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Lah66

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Everything posted by Lah66

  1. Sorry, I am no longer at a facility with a manual where I could look up this error code. The code is not familiar so I think your best bet would,be to call the company. Sorry I could not be more helpful!
  2. I use the Rumke table as well. I have not found a different tool to use. Sorry! Lauri
  3. We have been using the Innovance on our CA1500 for about two years now. We do just as you have suggested and have had no problems at all. We do remove the DDQ reagent immediately when testing is complete. (By the way, you do not need to keep the gray stopper in the reagent. We called Siemens because techs were neglecting to remove it and we had a few probe crashes.) We do go through the 50 test kit in about two weeks. Our QC SDI and CVI's have been fantastic! Hope that helps. Lauri
  4. Unfortunately there is a lot of creativity out there coming from people who do not quite understand what we do... I can see the WBC and plts falling in the sendout pouroff situation....if you pipette too close to the rbc/plasma interface, you will pick up wbc's and plts in the plasma...so the resulting plasma would have high reds, low whites and low plts....i wish my situation was that easy to explain. Tthanks for all of your input.
  5. Are you referring to instrument QC as the XB and XM analysis? WE do both commercial reagent QC in which Epic provides LJ. Our LH750's are set up for XB and XM...20 patients per batch. If 3 batches are outside our parameters, it alerts us. We do not specifically look at LJ's of XB and XM, just watch to ensure batches are not out.
  6. I agree cryan! I need to just let it go....and get those nurses retrained! I know our instruments are working great! Thanks for the input!
  7. It is a CAP requirement that you prove your method of mixing tubes is capable of completely mixing the tubes before testing. In our case, the only rocker we use is the built in belt of the Coulter. If you use an automated mixer, you need to test that as well. I know the instrument manufacturer must prove that their instrument is capable of complete mixing before the instrument is FDA approved, but you must prove this annually, if you are CAP licensed...not sure about JCAHO.
  8. I could see that happening! The patient had only a CBC drawn at this time.....I am perplexed. My pathologist is perplexed too! Time for some phlebotomy education for our RN's....Thanks for your input!
  9. SMILLER, Thanks for the input...you know anyone can say anything on these forums so it is good to get references. If it makes you feel any better, my department had no deficiences at our last CAP inspection for what it is worth. CAP standard HEM.35850 says Two different levels of stabilized controls are analyzed and results recorded during each 24 hours of analyzer use. We also use XB and XM to ensure our instruments are running well. We have never had our QC go out. Once in a while a vial will go bad, but our QC is always right on. My husbands lab is JCAHO inspected and they are required to run QC every 8 hours. Funny that they are more strict! We do not run QC after a reagent change (see HEM.24575). When new reagents are put on, you have to do something...you can run QC if you wish (expensive), or you can run a patient you previously ran on the old lot. Again, the med director sets tolerance limits. For inert materials like diluent, you just have to run a background on the reagent lot number. We do this when the diluent comes in...check one background on one box to say the entire lot/delivery is QC OK. The med director sets tolerance limits for this as well. HEM.30070 states that if you have more than one sampling mode that you must annually compare results between the modes. Our Medical Director has set tolerance limits for this comparison. We do it monthly though it is only required annually. But, you are correct, you must run Coag QC every 8 hours! HEM.37300 Good Luck!
  10. We have Coulters as well at our facility. Ask your rep for their mixing study procedure...it is nicely written on Beckman Coulter letterhead. Annually, we let a sample sit for 24 hours, load it into a rack without mixing the tube. It mixes only on the belt before being sampled. Next, rock the tube for 15 minutes and run it again. Compare results...we use the same criteria as our correlation studies to decide if the mixing study has passed....i thin wbc must be within 0.5, rbc within 0.10, hgb within 0.3 etc. This mixing study is required annually by CAP. Hope that helps...
  11. We are a smaller 208 bed hospital, so maybe this would not work for you if you are considerably larger, but our Heme department brings all cytospins from malignant fluids to pathology. It gives us the opportunity to confirm malignancy with the pathologist and we can let him know whether cyto was ordered or not. If cyto was not ordered, he will make a call to the physician. We put a comment on the cell count that the cytospin has been reviewed by the pathologist and we refer the physician to the Cytology report. When the pathologist reviews the cytology, he also has our cytospin slide on the tray and makes note of that in his dictation. Hope that helps!
  12. I have worked as a Med Tech for 25 years and have run a Heme department for just three years.. So I know the huge undertaking you were just handed....good luck to you! We run three levels of commercial QC every 24 hours. You do not have to run a patient control at all. One instrument is qc'ed on day shift, the other on midnight shift. You do not need to run QC on every shift. As far as the two modes go, as long as you run correlations at least once or twice a year (i cannot remember the exact CAP recommendation since we do this monthly for peace of mind!) you will be ok. We are going to be purchasing new heme instuments in the next 9 months. The Ruby is out of the question because of having to mix your own retics...but the technology is great. Love the optical platelet...we had Cell Dynes years ago...hope that helps!
  13. Hi everyone, I am wracking my brain trying to decipher this patients results. Every morning for the past three days his CBC showed a WBC of around 13.5, hgb of about 8.5 and plt count of around 325. The fourth day his WBC had dropped to 8.5, his hgb jumped to 13.5 and his plt count went down to 200. The next two days, his WBC was again around 13.5, his hgb went down to around 8.5 again and plt count went back up to around 325. Fiirst thought was they drew the wrong patient, but his rdw and mpv are right on, even the differential matched. All the tubes typed as A neg. The samples were repeated on two different LH 750's with the same results. I assume the problemis with the phlebotomy. What could the RN have done to the sample to get these results? If she drew the blood and set the syringe down and the cells started to settle and a clot began to form....and then she filled the edta tube without mixing.. Does anyone have other ideas?? Thank you for your thoughts!
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