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SMILLER last won the day on December 14

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

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    BloodBankTalk: Allergic Reaction

    I just answered this question. My Score FAIL  

    CPK Critical Value??????

    We do not have a critical cut-off for CPK. Earlier this year, however, we did add one for Troponin. Scott

    Training new employees

    All of our associates who train for BB, except for the coordinator, are generalists here. We are a trauma 2 250-bed hospital with no peds. Our training typically takes 3-5 weeks, depending on previous experience. Scott

    Direct antiglobulin test

    And its at least possible that the speck in question was, indeed, an artifact, and the anti-Jka that was discovered was just very weak, and a coincidence. Scott


    Whew! I was starting to think there were none left after I broke them all last year! Happy Holidays All! Scott


    Where's the snow?

    MCV and hyperglycemia

    This is a new one for me (after 30 years!) An ER patient presented recently with a MCV of 107 and low MCH, MCHC. This patient was in house at our hospital just last week, with all normal indices. Called the RN in ER who commented that she is expected to have a very high glucose. Googled it and sure enough, hit a few articles like this; https://www.ncbi.nlm.nih.gov/pubmed/7259094 The patient had a glucose over 1400 g/dl. My question is this: for those of you who are aware of this phenomenon, do you attempt a correction and report that out? Apparently this is a in vitro pj=henomenon related to hyperosmolality when the blood sits in the EDTA tube before processing on the ananlyzer. The "cure" is to do a saline replacement and let it sit a bit. Thanks, Scott
  8. We start with O Negs but after 4 - 6 units, we would switch to O pos for those patients in question in order to have the remaining O Negs on hand for women of childbearing age, should one show up. Note also that our nearby blood supplier can have more RBCs to us within about 45 minutes. We are a level 2 trauma center. Scott

    Patient identifiers on BB samples

    The difference between a BB armband and having only a hospital armband is significant only if the Lab is responsible for specimens drawn under the BB armband. One needs a strict policy regarding the use of BB armbands to make them effective for avoiding things like mis-labeling and lost armbands. Scott

    Frequency of vital signs

    Pre-, at 15 minutes (patient is monitored for first 15 mins), every hour thereafter, one-hour post-. I think that's pretty standard. In the US it may all be by the book as far as regulations. Scott
  11. Has anyone else ever noted these? These crystals appear with Wright-Giemsa stain as greenish aggregates in neutrophils. They are often associated with severe necotizing liver disease. Here is one reference but there are others on the net: https://www.ascls.org/communication/ascls-today/320-ascls-today-volume-32-number-4/431-a-case-of-blue-green-neutrophil-inclusions In the articles I've looked at, they may only appear in 1-2% of cases, so they are easy to miss. There are a few good images on the internet if you look for them. I was wondering if anyone else who is aware of these things, routinely reports them if they are noted. Thanks, Scott

    Direct antiglobulin test

    LOL! But it occurs to me you may have responded to the mini-cold issue even more often! Scott

    Direct antiglobulin test

    Malcolm-- How many times over the years, here on this most excellent internet informational exchange site, have you responded to this particular issue? Scott

    Direct antiglobulin test

    I would say that an electron microscope or a telescope would qualify as an optical aid also, but I am pretty sure that is not the intent of Immucor using that term either. The problem with using, say, a high-dry (40x) microscope objective on a specimen from a tube on a slide is that you will have to define how you are going to deal with a false positive. Because as it has been pointed out above, most specimens examined by tilt-tube, be they ABO typings or something involving AHG, will be seen to have at least a few small agglutinated clumps of RBCs if you look at it this closely. To create a procedure for using a scope, one would have to arbitrarily define what can and cannot be ignored under these conditions. Scott

    Direct antiglobulin test

    Microscopic check? No. As far as I know, no regulatory agency requires it for DATs. A mixed field reaction is a presumptive positive. We use Ortho reagents, proficiency used to be from CAP, we have since switched to API.

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