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SMILLER

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Everything posted by SMILLER

  1. SMILLER
    See the topic: 'Gel Diluent QC' started a few days ago. There are some comments and ideas there. Scott
  2. SMILLER
    I may be mistaken, but I think the idea behind freezing an initial specimen that was titred and then thawing and running in parallel with subsequent titres, was so that if there is any variation in technique between one testing event and another, the retest of the initial specimen along with testing the subsequent specimen would eliminate any question as to how the titres have risen (or not)--in comparison to each other as they are being tested at the same time--when the subsequent specimen is received and tested, Scott
  3. SMILLER
    We do the same for our traumas. I think its a common practice. Scott
  4. SMILLER
    On the other hand, if those 15% are in another emergent situation in the future... Scott
  5. SMILLER
    We used to get them from time to time. We just use a generic body fluid cell count and diff order. Scott
  6. SMILLER
    You would want to check the Ortho Instructions For Use (all Ortho IFUs are online) for stuff like this. I believe the MTS diluent is listed as being usable until its label expiration date (opened or not). The notes about QC are there also. I am pretty sure our Ortho customer rep went over all this stuff with us when we switched from tube to gel years ago. Scott
  7. SMILLER
    Oh, yeah. That's true! I think Ortho wants to make sure that you do not respin and try to re-read used cells. And still, you would not want to try to "fix" a bad card (liquid off the gel) by re-spinning before use I think. Scott
  8. SMILLER
    I think you need to worry about the quality of the cards before they are used. We also have had some bad cards shipped to us earlier this year (we do manual gel). Bad as in no liquid on top of the gel. According to Ortho, the gel goes bad in situations like this, so "fixing" them by re spinning doesn't seem like a good idea. They should just be rejected. Scott
  9. SMILLER
    We use diluent to make up the negative and positive control solutions for checking the screening cells. That seems adequate. Scott
  10. SMILLER
    The only use of Rh immune globulin that I have seen is for neutralizing the tiny amount of fetal RBCs that may enter the mother's bloodstream. I also would be interested in how this could work for large amounts of D+ RBCs being transfused in an emergent situation, such as a massive transfusion. Scott
  11. SMILLER
    There are a few ideas in this article;: https://www.mlo-online.com/home/article/13008689/lipemia-and-hyperleukocytosis-can-lead-to-cbc-errors It seems like manually removing the buffy coat is a bit crude compared to some of these other ideas, like subtracting the auto-WBC from the auto-RBC to get an accurate RBC. Scott
  12. SMILLER
    Whatever centrifuge or cell washer you use, you need to check it at different times for each speed. What you want to see is how long it takes to get a clearly delineated cell button for both a positive and negative reactions, in addition to a negative that dissolves easily. We check ours yearly, (I think it's regulated by our inspector-JCAHO). And sometimes we find we have to adjust a time for -- say -- an IS -- from 15 to 20 secs or whatever. Scott
  13. SMILLER
    When we got our DxH 800s a few years ago, we tried to correlate several types of body fluids, and decided that it was not worth the trouble. The linearity was not very precise (or accurate compared to manual counts) at lower levels, like those found in CSF. You will have to do a manual diff anyway, as no hematology analyzer is going to report out mesothelial or malignant cells. Scott
  14. SMILLER
    Same as Dave, above. Scott
  15. SMILLER
    A and B. Depending on whether or not the director determines that the supervisor or staff members are breaking any rules, they may want to consult with HR or any union reps as well. Scott
  16. SMILLER
    Remote as in down in the ER or the OR? At an outpatient facility? At another of your system's hospitals? Scott
  17. SMILLER
    While the patient is in the OR, they collect specimens. However, most surgical patients have blood drawn by the associates working in the pre-operative holding unit before they go to the OR. Scott
  18. SMILLER
    My idea was just a guess. If you come across any clinical reasons for this testing in the future, I would be interested in seeing them here. Thanks, Scott
  19. SMILLER
    Indeed! Keep up the good work! Scott
  20. SMILLER
    I would say, like all pre-natal atypical antibodies, they are thinking ahead to see if a particular titre increases. One would need a baseline to do this, and they already know the patient will produce antibodies. I would hazard that a significant increase in titre would suggest a feto-maternal bleed, which for this patient, would need to be dealt with as soon as possible. (There is no "S" equivalent to things like Rhogam...) Scott
  21. SMILLER
    I should have mentioned, the original screening cell that did not react with was listed as R1R1, while the patient reacted fine with R1R1 cells on the other set of screening cells and with the panel cells. So, kind of odd. We did call Ortho but they had nothing to add about the situation. Scott
  22. SMILLER
    We had a patient, 30-year-old female, B pos, who showed up last week with an anti-C along with a few equivocals. When it was time to repeat the T&S (and antibody ID) a few days later, we went ahead and set up a panel along with the screening cells, since we already knew there was an atypical antibody that would show up. To our surprise, the screen was negative (Ortho manual gel). The panel reacted as expected, pretty good 1+ reactions for the C, with a few equivocals. The second specimen's screen was with a different lot of screening cells. We also tested with the original specimen's lot number of screen cells, and 3% tube screening cells -- those reacted as expected for an anti-C. Kinda odd. The newer screening cells were checked with another patient who makes anti-C - that reacted as expected also. Its just the one patient with the one lot of screening cells that did not react. Kinda odd. Scott
  23. SMILLER
    You may want your lab manager to talk to your trauma docs. I am pretty sure that they are going to want to know that you can provide type-specific blood ASAP before the Blood Bank runs out of O negs. Scott
  24. SMILLER
    LOL! Or it would be nice if you could get your pathologist to talk to him. Scott
  25. SMILLER
    Periodically we audit bedside transfusions, to ensure the readback and other pre-transfusion procedures are followed there. If you believe that your OR is not following your hospital's procedures, it seems like you would have to run an audit there to ensure that those associates are not cutting corners. This si a department to department quality check so I would think you would have to set it up with the respective directors. Scott
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