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SMILLER

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SMILLER last won the day on October 16

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About SMILLER

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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

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  1. It's not snowing yet on Pathlabtalk! Scott
  2. We are in the process of switching our specimen collection tubes to Greiner Vacutte (previously we used BD). For some reason, with one of our STAT fuges, the stoppers keep coming off while being spun. Not all the time but enough to be annoying. The centrifuge in question is a Hitteck EBA200. The vendor has recommended a certain insert for these Greiner tubes, but they still keep popping off at random. The stoppers are slightly different from the BD tubes, but we cannot see what is causing this. If anyone has any ideas for fixing this they would be appreciated. We are trying to see if Greiner has any ideas. Scott
  3. You are not overreacting. You are being responsible, which is what all healthcare workers need to be. Other than discussing all of this with your department administrative director (your manager's manager -- maybe you have done this already -- at our hospital, this is at the department director level), I am not sure there is much else you can do within your department. You mentioned talking to the FDA and your risk management department. Your hospital should also have a corporate compliance fallback for things like this (that cannot be resolved through management -- you can report anonymously if you desire) For corporate compliance issues, the business must respond to your concerns and report back to you within a limited amount of time. Good luck. Scott
  4. How nice it must be to live in a country where people do not have to borrow another's ID to receive health care! Scott
  5. Welcome Vivek. You may note, from some of the old posts above from 2017, that many labs do not use grading. In my lab, for instance, we have a chart of all appropriate morphology that we report here. The chart lists the proper name for each, causes, and what a significant level would be when reviewing a slide. If a particular morph is not present in significant numbers, it is not reported. When it is reported, we do not grade it. Scott
  6. Also, I am pretty sure that our inspectors over here would also have a problem with D+ platelets being given to a child-bearing-age female who was actually D-! Scott
  7. We went through this a few years ago. The problem with any kind of written worksheet is that it becomes your primary record -- the computer entry is secondary. -- resulting in both sets of records must be retained. When results are directly entered into the computer, almost all written testing records are not needed. Scott
  8. Except, as been noted here on various threads over the years, it can happen that a patient becomes admitted under someone else's identity. Scott
  9. Agree with Ward's points, above. Any change in policy will involve discussion with ER, Surgery, etc. that includes education once a decision is made. When we became a level 2 truma center a few years ago, we had a rather elaborate MTP process that included things like Coag and CBC results. We have two different orders for emergent situations: An "Initial Resusitation Cooler" order (2 RBCs, 2FFP), and an "MTP Protocol" order (5 RBCs, 5 FFPs, 1 5-pk platelets). We repeat the MTP order until it is called off. In addition, individual orders for uncross matched products can also be made. Scott
  10. Here we have to positively ID a patient for each admission. This involves arm banding and at least an ABO/Rh for plasma or platelets. Scott
  11. I would think that the rephrasing was to emphasize that is is the reagent in the vials (not just the vials themselves!) that expires after 7 days. I think it is clear that they are saying they claim the reagent is stable for 7 days after opening. If I were an inspector, I would interpret the new phrase as indicating that the "performance characteristics" end after being "maintained" for 7 days, which would mean that you cannot use a vial after that time. Scott
  12. A policy that concerns massive transfusion situations (where a patient with an unknown ABO may have to be switched from AB to A plasma) would fit here I think. For the other, our blood supplier does not send out plasma from donors with atypical antibodies---I think that is common practice. Scott
  13. We have been doing open heart surgeries for decades and do not miss having a TEG or Rotem. (From what I understand, they are more sought after for trauma surgeries.) For BB products to be held available, you may have to have platelets on hand. Here, many OH patients end up having 2 units of RBCs on hold (or sent to OR in a cooler). Cell savers are maintained by Surgery here. Almost all of these issues should be determined by your cardiac surgery department--it is unlikely that you will have to make a decision one way or another for deciding on these types of services. I would think that rather your job will be the Lab side implementation once decisions are made. Scott Scott
  14. This may not be exactly what you are looking for, but it is instructive for basic step-by-step procedures for antibody ID. https://camlt.org/wp-content/uploads/2017/09/Advanced-ABID-Case-Studies-CAMLT.pdf
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