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April 2024 Challenge

KTUCK

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Posts posted by KTUCK

    Poly IGG/C3 Card

    in Transfusion Services

    Posted

    I was wondering if there was ant magical thing I was missing. Ortho brings this wonderful instrument in, states Oh yea you can do DAT easily on it. Yea, it is looking like its not going to be so easy after all. Looks like I would have to run the POLy, if POS, run an IGG and somehow anti-c3d, c3b prob in buffer card. 

     Im thinking I might just stick with tube.

    Although going back to when Im doing comparisons with the tube and gel, I havent yet seen where there was a 2+ reaction in the gel with a negative reaction in tube. Its usually about a reaction worth difference. and seem to always agree on being either positive or negative. 

    We do have alot of oncology so Im thinking it may be best to stick with what Im doing now and revisit later if possible. Thanks for input

     

    Poly IGG/C3 Card

    in Transfusion Services

    Posted

    Starting a new process here. Our current process is tube. We are switching over to use the Poly Igg/C3 card for DAT's.  I understand you get a negative or positive result with the POLY card, is this a final result?? How is it resulted in LIS examples? Does anyone extend the test to tube to determine which is positive, the Igg or C3?

    ABO TYPING DISCREPANY WITH MTS GEL

    in Case Studies

    Posted

    I have the Statspin express 4. Love these centrifuges, But I also do the platelet poor too.

    I was thinking it may possibly be the reverse cell situation like R1R2 stated, but don't run into too many problems like this (we are a smaller facility), so I wasn't for sure.

    Thank you all for your help.

    ABO TYPING DISCREPANY WITH MTS GEL

    in Case Studies

    Posted

    2 weeks Post partum G2P2 female in ER with vaginal bleeding.

    Patient HX includes B POS patient receiving blood from first pregnancy from 2 years prior. Upon initial OB work up, Anti-E and Anti-c(little) identified. Patient induced early due to antibody titers being high. Baby girl delivered and found to be group B rh POS with a 4+ DAT.

    at ER visit, Patient taken to OR and TSC ordered. In MTS gel, type displays Anti-A-0, Anti-B-4+, Anti-D-4+, patient plasma with a reverse cells- 4+, patient plasma with B reverse cells- 3+mf. Plasma warmed, still getting same results. No rouleaux  found. Tube typing demonstrates Anti-A-0, Anti-B-4+, Anti-D-4+, patient plasma with a reverse cells- 4+, patient plasma with B reverse cells- 0.

    Training new employees

    in Transfusion Services

    Posted

    WELL I HAVE DOCUMENTATION OF EVERYTHING AND IT JUST DOESNT SEEM TO PHASE MANAGEMENT. THEY WANT TO EXTEND HIS 60 DAY PROBATION PERIOD UNTIL he gets signed off in BB

    WHICH I DO NOT WANT TO SIGN HIM OFF AS COMPETENT.

    So here is another scenario. After an email was sent out to everyone that he is can now only do TSC's, he performs a CORD blood on the Provue and verifies the results out. He is asked why he performed the CORD blood and states that a midnight shift tech watched him do everything.

    But I still said in the email, only TSC's. So my management doesn't think this is a big deal, along as someone watched him. My point being, he still did not listen to me.

    Am I just freaking out for no reason, or should I just let it go...??? I don't know what to do

    Training new employees

    in Transfusion Services

    Posted

    Thank you all for responses. This person actually worked in a manufacturing plant before going to tech school. I contacted the place where he did his clinical rotations and they stated that they had the same problems and they wouldn't hire him because they couldn't trust him.

    One day he performed a DAT. I had not shown him, he had not even watched me do one and he did it. This was after the fact that I told him, with witnesses present, that he is to not do absolutely nothing if he has not been shown.

    He states that BB is his favorite department within the lab, and he is in school now to get his MLS. :(

    Training new employees

    in Transfusion Services

    Posted

    Just have a question regarding training new employees in the Blood Bank.

    I have a new employee that I have been training and he has been caught in several lies. For example after several weeks in training, when performing daily QC the employee has verified results into the LIS, then after the fact I have found his QC tubes in the centrifuge. I have asked him how he put the results in if the tubes were in the centrifuge and he states that he put them back in there for me to read. I have told him that he does not need to do this. I have trained many people but am fairly new in this BB supervisor position, been in lab for 21 years.  Another example, he does not put his results in the LIS as he goes. When he does a tube type from a type and screen, he pulls the tubes out and lets them sit in the rack and then puts all the results in when the screen is down. I communicated to him that he needs to put the results in as he reads the tubes. He still does not listen to me. I do not trust him at all now and I am actually scared for the patient care. I have expressed this to my higher-ups, they just state he needs more time in BB.

    What I'm trying to get at, its not an issue where he cannot do the work. I do not trust him doing the work. he reminds me of one of those people who likes to cut corners.

    What am I supposed to do, I feel no one is listening to me.

    PROVUE CORD BLOOD QC

    in Transfusion Services

    Posted

    WAS WONDERING IF EVERYONE DOES QC FOR THE DAT FOR CORD BLOODS ON THE PROVUE. OUR FACILTY CURRENTLY DOES NOT. IM NOT SURE WHAT THE PREVIOUS SUPERVISOR WAS THINKING AS TO WHY IT WAS NOT SET UP FOR QC???

    YOU WOULD BE QC'ING THE IGG IN THE GEL AND THE INSTRUMENT DILUTIONS (FROM DILUENT 2) RIGHT?

    Weak D testing

    in Transfusion Services

    Posted

    I'm curious of facilities who perform testing on automated analyzers.... we have a Provue analyzer and use Gel.

    When running cord bloods and the Rh is negative, do you perform additional weak D testing in tube or just result what the machine result is...Rh negative.

     

    ANTI-a1

    in Transfusion Services

    Posted

    Our Lis does not flag. We rarely seem them. But I'm not even sure the LIS will flag if the donor selected is not O pos. I was curious so I could set up our LIS correctly. We have Soft, I'm not too fond of the Softbank portion of it.

     

    Thanks for you input

    Antibody Titers

    in Transfusion Services

    Posted

    My facility does has a lot of Ob patients that end up having Antibodies. We send Titers out to our reference lab to be done. I was wondering how many of you do these Titers in house and how complicated it might be for me to just get them started at our facility, or would it even be worth it, from a patient care perspective..???

     

    STEC

    in General Information

    Posted

    We have been using the Ehec from Meridian for a while. It does pick up other STEC serotypes other than O157, but not as much as the Alere test.

    There have been some STEC missed using the Meridian because of the different serotypes. Plus the Alere you do not have do not have to incubate broth, it is direct from the specimen.

    We are switching to Biofire shortly.

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