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About milesd3

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    Med Lab tech
  1. K-Check tablet serum control

    Thanks Moyer yes I read the insert and actually talked to a nice gentleman there about the same thing as the instructions in the insert basically are what the urine control would be. He told me I could experiment with different volumes of acetone in ketone free serum and develop my own control but that seems like a lot of work and extra use of the tablet. Our pathologist just said to wait and see what JCAHO said if they indeed say anything.
  2. Has anyone found a QC material to use with the K-check tablet? we are currently using urine controls but the bulk of our ketone testing is on serum. Bio-Rad makes one for use on some chemistry analyzer but when I talked to them about it they said it was unsuitable for the K-check tablet stating that it made a speckled pattern on the tablet rather than the solid purple a positive patient would leave. JCAHO seems to be concerned about "matrix" as we found out 20 years ago when we were only using urine controls for pregnancy kit tests. Thanks
  3. Siemens Coag Instruments Question

    I was upset when we received our 660 because there is no way to save data so all of our QAP data has to be entered by hand. Plus what LauraMae said above..
  4. Siemens Coag Instruments Question

    We had the stago compact. superb instrument..! We replaced it with CA550 Sysmex and have since replace that with the 660 Sysmex. I'm not familiar with the 1500 or the 2500 but we stepped down in my opinion from the stago. We don't do near the volume you guys do but I feel the 660 would be taxed at that volume of testing.. we don't have allot of problems with the Sysmex but we have had some problems with reagents specifically Actin a few years ago.
  5. Urine Microscopic QC

    We are JCAHO inspected and we do microscopic on QC daily and we have for at least 21 years..

    Not sure what is available but you might check with George King biomedical. When we had the stago diagnositica instrument we used some known value samples during the lot roll over.

    Unless I'm mistaken AABB changed it wording on how good a sample is good for. Years ago it said 72 hours but that was changed to read 3 days so if the unit was given within those 3 days there is no problem. Might be a grey area after midnight since technically its a new day.
  8. Ketone body testing

    Thanks Scott, I called the company 1st for advice and he referred me to BioRad and their "Volatiles" control. I called BioRad and they said their two level control was designed for a quantitative methodology and both levels have Ketones in them but she also stated that when using them with the tablets resulted in a speckled pattern and not the steady purple one would expect to see with a positive patient thus FDA would not verify their use for qualitative testing. She did tell me they were trying to develop QC for the K-Test though but didn't have a time frame for when it may be available. I think they are still talking to the manufacture at this point. Here is the section regarding QC its rather vague (not as vague as the answer I received from JCAHO when I inquired though..): Quality Control: Use known positive and negative controls as recommended by your Institutional guidelines. This could vary from daily to weekly quality control. At least a positive and negative control must be run each time a new bottle of K –Check is opened. A positive control can be prepared by diluting 50 microlitres (one drop) of acetone to 40 ml of distilled water. The preparation should be comparable to “small”on the color chart. We don't do allot of ketone testing at our small rural facility and I'd say that almost all the tests are from the ER I'll check with Siemens to see if they offer B-hydroxybuterate test but at $24 a bottle of 100 tablets and the Dr's used to the semi quantative (small, moderate, large) result from the tablet, I think it would be a hard sell to our administration. I thought about trying the homemade control only use serum instead of DI water but I'm not sure how to validate it.
  9. Ketone body testing

    I know this is an old thread but I thought I'd revive it with a question and a concern. I recently found out that ketone testing on the K-Check tablet is now moderately complex. We have been using biorad urine controls for a very long time on the acetest tablet and since we started using the K-Check tablet a year or two ago. Biorad said they didn't have anything yet for serum/plasma so my question is since there is a matrix effect on the tablet, I'm guessing controls with a similar matrix should be performed with the patient testing...? I called Quest (our reference lab)and they said they couldn't even talk to me about the question. I spoke with a few other labs and no one is even aware that a change has been made. Years ago we got ourselves in a little trouble with JCAHO over qualitative hcG testing and only using urine controls so I'm trying to not have that problem with ketone testing. Does anyone know of a control available for serum/ketone testing? The insert says you can make a control with 50uL acetone and 40mL DI water however that wouldn't be the correct matrix.
  10. Advia XPT by Siemens

    After struggling with the 2120 for all those years I'd be afraid...
  11. Yes our director mentioned state requirements are sometimes remarkably different from JC requirements. I have sent a note to our sysmex rep about the fibrinogen but so far not reply.
  12. We were recently JCAHO inspected and the surveyor mentioned that calibration/verification was going away for hematology (maybe retics as well but he wasn't clear) Has anyone else heard this. I've done those so long now I'm almost afraid to stop. My director said the same thing. BUT he ALSO said we should be doing calibration/verification for fibrinogen. when we had the Stago we di do that with a high patient sample but the instrument did all the dilutions and calculations. Is anyone doing linearity for the Sysmex CA-660 instruments? If so what is the procedure? Thanks
  13. Mode-to-mode QC practice

    We run 2 levels per shift on the auto mode plus one level per shift open mode. we were running less until state inspected us and dinged us for not running enough controls. JCAHO's next inspector asked why we were running so many controls. My answer is because state said we had to State can shut us down.. ! I worked the night shift at another facility years ago and they used patient controls. about 10% of the time the patient control would not be within limits. Coulter Jr ya way back
  14. 0.8 Surgiscreen, vial # 2 reactions

    Several months ago may be 6 or more we had the same problem and with SCII. We made a complaint to Ortho but they denied any problems with their product because there weren't enough complaints???. we tried a second bottle from the same lot fearing the bottle was contaminated no difference. The controls were always positive or negative as expected. fortunately when this started happening we had a new lot of cells and all those we tested with SCII positive retested negative. Of course this is after doing several panels . I think the only patients that were effected were O+.
  15. lol I find that micro folks in most places only do micro. after being locked in micro for 50 years breathing those anaerobes its a wonder they even know their name hahaha Its the use it or loose it syndrome. As others have said above. I plate, do wet preps, gram stains but that's it with my micro knowledge. To be honest we are a small rural hospital and the extent of even our BB supervisor is minimal compared to any BB tech that works at a large facility. We do keep and give FFP though so when we have a nurse freakout about what appears to be mismatch we have a chart posted in the BB we show them. That is usually sufficient.