Darren

My hospital was cyber attacked and we've been down for about two months now. The end is in sight and it is the opinion of my boss that we will be manually entering all results from those two months into the LIS. Everything. Lab, Micro, path, BB. Thoughts? My thoughts that it is horribly unsafe and that all results should be scanned in and manually charged has fallen on deaf ears.

Hello all. Am I the only one that doesn't get hemocytometer controls. We run a liquid control when we do them, but it really seems that manual counts should be an issue of competency with a validated hemocytometer, not a qc issue. Even if you get a manufactured disposable hemocytometer with multiple counting areas you're only running qc on two areas that you don't even use for counting the patients. So it seems that QC is assessing the tech performance rather than the hemocytometer. Particularly if using an old glass one with the same coverslip over and over.

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.

Okay! Here's the deal. Cytotherm has gone under. A former employee has taken over the service parts and started his own business that hopefully lasts as long as the thawers do. We ordered 2 bladders from him and got them the next day! The website is called Cytosupplies. https://www.cytosupplies.com/
First purchase is via credit card and then after that you can get set up in his system for POs. So spread the word to get this guy some business so we don't have to fork out a bunch for all new thawers.
 

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

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!

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.

Officially we say "females less than 50", cheeky man.

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.

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.

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.

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

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!

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!

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.

Hello! Would any of your meditech users care to share some of your rules and calculations? Meditech's knowledge base is sometimes lacking in what you need to build these things. A lot of the keywords have no explanation of how they're formatted when used. I'll start out with one I came up with.
Filling in that patient history was checked when the specimen is received.
I built a t-type test called PT HISTORY. It's default result code is "." without the quotes. This result code's text is "No History\FV".
The other result codes are AN, AP, ABN, etc. The text for these result codes is "History On File\FV".
The "\FV" files and verifies the result in case anyone didn't know that.
In the BB calculation dictionary the trigger test and the target test are both PT HISTORY. I assigned the label "B" to this in the calculation. The calculation is as follows.
;The system will check for patient blood type history.
IF{B=. [f bsp bt]};
In English it says: If B (PT HISTORY) is "." then fill in the blood type from the patient history. In this case if there is nothing in patient history then the "." remains and the result is No History. If there is a type, then that result is put in as the result and displayed as History On File.
This helpful for anyone?

Hello! Would any of your meditech users care to share some of your rules and calculations? Meditech's knowledge base is sometimes lacking in what you need to build these things. A lot of the keywords have no explanation of how they're formatted when used. I'll start out with one I came up with.
Filling in that patient history was checked when the specimen is received.
I built a t-type test called PT HISTORY. It's default result code is "." without the quotes. This result code's text is "No History\FV".
The other result codes are AN, AP, ABN, etc. The text for these result codes is "History On File\FV".
The "\FV" files and verifies the result in case anyone didn't know that.
In the BB calculation dictionary the trigger test and the target test are both PT HISTORY. I assigned the label "B" to this in the calculation. The calculation is as follows.
;The system will check for patient blood type history.
IF{B=. [f bsp bt]};
In English it says: If B (PT HISTORY) is "." then fill in the blood type from the patient history. In this case if there is nothing in patient history then the "." remains and the result is No History. If there is a type, then that result is put in as the result and displayed as History On File.
This helpful for anyone?

First I have to get the pathologist to let us start using electronic crossmatch! I validated it and have been collecting info on how many specimens could qualify. It's a bit ridiculous because about 95% would. I'll definitely hound meditech about it when we go live. It seems like an easy and intuitive thing . . . maybe even they can grasp it.

Apparently they don't. I recall seeing a picture of them, but maybe they never got off the ground or were discontinued.