General Information

Anyone out there using Beckman's SlideMaker/Stainer for the DxH's: -what manufacturer of slides have worked best for you? -what slide manufacturers should I avoid at all costs? Thanks for the input! Nicole z

Hi, Is the only difference between tan & lavender EDTA tubes that tan tubes are lead free? They're both K2 EDTA. What about the concentration of EDTA, or liquid vs. dry? Occasionally our phlebotomists will draw only a tan EDTA tube for lead testing, missing the lavender for the CBC. I would love to run a CBC off the tan in when the lavender is missed. How would that skew the results? I don't have the resources to validate CBCs on tan tops. Thanks, Rachel

is anyone currently using the cellavision to perform white cell differentials? we are currently working one up and are curious as to how it is interfaced (we use SoftLab), how it fits into the workflow, etc....

We do body fluids on the disposable hemocytometers. Then if our WBC count is greater than 10, we are required to do a cytospin and report out a differential. To make the cytospin we use one drop with albumin with several drops of specimen. Does anyone have any tips on how to make the best cytospin slides? My main complaint is that some of the slides I'm looking at have cells that are so compressed that I can't tell whether they are lymphs or segs. What about when the body fluid is so bloody?? How do I make a slide that isn't just over-crowded with RBC's? Any tips are greatly appreciated.

Hi everyone, I am working on consistancy on manual differentials, especially on the bands. Looking for advice, education options, guidelines, pictures that have the cell labeled, any procedures. Thanks!

We measure PT and PTT tests with using sysmex (CA50) or Coalaser (DiaLAB) analysers using Biolab reagents. Both instruments measure the tests according turbidometric method. We encounter a "NC error" (PT>60 sec and PTT>180 sec) for about each 20 tests in non turbid patient's plasma. However, when we measure these samples with manual methods or by other instrument even with turbidometric method ( ACL analyser) and using the same reagents, the test results is normal/ mild to moderate increase. How could resolve this problem?

Hi everyone, We had a small hemo analyzer in a cancer center that we removed. My question since I am new to all this administration business, is there anything special that you do/have to do to "retire" the instrument properly? thanks!

I'm interested in hearing if other labs have a delta check set up for INRs. If so, what is the delta and for what time interval.

We are considered a high risk area for haemoglobinopathies and use the TOSOH for our HPLC antenatal screening. If we get a peak over 6% in the HbA1c window we check to see if they are a known diabetic. If they aren't we notify our consultant biochemist who issues a 'new diabetic' report. Recently I was running the samples and got an A1C of 20%, which is pretty much unheard of, so we sent it away for confirmation. It came back as a Haemoglobin South Florida and is clinically insignificant. Just thought I would share as it's not one I've seen before.

Thinking outside of the box here............... Does anyone not do platelet estimates (when determined there is no platelet clumping)? The analyzer is far more accurate than I. Plus, when my count is not within our range, I have to recount so that it is closer the analyzer count.

Our system currently uses the glass 4.5 mL fill 3.2% BD Vacutainers for our coag samples. Because BD will be discontinuing the glass pediatric tubes and replacing it with the plastic 2.7 mL fill 3.2% tubes, we have decided to switch completely to the plastic. Best practice (and CLSI recommendation) is to validate to prove there is no difference in results between the two tube types. Has anyone actually done this? How many samples? What was your range of results (CLSI mentions a difference may only be seen with prolonged samples)? Did you validate your entire test menu, or just PT/PTT?

