nziegler

I've heard about them, and we think we may have seen them, but not reported. Curious what people would report them as. I would think that reporting "rare green crystals of death" might be a little disconcerting to the physician!

We've seen this once. If we're lucky enough to realize that's the problem, we would saline replace to allow the cells to get re-acquainted with the proper osmolality. (The MCV on our particular patient was 134, so it was a bit obvious)

I have not heard of this 5 year requirement. Can you cite the exact standard??

Joint Commission Standard DC.02.04.01 Element of Performance 5 note: Retained records may be paper or electronic. Electronic systems must be able to retrieve all information printed on the original hard copy generated at the time of testing in order to be considered satisfactory for compliance. So, it can easily be argued that the LIS serves as that electronic record. But for something that doesn't have an actual computer workstation as part of the system, we play it safe and keep the tapes (plus NYS just has crazy strict interpretations of regulations). Luckily, the tapes don't take up much space.

You must be able to retrieve original instrument data for at least 2 years. For something like a small Clinitek, the result tape is the only thing you would have to prove what the instrument originally gave - as results can be modified once they cross the interface. Most bigger analyzers have a way to store patient data electronically.

We have an actual form the techs need to fill out that includes the criteria set by our hematopathologist. I've (hopefully) attached it here.... SMEAR REQUEST FORM.docx

I agree with Scott - even in hyper-regulated NYS there is no requirement for differential "QC", just stain quality as already mentioned. (But we do have to start doing UA microscopic QC ... ) Nicole

Scott - we switched to BioRad DDimer QC. Mainly because in NYS we have to have a control above and below any "cutoff" values and IL does not have one. Stability was an added bonus.

IL's liquid reagents are excellent! I just switched to the liquid Readiplastin about 4 months ago and have not had any problems. Same goes for their heparin Xa reagent. I've been using that for over 5 years and it is the most stable reagent I've seen. It is rare that I have to re-calibrate prior to the 6 month or new lot requirement. They had trouble with their liquid DDimer reagent a while back, but I haven't had any issues since they were resolved.

that spreadsheet looks great! I'm definitely going to give it a try. the only thing I see that I don't like is that it seems to use the manual count as the "reference" method to do the math... with today's technology, I would consider the automated count more accurate than manual (obviously excluding leukemic/dysplastic scenarios)

do NOT let my NICU know that!!

It's super easy to use, just like anything on the TOP. Liquid reagents, no reconstitution. the controls are lyophilized, though. I don't remember much about on-board stability, but the package insert is available on their website. I believe we plan on offering the test on-demand and then putting the reagent back in the fridge after each patient. Each set of reagents give you roughly 24 tests, and there's 2 sets per box. I can't wait to get it - just for improved TAT. Currently physicians have to wait 2-5 days to get the result from Quest.

i have the midas III stainer and the same problem. MarketLab sells these labels that magically dissolve in water when you clean the vessels: product 9744 "soluble MSDS reagent label" it's a roll of 250. I hate the amount of maintenance on the Midas - I used to have Hemateks. but I got it for free, so I can't really complain

Curious to know how you're doing them - the unopette was discontinued years ago. We do not perform them (despite doctor's best efforts to demand them).

Beckman makes specific body fluid controls that get run in body fluid mode, and you should be running those if you are reporting body fluids from the DxH. As Scott mentioned, the linearity isn't very useful for most of our fluids (we can usually report the TNC, but need to perform a manual RBC). I'd like to move them to our Iris.