I did another BTLP-TACT exercise this evening.
I was feeling rather tired and a headache was making it hard for me to concentrate.
Being under the weather was perhaps the very time to simulate an emergency;
after all they don’t always occur when I am on top form.
I was presented with one case – a ninety-year
old woman for anterior resection for whom a group and save had been requested.
The forward group and reverse groups were both
clearly “A”, but with positivity in
the Rh control, the Rh group could not be determined.
The antibody screen was positive in cells one
and three, so I requested antibody panels.
The IAT panel was positive in cells 1,3,6,9 and
10 (with negative auto) which matched
anti-Fy(a) but did not exclude anti Cw or anti Lu(a)
The enzyme panel was negative in all cells. To
my mind that rules out anti Cw.
I got the red light. The positive control invalidates
the entire group, not just the Rh… I know this… Perhaps if I had a simulation
of the techniques and materials I actually use rather than trying to remember
something with which I am utterly unfamiliar…
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