128
CORRESPONDENCE
against cord red blood cells of anti-Fy3 made thus far by blacks or whites differs slightly. The apparent difference may only be a chance association but it may be real, although the significance cannot a t present be understood. Janis Oakes. M T ( A S C P P B B and Debra Tuylor, M T ( A S C P ) Blood Bank, N o r t h s i d e Hospital. A t l a n t a , Georgia, and Carol Johnson, M T ( A S C P P B B , and W. Laurence Marsh, F.I.M.L.S.. M.I. Biol., N e w York Blood. Center. New York, New York.
References Albrey, J. A,, E. E. R. Vincent, J. Hutchinson, W. L. Marsh, F. H. Allen, J. Gavin, and R. Sanger: A new antibody, anti-Fy3 in the Duffy blood group system. Vox Sang. 20:29, 1971. 2. Buchanan, D. 1. and M. Sinclair: Unpublished observations cited by R. R. Race, and R. Sanger. Blood Groups in Man 6th Ed., Blackwell, Oxford, 1975, p. 357. 3. Oberdorfer, C. E., B. Kahn, V. Moore, K.Zelenski, R. @yen, and W.L. Marsh: A second example of anti-Fy3 in the Duffy blood group system. Transfusion 14:608, 1974. I.
Procedure for Donor Reaction
To the Editor: We feel that some published rebuttal is appropriate to the late Dr. A. S. Wiener’s “Problems in Immunohematology, Number 3,” Transfusion, 17:22 and 64, 1977, in which certain criticisms are made by Dr. Wiener of recommendations for treatment of blood donor reactions made in our Blood Bank Policies and Procedures, Medical
Examination Publishing Co., Flushing, NY, 1976. Dr. Wiener is critical of our recommendation that in the event of a donor reaction the donation be stopped and the phlebotomy needle removed, stating that instead an intravenous infusion set-up be connected so that saline can be administered or the donor’s blood reinfused. We should like to point out that blood Bank Policies and Procedures is a technical manual compiled for the use of technical personnel. The decision to administer intravenous fluids or to reinfuse blood is not in the province of technologists. Equally important, the relative hazard of allowing an intravenous needle to remain indwelling in the arm of an unrestrained donor who is fainting, vomiting or convulsing, in our opinion outweighs the problem of restarting an intravenous infusion in that rare donor whose condition requires one. W e emphasize t h a t o u r instructions a r e intended for immediate care of the usual reaction by technical personnel, and as such constitute a list of “things to do until the doctor arrives.” A procedure manual cannot hope to provide instructions for every eventuality, nor is it an appropriate place for discussion of the treatment of hypovolemic shock by physicians. As clearly stated in our recommendations, a physician should be called at once to treat any blood donor experiencing anything more than a minor reaction. Robert M . Greendyke. M . D . . Director. Blood Bank, Clinical Associate Professor. Department o f Pathology, and J a n e C . Banzhaf, M S . M T ( A S C P F B B . Chief Supervisor, Blood Bank, Associate in Pathology. University of Rochester School of Medicine and Dentistry and Strong Memorial Hospital, Rochester, New York. 14620.
CORRESPONDENCE
against cord red blood cells of anti-Fy3 made thus far by blacks or whites differs slightly. The apparent difference may only be a chance association but it may be real, although the significance cannot a t present be understood. Janis Oakes. M T ( A S C P P B B and Debra Tuylor, M T ( A S C P ) Blood Bank, N o r t h s i d e Hospital. A t l a n t a , Georgia, and Carol Johnson, M T ( A S C P P B B , and W. Laurence Marsh, F.I.M.L.S.. M.I. Biol., N e w York Blood. Center. New York, New York.
References Albrey, J. A,, E. E. R. Vincent, J. Hutchinson, W. L. Marsh, F. H. Allen, J. Gavin, and R. Sanger: A new antibody, anti-Fy3 in the Duffy blood group system. Vox Sang. 20:29, 1971. 2. Buchanan, D. 1. and M. Sinclair: Unpublished observations cited by R. R. Race, and R. Sanger. Blood Groups in Man 6th Ed., Blackwell, Oxford, 1975, p. 357. 3. Oberdorfer, C. E., B. Kahn, V. Moore, K.Zelenski, R. @yen, and W.L. Marsh: A second example of anti-Fy3 in the Duffy blood group system. Transfusion 14:608, 1974. I.
Procedure for Donor Reaction
To the Editor: We feel that some published rebuttal is appropriate to the late Dr. A. S. Wiener’s “Problems in Immunohematology, Number 3,” Transfusion, 17:22 and 64, 1977, in which certain criticisms are made by Dr. Wiener of recommendations for treatment of blood donor reactions made in our Blood Bank Policies and Procedures, Medical
Examination Publishing Co., Flushing, NY, 1976. Dr. Wiener is critical of our recommendation that in the event of a donor reaction the donation be stopped and the phlebotomy needle removed, stating that instead an intravenous infusion set-up be connected so that saline can be administered or the donor’s blood reinfused. We should like to point out that blood Bank Policies and Procedures is a technical manual compiled for the use of technical personnel. The decision to administer intravenous fluids or to reinfuse blood is not in the province of technologists. Equally important, the relative hazard of allowing an intravenous needle to remain indwelling in the arm of an unrestrained donor who is fainting, vomiting or convulsing, in our opinion outweighs the problem of restarting an intravenous infusion in that rare donor whose condition requires one. W e emphasize t h a t o u r instructions a r e intended for immediate care of the usual reaction by technical personnel, and as such constitute a list of “things to do until the doctor arrives.” A procedure manual cannot hope to provide instructions for every eventuality, nor is it an appropriate place for discussion of the treatment of hypovolemic shock by physicians. As clearly stated in our recommendations, a physician should be called at once to treat any blood donor experiencing anything more than a minor reaction. Robert M . Greendyke. M . D . . Director. Blood Bank, Clinical Associate Professor. Department o f Pathology, and J a n e C . Banzhaf, M S . M T ( A S C P F B B . Chief Supervisor, Blood Bank, Associate in Pathology. University of Rochester School of Medicine and Dentistry and Strong Memorial Hospital, Rochester, New York. 14620.
