Barb Thompson

Never miss an opportunity to keep your mouth shut. and... When you're going through hell, keep going! (Winston Churchill)

My daughter from Chicago came to visit me here in Florida, where it is currently 73 degrees. Have to mention.....I have a thing about spelling. One of my lab managers consistently spells congratulations as "congradulations"; spells separate as "seperate"....drives me nuts! He also refers to himself as "myself", as in "If you have any questions, see XXX or myself" I was in the storeroom the other day and came upon a box that was labeled "Misc Testes". Being the curious type, I looked inside. It was a box of papers documenting miscellaneous TESTS! What a disappointment. Happy New Year everyone. Here's to more laughter in 2010!

wrong answers in the answer key, possibly some incorrect content...I can't find the book at the moment to check; I may have loaned it out. There may be an updated edition available now that addresses these issues. Also, some of the flashcards have the answer on the next card, not on the back, where one would expect to find it. I still think it's a good book, though.

Be careful with this book. There are many typos, also typos in the flashcards. It's an excellent review book, however. Just be warned!

We got a request once for "X-rated" blood.

How about "I swear, I did NOT pour blood from the purple into the green!" Really? Did your patient have a pulse? (calcium = 0, K = 20)

Am I correct in thinking that adsol units do not have donor plasma in the segs? Isn't it red cells and adsol? So the reverse group wouldn't work.

Today I got a call from L&D for an add-on XM. When I called to tell them the blood was ready, the nurse replied"Blood? I don't want blood! I ordered a crossmatch!"

I have a pdf of the SBB review from AABB Miami 2007. I can email it to anyone who would like it. Barbara

This reminds me of an OB patient who was AB neg, delivering an O Pos baby. My first thought was "Uh Oh!". Tested, retested, grabbed the hemo tube and tested again.....still O pos! Then I noticed the mom's age....49. I called OB and asked if it was a donor egg; sure was! The mom came in 2 years later and did it again.

Received a cord blood yesterday on a baby whose diagnosis was "Pre-Newborn"

I had an RN call and demand that we re-calibrate the machine that does the cord blood DAT's. She said we were calling too many positives, and the results were wrong. I guess she could tell just by looking at the babies whether or not their DAT would be positive. I asked if the mother's and baby's blood types were different, and she replied "of course!". At that time, we were still doing DAT's manually by tube. I held off suggesting that in the future, the mothers should be more choosy about picking the fathers of their children.

I loved "St Elsewhere"....except for the scene that showed a doctor going to the lab....and no techs were there. Then he went to the blood bank, again, no one there. He opened the blood bank refrigerator and pulled out a bottle of champagne (or vodka? or some other bottle of liquor...) (I think it was New Year's Eve) and implied that the lab was drinking on the job.....I was offended.

Most memorable diagnosis: "hard won't go down" Scary scenario: Mom O pos, Anti-E, baby O Pos, positive DAT. Doctor (yes, the doctor!) calls and tells me I am wrong; the baby can't have a positive DAT because the mom and baby are the same type. I explain about the Anti-E, and he tells me that's just a minor antibody! Had a mom with an anti-D titer>2000 at delivery, doc demanded RhoGam. It was the mom's 5th baby, 2 previous babies did not survive, and the docs did not know why. Her prenatal Anti-D titer was 16, and no one noticed. They never checked the baby's H&H, so at 5 days old, the baby was in PICU with a Hgb of 5. The pediatric hematologist thought the baby's positive DAT was due to an ABO incompatibility, but the mom was A neg and the baby was A pos. Also, had a patient with Anti-c and 2 other antibodies. The tech did not complete the workup the night before surgery (I guess multiple antibodies confused him), so it didn't get sent to the ref lab until the next day (the day of the surgery). OR was notified, and they took the patient in anyway. Of course they needed blood super stat. I was already at home, when they called me. I told them not to emergency release any O negs....they didn't believe me and called the path. Guess what they gave? Yup, O negs!. We also get calls about room numbers. I ask them to call back when their room number has a name. Along the same line....I inspected a lab that had in their collection policy that the 2 independent patient identifiers were name and room number!

Take a notebook with you and leave it in your car. When you are done with the test, and back in your car, write down all the questions and answers you can remember. Someday, somewhere, someone will ask you what the test was like, and you will have all those notes to refer to Good luck! (Make sure you know coag!)

Thanks for all your replies. My supplier is the one who said 4 hrs,and that is what I go by, but I work per diem at another hospital and their policy is 24 hours. I just didn't think that was right. Thanks again! I'm sticking with 4 hrs until my supplier says otherwise. Barbara

To stop the alarm, hit the "mute" button. We do not set a low alarm. Our temp is set at 36.0, alarm is set at 37.1. When the alarm goes off, the baskets lift the plasma out of the water. We do turn the unit off to lower the temp faster. We have had rare occassions when the basket lift malfunctions at the end of the cycle, but has not happened yet with a high alarm. Barbara

We have started receiving pre-pooled cryo (10 units in the pool) from our supplier, and I cannot find a reference for when the unit expires after thawing. I checked with several other facilities, as well as the supplier, and have received responses of 4, 6, 8, 12 and 24 hours. Currently, we assign an expiration time of 4 hours post-thaw. What are others doing, and does anyone have a reference for this? Thanks, Barbara

We have a 4 unit Helmer; I love it! Thaws 4 units in under 20 minutes. I used to use a microwave, but we had problems with uneven temperature sensing and cooked segments. Also, when a unit broke, the plasma ran all over the counter, and the room smelled bad for days.

For trauma patients,if a KB is ordered, that's what we do. Most of the patients are Rh pos, so the fetal screen will be positive. For our RhoGam patients, we do a fetalscreen if > 20 weeks gestation. Barbara

We have one of these, with all of the same problems....dripping bowl, peeling paint inside the lid (not from bleaching).....also, I don't like the way it spins. We were told that this is just how it is, so we repaired our old CW, and use this CW2+ as a rarely used back up. Personally, I would rather wash by hand than use this. I will never recommend this CW to anyone. Barbara

We offer the test stat on all shifts. I have a problem with most of my techs making poorly stained slides and/or undercounting. Everyone is required to participate in surveys and competencies twice a year. It is expensive, but a necessary evil, as this is the only way to see who needs additional training and practice. Each tech must make, stain and count their own slides. For patient testing, all slides are reviewed within 48 hours. 99% of our KB orders are for OB patients who have fallen, experienced abdominal trauma or been involved in a MVA, and do not involve RhIG. For those of you sending out FMH by flow cytometry, which reference lab performs this? I could not find it in Quest or LabCorp. Thanks, Barbara

How about the movie "Pursuit of Happyness" where the main character is broke and sells his blood. Problem was, the bag was clearly labelled "volunteer donor". Oops! AABB made a stink about that one!

We had a similar case a few years ago.....cancer patient in the ER, hgb was 4. The ER dr ordered 2 units emergency release....we had a history on her, but 3 weeks prior she had a negative screen. Now she has anti-Jk(a), identified after both units were infused (later tested and found to be Jk(a) positive). Her serum turned brown. Her DAT became positive (IgG and C3), but was negative less than 12 hours later. She developed acute renal failure, and 4 days later, I saw her obituary in the paper (our patients never die, they are only "discharged", and we in the lab never know where they go). Her death was attributed to the cancer, but I often wondered if we hastened her demise.

Check out aabb.org. They post a list of SBB programs, and you can see which ones are on-site or on-line. The ASCP website (ascp.org) posts a list of suggested reading. I think you can access the info without having to be a member. Barbara