knelson

We have two Sartorius ABO-M pipettes.  We use the tips from Ortho:  MTS9632 bulk tips.  Our Otho rep confirmed with Ortho that these were the correct tips.  We used these same tips for our old Biohit pipettor.

We get ours from Medline.  800-MEDLINE.   Ref# MLABTP5NGRAD

We were told by the Ortho rep that trained our staff that you need to have an air gap between the patient plasma/reagent rbcs and the liquid on top of the gel in the column for the same reason described in Arno's post.  Years ago we had a tech that always got weaker reactions with daily QC and we finally figured out that after she pipetted the rbcs and patient plasma into the gel columns, she would tap the card until the plasma/rbcs mixture touched the liquid layer in the column.  Her reactions were always 1-2 grades weaker than everyone else.  Once she stopped doing that, she got much stronger reactions.  We use a Biohit pipettor and hold the pipettor at a slight angle and pipette towards the side of the well.  This works well.  Should the rbc/plasma mixture touch the liquid layer in the well, we discard that well and repipette using a new well.

We were told by the Ortho rep that trained our staff that you need to have an air gap between the patient plasma/reagent rbcs and the liquid on top of the gel in the column for the same reason described in Arno's post.  Years ago we had a tech that always got weaker reactions with daily QC and we finally figured out that after she pipetted the rbcs and patient plasma into the gel columns, she would tap the card until the plasma/rbcs mixture touched the liquid layer in the column.  Her reactions were always 1-2 grades weaker than everyone else.  Once she stopped doing that, she got much stronger reactions.  We use a Biohit pipettor and hold the pipettor at a slight angle and pipette towards the side of the well.  This works well.  Should the rbc/plasma mixture touch the liquid layer in the well, we discard that well and repipette using a new well.

We were told by the Ortho rep that trained our staff that you need to have an air gap between the patient plasma/reagent rbcs and the liquid on top of the gel in the column for the same reason described in Arno's post.  Years ago we had a tech that always got weaker reactions with daily QC and we finally figured out that after she pipetted the rbcs and patient plasma into the gel columns, she would tap the card until the plasma/rbcs mixture touched the liquid layer in the column.  Her reactions were always 1-2 grades weaker than everyone else.  Once she stopped doing that, she got much stronger reactions.  We use a Biohit pipettor and hold the pipettor at a slight angle and pipette towards the side of the well.  This works well.  Should the rbc/plasma mixture touch the liquid layer in the well, we discard that well and repipette using a new well.

We do the saline replacement after the tubes have been incubated at 37C, just prior to washing.

We do the saline replacement after the tubes have been incubated at 37C, just prior to washing.

We do the saline replacement after the tubes have been incubated at 37C, just prior to washing.

We attempted to validate a "prewarm gel" procedure, but did not have much luck.  As you say, it is not truly a prewarm method due to the 10 min centrifugation at room temp.  It seemed to work for patients with weaker colds, but if the cold ab was strong, the prewarm gel would usually still be positive.  We dropped it.

Our physicians are pressuring our Blood Bank to start stocking Factor X, Prothrombin Complex Concentrates, etc. for reversal of Apixaban, Xarelto, Pradaxa, etc as they are routinely prescribing these dregs to their patients. Our pharmacy does NOT want to stock factor concentrates. The problem is the expense, return policies, etc. We would like to know how other facilities are handling factor concentrates. Does your facility stock these factor concentrates? If so, in the Pharmacy or Blood Bank? Thank you!

Our physicians are pressuring our Blood Bank to start stocking Factor X, Prothrombin Complex Concentrates, etc. for reversal of Apixaban, Xarelto, Pradaxa, etc as they are routinely prescribing these dregs to their patients. Our pharmacy does NOT want to stock factor concentrates. The problem is the expense, return policies, etc. We would like to know how other facilities are handling factor concentrates. Does your facility stock these factor concentrates? If so, in the Pharmacy or Blood Bank? Thank you!