JasonS

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I've never entirely understood their purpose either. We have a commercial control which we use with our classic re-usable hemocytometers. We use a homemade stain for our counting. Yes, if a tech tends to count somewhat higher/lower than their peers they risk failing QC. This would also include variables for doing the setup such as overfilling the chamber, poorly cleaned chamber, or poor mixing(Since we use a stain). You could argue that since the QC is done once a day, that a competent tech would pass the QC, and later on a less competent tech would set up a body fluid and do it with poor accuracy(They're not doing QC so this can't be assessed). In my case you could say the QC proves the stain is working properly though in my experience our stain can be used for months and have no stability issue. It would also help prove that the hemocytometer they used is in satisfactory condition(We would use 2 hemocytometers for daily QC and we have 10 in use, so we might not QC each individual one every week since there is no plan for rotating them). So we are kind of proving that some of the systematic parts of the fluid counts are working properly(but not all of them) and proving that at least one of the techs is counting properly.

In theory the "classic" situations with acute pain are an Acute Hemolytic Reaction(as mentioned above). I have also never seen one of these practice. Have you repeated the crossmatch with the unit and a new sample? Have they done bloodwork for hemolysis markers? The pain could always be due to one of the other common transfusion reaction causes(not everything presents in textbook fashion), or not due to transfusion at all.

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We will test any antibody panel on receipt with a diluted version of a commercial anti-sera (Such as anti-K).

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1. Babies of Rh negative moms. 2. Reflex testing from cord bilirubin >150 umol/L 3. Any others upon request. This system doesn't seem to cut down much on the amount of ABO/DAT we do on babies to Rh Positive moms since nurses will order it most of the time anyway. I would like to hear a physician's input on their reasoning behind ordering them and what the results would do to influence their clinical decision making.

Haven't had to do this since I was a student so cut me some slack if I make a mistake here So we want to find out how many years "x" it takes for Company A/B to be equal. So... 275 + 6500 + 1600x = 1300 + 7000 + 1000x 6775 + 1600x = 8300 + 1000x 1600x - 1000x = 8300 -6775 600x = 1525 x = 2.54~ The question asks how many years after the initial year. Since this equation takes into account the initial year just do 2.5 years - 1 year = 1.5 years So the answer is B

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Our LIS prints out a requisition for the Cord whenever a baby is born. This requisition contains the mother's type and screen results.(Conveniently our LIS connects the Mother & Baby's accounts. We have Meditech and I'm not exactly sure how they do so.) The technologist then looks at the printout of every cord we get and automatically does the ABO/DAT if the mother is Rh negative. We have a comment in the mother's specimen(if she is RH negative and giving birth) that needs to be filled after the baby ABO/DAT is finished, so it will show up on our pending board until the baby specimen is done and the results added to the mom's specimen. We do not automatically test the cords if the mother is group O. In these cases it has to be requested by the floor or as reflex from the baby's bilirubin threshold. We will also do it for positive antibody screens.

I know some hospitals where it is done in Hematology, though here it is done in Blood Bank. I agree with Malcolm on this issue. Your calculation uses the total #counted and # of fetal cells. This is a ratio and so the calculation shouldn't change(other than you changing it to the correct number of total cells counted)

Yes, we do that here.

Our blood bank addon printouts are formatted a bit differently than those for the rest of the core lab. There is a text entry prompt for additional requirements such as Irradiated and CMV negative. This defaults as NONE.

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Is the problem that they can't add a PC onto a submitted type and screen? Or is it when they initially order a type and screen + 2 packed cells it makes 2 requisitions? We have packed cells as an option for the clinician when making a requisition for a type/screen, if they want 2 packed cells when ordering they can simply change it the count to 2. This works similar to adding onto any chemistry test in a requisition except there's a count that we can edit. Once the order is placed though, only the blood bank has the option to add/remove units. The floor can ask for more units via addons which works similarly to addons for the chemistry module where we get a printout and manually change the unit count to whatever is requested.

No, we don't run any controls with it.

We still use the IS crossmatch. (No electronic crossmatching here yet ) If the sample is not on the bench(we put it away) we would also perform RA/RB to confirm the group on the sample. I believe we are moving towards the 2 sample policy and can then bring in electronic XM. Until then I will spend my time doing all these IS crossmatches.

In our system the physician can either order a screen only, culture only, or a screen + culture. The lab does not reflex culture based off of the results when only a screen is ordered, so it is up to the physician to request an addon for a culture after viewing the results. If a culture is ordered it is worked up regardless of negative results for the UA. Cultures are probably ordered preemptively and thus worked up on > 70% of urines, but it really depends on the physician. I would be curious as to what our stats are for urine culture growth rates. On a side note, how often do your hospitals perform urine microscopics? Ours are not order-able by physicians, but reflex off of any positive for PRO, NIT, WBC, BLOOD. As a result we read dozens a shift.

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I was wondering this too.

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