL ID SYSTEM REPLACING THE MSDS) SO IS IT POSSIBLE THAT A UNIVERSAL TRANSFUSION AND AB HISTORY IS IN THE MAKING?

It's a great idea. We have talked about this in our area for years. Logistal problems include conflicting computer systems, turf wars as to who would own the system, and the problems of inputing a huge amount of old records. Everyone has their own medical record # system, and, unfortunately, we are all going away from the SS# which is a truely unique identifier (I am not a fan of DOB, a pool of 365.25 of them is hardly unique). Gotta be easier with the countries with more socialized medical care where everyone has their own #.

comment_53779

This would be an enormous improvement over the present system in the US.  We do not enjoy the benefits of a single-payer system yet, however. 

 

In the meantime, it does seem like the federal government could do a decent job in arranging access to a database that can be searched on the internet even if it can't be directly interfaced with individual blood-banking systems.

 

Scott

comment_53781

It's a great idea. We have talked about this in our area for years. Logistal problems include conflicting computer systems, turf wars as to who would own the system, and the problems of inputing a huge amount of old records. Everyone has their own medical record # system, and, unfortunately, we are all going away from the SS# which is a truely unique identifier (I am not a fan of DOB, a pool of 365.25 of them is hardly unique). Gotta be easier with the countries with more socialized medical care where everyone has their own #.

 

DOB isn't really as bad as 365.25.

 

Assuming that the oldest living individuals in your MPI are 110 there are 40,177 date of birth buckets to place individuals within (365.25 days in a year * 110 possible years). You're right that it's still not all that great either.

 

I learned how to circumnavigate the master patient index in my quest to prevent mistransfusion of antibody patients due to duplicate medical record numbers. I find that checking by date of birth (using B#MMDDYYYY in Meditech) is the easiest solution. Then you just have to pray that it was entered into the system correctly.

  • 6 months later...
comment_56493

I have a related question.   Let's say you get a new sickle cell patient who has been transfused regularly at another facility.  You call the facility and are given a list of antibodies identified and a RBC phenotype.   What do you do with the phenotype information?   Do you transfuse RH and K matched blood based on this information?   Do you "try" to get a RBC phenotype even though patient has been transfused?  Do you hypowash?   How do you handle these cases? 

I'm writing a case study and would love to get some data on this.   Thanks!

comment_56498

I would rather hypowash and do an extended phenotype of the patient and then transfuse RH and K matched Blood.You always need to verify what is done else where.

comment_56501

I would rather hypowash and do an extended phenotype of the patient and then transfuse RH and K matched Blood.You always need to verify what is done else where.

 

Just curious but why do you always need to verify what is done else where? :confuse:

comment_56502

We do it because, at various times, we have come across an allo-anti-I in an adult ii, which another reference laboratory had "diagnosed" as an auto-antibody, a DAU-4 that another reference laboratory had "diagnosed" as a Partial D Category VII, to cite but 2 examples.  Our results were verified by the International Blood Group Reference Laboratory.

comment_56503

What happened to National Patient Antibody Register (NPAR) in the USA? I was jealous when I read about it. Did it die an unnatural death>

Years ago in Oz, we had the Aust Red Cross with an antibody register, but I don't think that all Abs were reported to it.

Lots of people have been pushing for it here in Ireland, Pushing hard - but nobody (with the money control) moving. Let's just have a few more DHTRs due to Fya!!!  :abduction:

 

Cheers

Eoin

    •
    comment_56505

    We've got Sp-ICE in NHSBT now, but, again, not every antibody (from years back) is on it; but we are getting there!

    comment_56506

    What happened to National Patient Antibody Register (NPAR) in the USA? I was jealous when I read about it. Did it die an unnatural death>

    Years ago in Oz, we had the Aust Red Cross with an antibody register, but I don't think that all Abs were reported to it.

    Lots of people have been pushing for it here in Ireland, Pushing hard - but nobody (with the money control) moving. Let's just have a few more DHTRs due to Fya!!!  :abduction:

     

    Cheers

    Eoin

    NPAR  is still alive! Our blood center (Blood Systems - United Blood Servcies, Blood Center of the Pacific, Inland Northwest) just gave a presentation last week. Blood Systems is providing the subscription to all of their full service customers.The hospitals will have to approve of it berfore we implement.

    https://www.npar.com/

    Edited by tricore

    comment_56589

    I put it in the patient's history and make a comment that is was identified at another facility.

    I also listen to patients and call other facilities.

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