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Auntie-D

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Everything posted by Auntie-D

  1. In the MHRA inspection I had when I was BBSup I challenged on 4 different non-conformances and had them wiped off. My current employer (and others too) seem to think that you cannot challenge their interpretation of your policies - and sometimes the interpretations are incorrect.
  2. ISO inspectors have said the fridges have to be under direct control of the lab - a few labs I know have been told to remove their remote fridges.
  3. POETS day is a good one... All the managers covering the lab so staff can go an hour early on a Friday.
  4. In the UK we are forbidden from having remote sites now. We have O-Neg, CMV neg, K-neg, HEV neg, units. We do not have irradiated units, or less than a certain date as we do not have babies who have undergone IUT, and if we do we are notified in advance and we get irradiated units in for them.
  5. Surely it's just common sense not to accept it? The tech on duty needs a rocket up their bum!
  6. We've given a patient an anti-D with apheresis platelets - fortunately a man, but unfortunately he then went on to be transfusion dependent, meaning full crossmatch and no electronic issue possible This was within the past year so it certainly still happens. We would only give anti-D to patients of childbearing potential and we keep one unit in stock of APos in case of massive haemorrhage/urgent need
  7. Not in Micro any more but we used to add 2ml, shake and then centrifuge the liquid. We would then remove the supernatant and use the remaining pellet.
  8. Could it be the modified KB that is being developed? If you do a KB then dip in Geimsa for 5 seconds it stains the nuclei making it easier to differentiate between lymphocytes and foetal cells.
  9. Are there two Joyce Pooles? My transfusion lecturer at uni went by the same name. She wasn't famous was she???
  10. I'd say the fact that you are getting so many calls means that either training/competencies aren't up to scratch, or the SOP is lacking. You say that the tech had signed to say they were competent in the task - who had verified this? It sounds like you need to look at your own management, rather than blaming the techs. I've been in the situation you are in as a young supervisor with people who are older (and more experienced in terms of years) below me and it is a hard place to be. Ironing out the issues with poor performers is the hardest thing to do and the only way to do it is with good competency-based assessments. Another thing to consider is including a list of changes when putting a new SOP out - you will find that 'old-timers' think they know the SOP so won't bother to read it (I've been guilty of that myself). Another thing I did was introduced an hour a day for each section where one person (on rotation) could spend the quietest time of the day (usually 11-12 or 2-3) getting up to date with any outstanding training. It meant that everyone (in theory) got an hour a fortnight. Do keep in mind that how they perform, and your response to it, will reflect directly on you - it's a good idea to keep them on side and make sure competencies are absolutely spot on. Anything that isn't can be brought up at their appraisal as a goal for the next year (not a stick to beat them with). Help your staff, keep them happy, and they will start having the confidence to trouble shoot themselves without fear of reprisals or looking stupid. You could really make something positive out of this situation and get brownie points for it in your own appraisal.
  11. I've looked into this as the UK imports some of its Frozen Products for the US - as the virus is lipid encapsulated methylene blue should deactivate it, so there shouldn't be any worries with FFP/cryo/Octoplas etc. Remington KM, Trejo SR, Buczynski G, Li H, Osheroff WP, Brown JP, Renfrow H, Reynolds R, Pifat DY. Inactivation of West Nile virus, vaccinia virus and viral surrogates for relevant and emergent viral pathogens in plasma-derived products. Vox Sang. 2004 Jul;87(1):10-8
  12. We only reflex to a confirm if the screen is positive. If the LNR is >1.2 we then report as "Possible Lupus anticoagulant, please repeat in 12 weeks for confirmation.". This eliminates any acute phase patients which may be falsely positive - they aren't the best with the clinical details.
  13. Just check the release date/version number of the insert - if that hasn't changed then nothing in it has.
  14. Is she Rh neg? Could it be anti-c persisting from the Rhogam?
  15. Very polite way of putting it... It would be interesting to compare the ones IV due to their mass compared to the ones just under the cutoff and still having it IM.
  16. I understand now - in the UK it is required that it is quantified as guaranteed less than 2ml so KB for us for all pos babies. ETA - doesn't the manufacturer instructions state that the rosette test is only for antenatal use, not postnatal? I remember a thread quite recently...
  17. You mean like the non-sterile bag of blood being hung in theatre?
  18. Today my dear chap you win the internet! (again)
  19. I just can't get my head round how any hospital can only be doing one a year. ETA - it seems an awfully faffy stain that you are using! If it isn't following the actual KB staining regime (which every other kit I have ever used does) then I'd be revalidating it.
  20. Every lab I have worked in in the UK (and I have been around a bit) only do anti-IgG, and anti-C3d and an auto control as that's what is in the cards. Surely this is enough to pull up if it is clinically significant? Or should we be using 6 well instead of 3 well, cards.
  21. Why do you keep your buffer in the fridge? It is supposed to be stored at room temp. Decent smears - it doesn't really matter if they are decent or not (unlike for a diff). 2 drops of saline and one of cells will 99% of the time make a prep that is a uniform monolayer. Lastly - if the foetal screen kit isn't quantitative how do you ensure you are giving sufficient anti-D?
  22. Sounds like a real adventure! Think of how little cleaning you will have to do!! Do you have an awning for alfresco dining?
  23. A KB doesn't take 30 minutes - 5 minutes to dry, 3 minutes to fix, 30 seconds to leach and 2 minutes to stain. How sensitive is the foetal kit? Can you judge the volume of bleed accurately from it?
  24. As someone who has never done one - how is a foetal screen easier than a KB? KBs are so so simple I am finding it harder to envisage a simpler test.
  25. How on earth do you get away with not doing them in the US, with it being such a litigious society? We do several every day...
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