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SMILLER

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SMILLER last won the day on May 14

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About SMILLER

  • Rank
    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

Display Name History

  1. Ya, Malcolm. I can think of a few other situations where this may not be the best policy. When requested by physicians, we have done eluates on compliment-only positive DATs where we ID antibodies, showing that one can have a "false IgG negative" DAT in certain situations. Anyway, in most cases we would repeat the eluate if, in the first place, we identified that an allo-Ab was present on the patient's cells. But as for initially negative eluates, if a repeat DAT is still positive but not stronger than the previous, we would not bother with another eluate. The idea being that if the patient is producing a significant amount of antibody, the DAT reaction would be stronger. Scott
  2. Just realized my last post was to a query from over a year ago! For this one: 1. We would repeat the elution in most cases I think. 2. If the DAT strength has not increased, we would not do another elution. -Scott
  3. 1. When: positive DATs with recent transfusion 2. How: Acid elution 3,4. ID Method: In general Gel AB screen and panel if screen positive, same as regular AB ID. -Scott
  4. We slide those notices inside the outer zip-lock freezer bag so that they show through the plastic. I am not sure if there is a sticker made that will stay stuck at -70! Scott
  5. We recently retired our old-old Coulter LH780 and LH500s and replaced them with DxHs. The system at the main lab is actually a linked set of DxHs that run under one control system. They seem to work fine once we got past a few odd break-in problems. If you are familiar with Coulters, you would have to get used to the newer workstation interface, but they run pretty much the same with some technical improvements. We like em. I would not recommend having a linked set installed. You have more versatility with two separate units. Scott
  6. I assume you are talking about a microscopic for a urinalysis? If a urine is grossly bloody, we add a drop of lysing agent from our hema analyzer (weak HCl) to a few drops urine and look for casts. crystals, etc. In some cases we simply would state present or absent since even semi-quantification on an unspun specimen would be meaningless. Scott
  7. If you are concerned about validation, I suggest you contact your manufacturer. You customer rep should be able to provide you with a list of labs that have already done what you are trying to do -- they should be able to help. Scott
  8. What Malcolm? No anti-weak D antisera available in the U.K.? (There is such a thing as an auntie weak D, however.) My father's sister was a terrible center-back when playing for Suffolk. Scott
  9. From the My Two Cents Dept... I would just point out that it is important that people doing testing understand what and why they are doing what they are doing. I guess this goes without saying. I am not a fan of throwing computer AI at problems when staff have trouble understanding what it is they are doing. I get it that with staff shortages and what not, that generalists have a lot of hats to wear, but a computer algorithm should never be a substitute for appropriate education and regular, effective performance evaluation. Scott
  10. Come to think of it, there may be a problem with using CLR or other de-scalers with water baths. You definitely want to check with the manufacturer as has been suggested! Scott
  11. We have seen this happen with a few patients, though it is indeed very unusual. We figure that a patient is developing a (likely transient) IgM antibody to one of those unusual antigens mentioned above, that just happens to be present on the reverse reagent RBCs. Using another lot number has always resolved the issue. In cases where it does not, we are stuck with an indeterminate ABO typing. Scott
  12. CLR is a product that almost certainly will get rid of scale build up. I am a bit surprised that distilled or deionized water is not recommended by the manufacturer. It seems more likely that is what they would recommend using. Scott
  13. Just to add a bit to what David has already explained. I tend to think of dosage as relating to the amount of antigens present on the RBCs that you are using to ID the patient's antibody, and if the reagent RBC has lots of antigens of the type in question, then the reaction will be stronger. This is really important for a patient whose antibodies are just developing--you want to use a reagent RBC with the strongest expression possible, and these are the homozygous cells. For example, at our hospital, we use the 3 by 3 method for antibody ID (for each type of significant antibody, if the antibody is present, we want to rule in with 3 positive RBCs, and to rule out all the other antibodies, we want to have 3 negative reactions for those.) So for antigens that "show dosage", we want at least one of those three rule out RBCs to be homozygous. Scott
  14. Since IS is at room temp, couldn't it just be an odd non-specific anti-M antibody? Some antigen present on the reverse cell or cells but not on the screening cells? Scott
  15. I believe that it has more to do with HHS seeing a need to fix the shortage of available lab scientists, and coming up with a political solution that seemingly will allow any B.S. degreed person to be eligible. Of course, this is a short-sighted approach that would, if fully instituted, result in a degredation of patient care at a greater expense. But this is not yet a done deal. (Next thing you know, they will allow just any unqualified person to become a physician, attorney -- even president... oops, wait a minute...) Scott