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SMILLER last won the day on August 6

SMILLER had the most liked content!

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

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  • Biography
    Medical Laboratory Scientist
  • Location
    Saginaw, MI, USA
  • Occupation
    Generalist, mid-sized level 2 trauma center
  1. Verbal orders for blood

    Our hospital IT people created a "uncrossed-emergency-MTP" order (actually just a notice) that can be entered into the hospital system that sends the patient's registration to the BB system. That way, we can order whatever on our BB system when a MTP is started. The "order" also serves to document a physician's order for using uncross-matched blood. Scott
  2. Dermatology

    It does not seem like there would be a problem in just looking at a specimen. The problem would be in billing for that review as PPMP (if that is going to be done), and then having another billing submitted by your path lab. I would suggest you get advice from your Path Lab for starters. Other than that, I guess I would see what CMMS has to say about it. Scott
  3. Blood Bank staff

    Whether you call yourselves Lean (or Six Sigma or some other facetious productivity name) or not, the reality for many labs these days is that generalists are more and more necessary to keep things going in light of personnel shortages, We are a 250 bed level 2 trauma hospital, with a fair amount of Lab work on the type of patient population we see, including BB. The only real "dedicated" techs we have are in Micro (and of course, Histology). About a quarter of the techs on first shift are generalists that can work on a regular basis in BB (in addition to the main Lab area). On second and third shift, virtually all of the techs work BB in addition to the main lab area. Whether one has BB with all dedicated staff or no, the key is to have adequate training and competency, along with extensive references, including having good P&Ps available. This is true for all areas of the Lab (and in health care in general!). It requires a sharp and dedicated management model and staff. Scott
  4. Verbal orders for blood

    Simular to AMcCord, above, except that once something like a massive transfusion protocol starts, we follow a documented P&P to get further units ready until the MTP is called off. We do the ordering during that time ourselves. Scott
  5. Consultation Charges for Antigen Typing

    Those dang physicians! Running up bogus charges! What we do is similar to Molly, above. The issue of changing billing regarding whether or not a unit is crossmatched or used does not matter to us. If we have an order for a crossmatch for compatible units, we do (and bill for) whatever work is needed to get those ready. if that involves a simple IS crossmatch, that's what the patient is charged for. If we have to screen 10 units to find two Ag-compatible, we are going to charge for all of that work. Scott
  6. That makes sense to me, too. Would you have to be careful with platelets though? They are often in plasma that's not necessarily ABO compatible. Letting O platelets sit with A RBCs in a reservoir does not seem like a good idea. Scott
  7. Antibody Titers Gel vs. Tube

    Anna, in the bit about gel interference I posted above, CRP was just mentioned as an example of something that can cause gel interference (along with cold agglutinins, high levels of immunoglobulins, etc..). CRP is an acute phase protein where huge amounts of it could conceivably sticky-up RBCs in gel. The main question I had was wondering if something that causes gel interference could result in an over-reading of titres when comparing results from serial pre-natal specimens. But as Malcolm has pointed out above, it does not seem to be an issue. Scott
  8. Antibody Titers Gel vs. Tube

    The only thing I would worry about with pre-natals, where titers from one month are compared to the next, concerns things that may intermittently cause gel interference. For example, if I am not mistaken, CRP goes up and down with any pregnancy, and could cause gel interference (potentially upping the titer I would think) for one month but not necessarily the next. What would one do with gel titers were interference is noted in one specimen but not another? Or maybe this would never happen? Scott
  9. The nursing references I have seen specify only normal saline for infusing blood. If we were releasing a FFP and a RBC at the same time (or two RBCs for that matter), we would ask if they have two lines running. Scott
  10. Antibody Titers Gel vs. Tube

    "Do you want it to be faster and more hands-off or more exact?" They really said that? Yikes! Scott
  11. Antibody Titers Gel vs. Tube

    On p. 563 of AABB Tech Manual 18th edition, it only mentions that titer methods other than "saline AHG 60 minute incubation" in tube may result in higher titers and "should be validated with clinical findings" (see Malcolm's post, above). So it does not seem to say one cannot use gel or other methods, just that you need to document validation. I have always been a bit uncomfortable with identifying an antibody with gel (for a prenatal), then doing the titers in tube. But then again, I guess it is the comparison of the series of tube titers that they are looking at. Scott
  12. IL HIT test

    Is anyone in the US using this test? I just found out it is available. I would appreciate comments from anyone who has had experience with it. Thanks, Scott
  13. Manual platelet counts

    We still order the kits here: "BNP Leukochek"s they are called. We need them for a check-off item for our students. (No Eosinophil stains though!) Scott
  14. Automated body fluid q.c.

    Due to issues with linearity limits and other inconsistent results, we have chosen to not run body fluids on our Coulter DxHs, but we were given the impression that specific controls are necessary if you are going to report those out. Scott
  15. Manual platelet counts

    No. Scott