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About rravkin@aol.com

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    Seasoned poster
  • Birthday 08/01/1961

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    Acoustic Guitar, Congas, Oil on Canvas
  • Occupation
    Medical Technologist
  1. BloodBankTalk: Antibody/Antigen Reaction

    I just answered this question. My Score FAIL  
  2. Stago Compact Max vs ACL Top 350

    Hi Kimg, I have used both for many years. The bench top Stago appears to be a more reliable instrument. The means by which it tests the plasma, movement of magnetic ball in reaction cup stops when clotting occurs, gets around most HIL (Hemolysis, Icterus, Lipemia) issues, which is a big plus. The only draw back, for some, is the loading of specimens one at a time. The TOP instrument uses specimen racks that hold ten specimens each and have eight rack bays for loading; so one can load eighty specimens consecutively. However it's means of detection is spectrophotomic, light transmittance I think, which can be altered do to HIL; the degree of which differs for each assay.
  3. Not withstanding the need for completing this vital work by chosen means available, if the transfusion of this patient becomes a life or death issue, as determined by the patient's physician, then the patient's physician would sign for uncrossmatched ABO/Rh compatible PC's.
  4. Return of issued products

    We go thirty minutes although it seems well known that the rbc unit will exceed 10C well prior to thirty minutes.
  5. Return of issued products

    Does this unit have to be reissued or transfused before this new four hour expiration?
  6. FDA reportable Question

    Is there a way to ask the FDA directly? Does the FDA offer accessible public information as to the specifics of what is and is not reportable?
  7. Beckman DxH

    Hi Scott, I guess you have a better service package than what I currently work with. But you say that you run one level of control each shift and does that mean that you never have a need to run all three levels of QC consecutively in a 24hr period? How long have you had your DXH's? As far as the slide-maker-stain is concerned, I have worked with both Beckman/Coulter and Sysmex instruments and from my experience the Sysmex SMS is a better and more reliable choice. I had the opportunity to learn about the new line of Sysmex instrument in a one-on-one, four hour lesson with a technical rep and I think that the Sysmex is the better of the two instruments. I in no way connected to Sysmex or DXH from a sales perspective or any other perspective other than being an end user. From the direct experiences I have had with both of these instruments I think that the Sysmex comes out on top.
  8. Beckman DxH

    Sysmex XN; less maintenance, direct technical service monitoring- will contact you if trends are noted in QC and X-bar-B statistics, reduced frequency in reagent change (example: isoton diluent changed approx. once every 6 months- depending on use) New Parameter- IPF= Immature Platelet Function- gives insight on functionality of new circulating platelets, helps physician decide on platelet transfusion; second new parameter gives insight on health of reticulocytes, physician can decide on rbc transfusion or other treatment (I do not recall name or initials of this parameter) can be set to auto repeat testing that meet preset criteria, minimal downtime, tests pediatric specimens with greater precision and uses less specimen (for adult samples as well) ; slide maker strainer unit- uses less stain, stains slide individually, must clean slide individual slide cassettes with methanol daily, sound construction and infrequent technical service. DXH: More maintenance, no direct monitoring by tech service, frequent technical service calls for hardware and software issues, greater downtime, run qc more frequently, change reagents much more frequently, no newer parameters, no auto repeat, uses greater specimen volume; the SMS unit has inherent design problem such that minor stain explosions can occur sending stain all throughout the inside of the instrument and the floor; it was said that stain on the floor is a laughable trait of this SMS system, this SMS unit has greater downtime by comparison; main design problem seems to be associated with the Wright Stain line whereby this line becomes clogged with stain precipitate frequently despite manufacturer's recommended weekly flush with methanol; having used this unit for some six years I would recommend a daily flush with methanol. No disrespect to Dr Coulter, a hero in hematology, but I would say that the Sysmex is far more advanced and reliable, with less maintenance, less reagent use, and more reliable technical service, as compared to the DXH. I think that having worked through the merger of Beckman and Coulter, the Hematology instruments have become less competitive. I understand, however, that for some there is a significant price difference. I hope this helps a little. Also, Sysmex handles lipemic specimens directly with dilution and calculations automatically maid and reported; DXH does not have this capability.
  9. can wash change the strength of the reaction

    Exlimey, thank you for pointing this out. It is definitely the weakly reacting antibody that may be washed away with excessive washing.
  10. Blood Bank staff

    Yes, you are correct; ..management recourses not withstanding.
  11. Blood Bank staff

    From the posts given here it seems that there is some dependency on the size of the hospital (number of beds) and the patient populations treated. There are issues of fiscal responsibility and best utilization of staff and other recourses such that dedicated staff, although ideal, may not be cost effective in all settings. A well qualified and dedicated managerial team is always needed as this factor can make a huge difference in meeting the obligations of resource management and service delivery, and staff maintenance, while maintaining fiscal responsibility. It is here that I have experienced the greatest shortage.
  12. Elution Studies

    1) IgG positive adult cells ( not Cord cells) 2) Acid Elution Method 3) Ortho Gel Card 4) Screening Cell 1 and 2, along with Last Wash supernatant as a control, and full panel if either screening cell is positive. It has been awhile but I think that we practice to perform the panel in tube; I will check up on it. 5) Our Acid Elution Kit comes with a Working Wash Concentrate which is diluted 1:9 with BB Saline and used for testing. Our method also gives the option of a total of five or six washes with saline if suspecting a weak antibody that may be rendered inactive with the Working Wash Solution.
  13. can wash change the strength of the reaction

    jwnola I believe, though practice of procedures from different blood banks, that washing the cells eight times is considered excessive such that the antigen, if present, might be partially wash away or altered rendering weak reactivity. The maximum number of washes when testing Cord blood cells is four times, as I have practiced. Do you know of any studies or articles stating that eight wash cycles is practical and does not alter antigens?
  14. Thank you Scott. So the original post makes more sense. It would seem that a manipulation of the screening cell would be considered an LDT especially in the absence of any manufacturer's instruction and testing thereof.
  15. The only time I have seen reagent cells diluted is when they are being used for an antibody titer, and here QC is run. The other manipulation to reagent cells that I have witnessed, but not practiced, is the replacement of the manufacturer's reagent cell solvent with blood bank saline, when trying to get rid of week non-specific reactions. I do not know if QC is run in this case. I do have to ask a dumb question though; what does LDT stand for? Keeping track of the meaning of lettered abbreviations is difficult especially when they are not used regularly enough. Thank you in advance for any reply, Ronald