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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
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    Saginaw, MI, USA
  • Occupation
    Generalist, mid-sized level 2 trauma center

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  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. All 'it is written's should be the property of each individual facility, approved by your medical director or pathologist. Here is one discussion regarding drawing blood specimens and transfusions: https://www.phlebotomy.com/pt-stat/stat0513.html There are also old threads here in Pathlabtalk on this topic. Scott
  13. Ya. If I recall correctly, this patient had a strong 1+ reaction with all C pos cells, except for that one screening cell. That one screening cell otherwise reacted normally with anti-C from both reagent and another patient. So just have to forget about this one. Scott
  14. Some important stuff here, too... https://www.youtube.com/watch?v=1VKt2LysGxA
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