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milesd3

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Everything posted by milesd3

  1. The issuing tech should have questioned the "O" plasma even though it was her boss. Without pathology approval (at our facility) we cannot give inappropriate units knowingly. I'm interested in what the pathologist is saying because at least at our facility, the pathologist is ultimately responsible. The "boss" at the very least should be counseled and or written up personally if this is the second blunder perhaps he should be gone. The issuing tech should at the very least receive a verbal warning. all my opinions..
  2. Yes we still do them on a rare occasion. One of those archaic nearly useless tests that some doctors can't get away from.
  3. Thanks Scott, I'd be totally fine with the old manual test but we are a small rural hospital and the night tech is alone after midnight and if he/she is in the ER or on the floor when the hour is up it would have to be remixed and the process started over again thus making the ER Dr. upset. I realize ESR is not an emergency room test but someone forgot to inform the ER Dr.s about this fact. We also do CRP's but if "our" ER Drs order a CRP they seem to want the ESR as well. In the 23 years I've been at this place, we've never had a backup for ESR and haven't ever had a need. I suppose
  4. Streck is discontinuing the ESR plus sed-rate analyzer and I was wondering what everyone else is using. streck is recommending the mini-cube but I don't know any thing about the analyzer good or bad as I think it pretty new but is able to test directly from the edta tube eliminating the need for sed-rate tubes. we only do 10-15 per month so we do not need an analyzer that can test dozens of sed-rates at a time but something affordable and reliable. Thanks
  5. Is that a Sysmex instrument? You might check on their website for CLSI procedures for that particular analyzer. We have a xt2000i and that's where I got the bulk of our policy from.
  6. Are you saying that a specific parameter is consistently the same exact value each and every time QC is performed and for all three levels? That would be amazing. There are a couple non reportable items on our analyzer that stay pretty consistent but they are items that have to do with the operation of the instrument such as diff X and Diff Y. none of our reportable parameters are steadily the same number each time...
  7. When we had the Stago we ran QC every 6 hours but it was because we were able to utilize the QC material better that way. I cannot remember how long the QC lasted (hours) maybe 24. We are on our second Sysmex and allot of us set timers so we don't forget. Occasionally though we are on the floor or ER and we end up being late. We document that we were late and why. Obviously not all the samples between the late QC and previous are suitable for retest so we look back at previous coag results on that patient if there is history and compare. State health recommended this but I'm not sure wha
  8. Thanks Scott I'll take a look at comparing my data with QC ranges to see if that will help me. I talked to a guy at JCAHO and basically they can't tell you anything or maybe won't would be a better term. He did tell me though that there should be some individual limits and that our director has to decide what they are... He doesn't have a clue nor does our pathologist. The problem with sysmex is that they make claims about the correlation between the modes but they don't elaborate. On average we are aok but individually we are out on different parameters. Sysmex went as far as to tell me
  9. how about other instruments. Someone "has" to know ????
  10. I've been performing open vs closed comparisons on our Sysmex for a couple years but had the expected limits wrong. I was using instrument vs instrument numbers but actually found the correct data accidently searching for something else. My question is: Does each individual sample comparison have to meet Sysmex claims or is it on average. I couldn't get a straight answer from sysmex at all in fact they claimed that no one was doing that and that if we were testing controls on both modes then it was all we needed to do. I finally talked to someone that told me that the average was ok and
  11. Cool I talked to them sometime ago and they told me their control was "not" acceptable for use with the tablet because it makes a speckled pattern on the tablet rather than the solid purple that serum does on the tablet. Have they reformulated the control?? Thanks
  12. We don't send units with the patient unless they are already hanging. We found out years ago that units sent were discarded by the destination hospital and the explanation is simply that the other hospital didn't do the work and didn't want to responsible for someone else's work. I understand the reasoning thus we don't send units...
  13. We haven't had the 2120 for 5 years but yes, unless something has changed with that analyzer, all three modes have separate pathways thus the comparison between modes is a requirement. We also had to run controls on all three modes as well. That analyzer was a bear. I hope you have better luck out of yours than we did... very needy..!!
  14. 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.
  15. 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
  16. 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..
  17. 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.
  18. We are JCAHO inspected and we do microscopic on QC daily and we have for at least 21 years..
  19. 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.
  20. 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.
  21. 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.
  22. 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 c
  23. After struggling with the 2120 for all those years I'd be afraid...
  24. 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.
  25. 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
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