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SMILLER last won the day on March 27

SMILLER had the most liked content!



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    Has been around for a while
  • Birthday 08/10/1958

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    Medical Laboratory Scientist
  • Location
    Saginaw, MI, USA
  • Occupation
    Generalist, mid-sized level 2 trauma center
  1. Temperature Monitoring

    This particular alarm is a little thing from Supco, its a TA-6. We have a separate chart recorder. Scott
  2. UK qualification and experience in USA

    I think so. One thing you could do is call a hospital in the state you are moving to and see if they have any suggestions. Scott
  3. gel card quality control

    Good point about some antigen typing antisera not appropriate for gel QC. For our QC, we do indeed use a kit that is appropriate for gel. We dilute down the anti-sera from the Ortho Confidence QC system (same one that we use for ABO reagent QC), which has anti-D and anti-c IgG. Scott
  4. Temperature Monitoring

    Over the years we have tightened our monitoring of temps in the BB to include requirements from various regulators. For example, we store room temp tissue for OR and have been recording temps from a thermometer there, but just recently we added an alarm to the side of the cupboard where it is stored. In general, we check all alarms and temps for the various refrigerators, platelet rotators, freezers, etc. and record them once a day, documenting that the charts match the readings match the thermometers. All of our freezers and refrigerators are also monitored automatically by a computer system in engineering as a back-up. Also, everything is checked quarterly against calibrated thermometers. Scott
  5. UK qualification and experience in USA

    It looks to me that there are 12 states in the US with licensure requirements, including Florida, California and New York. You will want to check the state government website for more information for the state you wish to move to. As for certification, which is required for any clinical lab science position in the US, check out the ASCP website as Cliff suggested. You will have to take a national certifying exam. You can google that also, here is one resource: https://study.com/articles/ASCP_Certification_Requirements_and_Information.html Scott
  6. In Vivo Hemolysis

    There is a paragraph here: https://onlinelibrary.wiley.com/doi/pdf/10.1002/ajh.10062 in a journal article from 2002 that mentions a few drugs that can cause auto-immune hemolysis. There are probably others out there. Scott
  7. ABO/ Rh Testing- MTS gel vs. Tube

    The rule in many cases in the US seems to be, if there is a control available, you should be using it. We used to do cell counts without controls, then the manufacturers came up with "body fluid" controls, now they are required, even for manual counts! I don't know how many hemocytometers I have had to recalibrate because of those damn controls! Scott
  8. Laboratory Massive Transfusion Protocol

    There is no requirement that I know of that requires a physician to enter all orders at all times. But the amount of orders entered by a particular physician does affect compensation for the hospital (in the US anyway). So insisting that a doc enter all orders for an emergent situation like a MTP is a dangerous bit of overkill. To make it easier for our docs, we have an order set that includes a "heads up" order to the BB for things like an MTP. We follow our established protocol in BB when that happens, and keep on it until the MTP is called off. These orders are entered typically before the patienet arrives at the hospital in the case of ER. Scott
  9. Daily QC Requirement

    Agree with John, above. Scott
  10. Rh phenotypes

    History is part of the workup--it doesn't matter if the info is from my own system or another hospital's--I would try to get those concession/declaration forms signed after a consult with the attending. Scott
  11. Accessioning Error Rate

    You should be able to find a number of journal articles online, for instance, this one: https://academic.oup.com/ajcp/article/138/suppl_1/A195/1772848 , just by doing a google search. Ideally of course, your quality target should be 0 errors. But practically,I think what you will want to do is establish where you are now and show how, month after month, you are improving on that. Like all projects of this sort, you will end up having to drill down on your data to identify areas that you can improve. Scott
  12. Ror Phenotype

    Well, it may seem subjective to YOU... The particular problem we had was with a few panel cells on a new panel coming up only slightly hazy--not even a weak 1+. (These are R1R1 cells that should be clearly positive with our usual QC anti-sera which contains anti-D and ant-e. So that is what is under investigation.) Ortho said that we should be seeing a definite 1+ at the least. We are used to seeing 2+ or 3+ with these gel panel cells. Scott
  13. Ror Phenotype

    Actually, I was talking to an Ortho tech the other day in regards to another issue, and asked them about their QC for gel panels. They said they test each antigen on each cell to make sure that they get a decent reaction (pos or neg depending). Did not ask what they used for QC anti-sera though. sCOTT
  14. Ror Phenotype

    Yeah, I wondered about that hetero/homozygous D thing as well... I will also mention that according to Ortho, Panel cells are all tested with specific antisera for each antigen for appropriate reaction strength before being released for shipping. Scott
  15. I am not sure what the various regulatory inspectors would say, or exactly what standards they would cite. I do think that any facility that is going to do transfusions would want a armbanding procedure that established an unbroken chain of identification from the initial T&S draw, through processing and testing, to the transfusion. As can be seen by the various responses here, this can be accomplished in a number of ways. Scott