Hi everyone, We are implementing a new hematology analyzer (Sysmex XN series), and will be performing automated body fluid counts on this platform. For those of you who perform automated counts - do you report a total nucleated cell count, a white blood cell count, or both? What cells are included in your differential? We had planned to report WBC and RBC counts off the analyzer. Our differentials include neutrophils, lymphs, monos/macrophages, mesothelial cells, and "other" cells. Since our differential includes non-WBC nucleated cells - some techs feel that means we need to include the total nucleated cell count on the report (not just the WBC count). Though…

Hi everyone, I am learning about instrument correlation right now, and am wondering a couple of things. 1. what parameters of a CBC must be monitored? I have heard that CAP only requires the WBC, RBC, HGB, HCT, PLT, and MCV but not the differential. 2. When you have a parameter failing the allowable error, where do you start? What is the best way to see which anaylzer is the one at fault for the fail? And once you establish, how do you get to match if you have done all the checks for maintance and QC is looking good for the faulting one...do you adjust the cal factor so they are alined? 3. When dealing with different manufacturers for your analyzer comparison, the…

Hi everyone, I am a well trained generalist but have only worked in blood bank reference labs since my training. I have just encountered a startling situation...based on my training. The CLS's where I work are trained to vortex any CBC specimen if it is suspect for platelet clumping and then re-run it on the analyzer to see if it increases the platelet count. Is it just me or do you guys think this is nuts?

does anyone do any testing on amniotic fluid? we have some ob/gyn md's requesting (demanding is a better word) that we do: cell count, leukocyte esterase, glucose, and gram stain with culture. I don't understand why they want a leukocyte esterase (they want us to just use our urine dipstick) if we would be giving a cell count. ** does anyone do "leukocyte esterase" testing on amniotic fluid? if so, by what method and how did you validate? ** how different does amniotic fluid look when doing a cell count? are there any kinds of cells a general tech wouldn't be familiar with? (for example, I know there are lamellar bodies, but haven't been able to find a picture of they w…

I am looking for the official Nice document that referws to doing a long slow spin and a second spin for Lupus samples, rather than a fast spin and microfilter. Where I am now working is acting as a regional reference centre for thrombophilia and lupus testing but isn't handling the samples according to current guidelines. I know the documentation saying not to use microfilters is out there but I cannot find it And the coagulation supervisor will argue black is white rather than be 'wrong'... Can anyone help?

Our lab is looking to acquire a new cyto centrifuge. We are a small 50 bed hospital and primarily it will be used for body fluids. What kind of cytofuge do you use and would you recommend it?

Hi All, I'm interested to know your thoughts on digital imaging for manual differentials. Does anyone have any experience of the EasyCell Assistant? It digitally scans blood films and then categorises them into cell populations. You then manually review the morphology on a computer screen before authorising or sending for clinical review. It is claimed that this technology can cut manual diff times in half, and a UK company (Horiba Medical) has just announced that it will be distributing this system. I'm interested to hear from anyone who has used one? Thanks, Sonia Nicholas Here is the Horiba press release: http://bit.ly/ZaUTRP

Does anyone currently use the Advia 2120i? If so, do you use it for body fluid analysis?

Hi, how many labs out there use the WBC correction formula for CSF when the CSF has a high RBC? I used the calculation at my old lab, and my new lab does not.

Left out 3 hours then refrozen -do we need to recollect?

For anyone running aspirin and P2Y12 on the VerifyNow: have you been having trouble with error codes using the P2Y12 test devices. All of our aspirins run just fine, but it seems as if every other plavix device gives an error. This is causing patients to be redrawn numerous times and is getting frustrating. (Some other background: we have had several analyzers over the past two years, so it's not the analyzer itself, and a bold reminder for everyone to tighten down the needle before running.) Just wondering if someone else has seen the same problem.

If a patient is receiving blood how long after can a quality cbc be drawn? If doctor insists the patient be drawn do you comment on the specimen?

Hi everyone, I'm interested in knowing how other facilities deal with bone marrow specimens/processing. A few specific questions I have: 1. What department is responsible for creating bone marrow slides? 2. What department is responsible for staining bone marrow slides and what stain is used? 3. What is your hematology department's role in bone marrow processing? 4. Does your hematology department perform bone marrow differentials (med techs) or are these done by someone else (who?)? Any information you could provide would be very helpful. Thank you!

I was wondering if anyone partially auto releases the hemogram part of the CBC that contains a flag? An example would be if there was an Immature Gran flag or an anisocytosis flag that required a smear review. The hemogram part of the CBC would auto release but the differential part would be held pending the smear review. Thanks in advance for your input.