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Darren

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Darren last won the day on October 5

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    Clinical Laboratory Scientist

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  1. Darren

    Rh Pos or Rh Neg?

    It was a bit of a troll question. It seemed to me that if we can't trust the reactions we get in gel then what's the point of using it. As far as I can tell regarding the IFU's Dansket is right. I realize the importance of precision and care being taken in the blood bank, but I think a lot of times we fall victim to an overabundance of undue caution.
  2. Darren

    Rh Pos or Rh Neg?

    Do people call antibody screens negative if they are 1+ or 2+?
  3. Darren

    Rh Pos or Rh Neg?

    If it's positive in gel, we consider them positive. It's been that way at this facility since we went to gel in 2004. We haven't see any complications because of it, but then with our volumes we probably wouldn't. Probably the majority of our daily testing is prenatal type and screen testing from our doctors office. We don't have a huge daily volume though. A dozen separate patients would be about as busy as we'd get. I would say most of our patients are pretty healthy with strong antigen expression. I don't see many below 2+ on them. We only weak D test cord bloods. Isn't it the general statistic that 16% of Rh neg mothers will develop anti-D without RhIgG? You can probably run the numbers on how many you have that test at 1+ and 2+ and then check their results against any DNA testing you've done. You might find that the low the percentage may not be worth the extra fuss. I believe I heard the number of people having just one child is increasing. Huge world of statistics to consider!
  4. Darren

    Therapeutic Phlebotomy Scale Maintenance

    Can you give a description of your validation process? I'd like to do away with the #%$^& Ohaus hanging scale we use. I just got some macopharma bags in to get up and running. Thanks.
  5. Darren

    Electronic vs Immediate Spin Crossmatches

    Does anyone here use poc phlebotomy? We're looking into it and evaluating it now. I've heard of hospitals adding T&S/Xm testing to existing CBC specimens when they use the bedside labeling with patient wristband barcode scanning. In these cases I think they just run a second type on the same specimen if they do EXM. We have EXM validated (for years now), but are not using it yet due to having a timid pathologist. Currently we have a two person verification system when blood bank specimens are collected and banded and we run a second type on that same specimen. Probably not ideal if we go to EXM (eventually . . . hopefully . . . dear god please!). I've heard of other hospitals running a second type on an existing CBC specimen collected at a different time, even from up to a week old. Thoughts?
  6. Replacing with the cal expires seems extremely wasteful. Although it's probably good for whoever's turn it is to get a new thermometer for their home chest freezer or what not. We have a company that comes in every six months and checks out all of our pipettes and thermometers and maintains various things like microscopes. It's quite nice.
  7. Darren

    Radiometer Aqure

    Anyone using Radiometer's Aqure Xpress? If so, how much does it cost? i assume it's a yearly fee. If anyone uses the full version I'd like to know if handles glucometers as well. And how much it is.
  8. Darren

    Antibody Screen before Issuing RhIg

    We use the FetalScreen II from Ortho/Quotient. Reading through the instructions for use makes me wonder if it's useful at all. I think we may consider some send out options for KHB or flow cytometry and relieve the bench staff of the effort altogether.
  9. Darren

    Proficiency Testing

    I order all tests for all blood bank CAP specimens in our LIS and label them for the techs doing the testing. I've always been told that QC and CAPs are supposed to be ran exactly the same as patients. With that in mind I order everything for the tech and present it to them as if it were any other patient. It really cuts down on flubs and clerical problems and you get so much less complaints about having to do a survey specimen.
  10. Darren

    Antibody Screen before Issuing RhIg

    We will run a type and screen on patients with no history with us. Usually these are ER visits. Other than that we just run a Fetal Bleed Screen if the gestation is >14 weeks or the baby has been delivered and is Rh positive.
  11. Here's the setup I did recently for putting hemacytometers into meditech and have meditech do all of the calculating for the staff. Here's the RBC or WBC count average formula. R and S are the labels assigned to Side 1 and Side 2 of the hemacytometer [f qc spec], -------This makes it use the calculation for the qc test as well. (I'm a one man paper eliminating machine.) S!R^H, -------This evaluates side 1 and side 2 and assigns H to the higher number. S&R^L, -------This evaluates side 1 and side 2 and assigns L to the lower number. ((H-L):2D/L:2D)^P, -------H-L (up to 2 decimal places) divided by L. This is the percent difference in the two sides expressed as a decimal. IF{P*100>10 ">10%"; -------This multiplies the decimal from above by 100 to make the percentage, then looks to see if it's greater than 10%. If it is greater, it displays ">10%" which is an unacceptable result and indicates a recount is required. P*100'>10 (H+L)/2}; -------If the percentage is less than 10% then it calculates the average count of the two sides. A separate calculation performs the hemacytometer count for RBC and WBC when the number of fields counted is entered. Much simpler than the above one. (L/F)*10; -------L is the the average count from above. F is the number of fields counted. If there is a dilution the staff have to multiply this result by the dilution factor manually.
  12. Anyone using the [f qc spec] keyword in calculations so that they work on QC samples? There are no examples of it being used in the Meditech knowledge base. I've got a few calculations that use it and work.
  13. I came up with a reflex rule for our fetal bleed screens. We have the fetal bleed in an Order Group that reflex orders the FBS if a tech says that RhIgG is indicated. We don't run fetal bleeds on patients with a gestational age <14 weeks. You attached the reflex rule to the order group. We have a custom screen on the RhIgG screen order that requires that the gestational age be entered in a query by nursing. It's a number query. The logic is: [q L.FF2]^W, IF{W<14 [f rflx not ok]; [f rflx ok]}; Our number query for the gestational age is L.FF2. We assign it to the letter W and then the rule says if the number is less than 14 don't reflex, otherwise reflex the FBS.
  14. Yes, it does. It results it as soon as the specimen is received. The result of the calculation will be ABN, ABP, AP, AN, BN, BP, ON, or OP. You can have any of those set as the result code and then make the result text whatever you want. If the calculation sends a blood type I have it translate all of the blood types to History On File. You could leave it the blood type if you want. If no type is sent it just says No History. I should have also said that the type of calculation is "PRE" and in the trigger test section I have ORD set to N.
  15. Yes, it does. It results it as soon as the specimen is received. The result of the calculation will be ABN, ABP, AP, AN, BN, BP, ON, or OP. You can have any of those set as the result code and then make the result text whatever you want. If the calculation sends a blood type I have it translate all of the blood types to History On File. You could leave it the blood type if you want. If no type is sent it just says No History. I should have also said that the type of calculation is "PRE" and in the trigger test section I have ORD set to N.
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