Simulated ABO and Rh blood typing

BACKGROUND: Blood typing historically has been used to introduce students to the concepts of immunohematology. Risk of disease transmission has compelled school districts to prohibit the use of human blood in student laboratories. A method is needed that will safely simulate ABO and Rh typing. STUDY DESIGN AND METHODS: A method that uses inorganic salt solutions to simulate ABO and Rh antigens and antibodies was studied. Additional salt solutions and diluents were tested to investigate the feasibility of simulating both ABO and Rh typing in a more realistic medium. RESULTS: Cobalt nitrate and sodium hydroxide were found to successfully simulate D and anti-D, respectively. The addition of these solutions did not produce cross- reactions in ABO tests. Use of simulated blood as a diluent improved the appearance of the samples. CONCLUSION: This method can safely and inexpensively simulate ABO and Rh blood typing procedures and provide students with hands-on blood-typing experience.     

Current autologous transfusion practices. Implications for the future

A questionnaire was distributed to 509 AABB institutional members to evaluate current autologous transfusion practices. Results were returned from 47 blood centers, 108 transfusion services and 64 hospital blood banks (response rate 43%). Results indicate that not all eligible patients are allowed to donate due to unnecessarily strict eligibility criteria. Thirty percent of autologous units are not tested for infectious disease markers. Of those units tested and found positive for anti-HIV or HBsAg, 53 and 72% respectively, of the institutions provide the units to the intended recipient. Forty-seven percent of institutions perform an AHG crossmatch for autologous recipients. Sixty five percent of institutions permit "crossing-over" of autologous units for homologous use. Implications of these findings for the development of standards for autologous transfusion programs are discussed.     

The assessment of frailty in older people in acute care

Aim: Develop a measure of frailty for older acute inpatients to be performed by non‐geriatricians. Method: The Reported Edmonton Frail Scale (REFS) was adapted from the Edmonton Frail Scale for use with Australian acute inpatients. With acute patients aged over 70 years admitted to an Australian teaching hospital, we validated REFS against the Geriatrician's Clinical Impression of Frailty (GCIF), measures of cognition, comorbidity and function, and assessed inter‐rater reliability. Results: REFS was moderately correlated with GCIF (n = 105, R = 0.61, P < 0.01), Mini‐Mental State Examination impairment (n = 61, R = 0.49, P < 0.001), Charlson Comorbidity Index (n = 59, R = 0.51, P < 0.001) and Katz Daily Living Scale (n = 59, R = 0.51, P < 0.001). Inter‐rater reliability of REFS administered by two researchers without medical training was excellent (kappa = 0.84, n = 31). Conclusion: In this cohort of older acute inpatients, REFS is a valid, reliable test of frailty, and may be a valuable research tool to assess the impact of frailty on prognosis and response to therapy.