Does anyone accept EDTA tubes which are less than half filled?

Why or why not?  Thanks in advance.

Yes, we always did.  It made no difference to the antigens expressed on the red cells, or to the antibodies in the plasma (as long, of course, that there was sufficient sample to test in the first place).

We use the 6ml Pink EDTA tubes. We require the specimen be up to the bottom of the manufacturer's label. (~2 ml) That way we won't run out of plasma if the patient needs a lot of units crossmatched. (No electronic crossmatch yet!) If the patient happens to have an antibody we may need to have the patient redrawn, but it usually work out.

Back in the day, the tubes contained liquid EDTA and we required 1 ml to avoid over-dilution of the specimen for Hematology testing.

Thanks.

No, I do not accept tubes that are less than half full, The reasoning behind this is should we need to perform ID's and crossmatches, we want to insure that there is enough specimen to go around.

thanks

We accept them as long as they don't have a really nasty antibody history (Warm or multiple antibodies) since we perform electronic XMs.  Sometimes we have to get samples redrawn due to unexpected issues, but that is the exception, not the norm, so we try to work with what we get if possible.

I don't see why you'd reject a sample just for not being full, that seems a bit unnecessary. QNS or a short sample, obviously, but most patients come through for their T/S, the screen is negative, and that's it.  If you had to wait for a new sample, their old sample could have been done by then. Additionally, calling for "fuller tubes" isn't really the way to ensure higher quality in patient care. 

Overall, not worth the effort. The care teams on the floor are already quite unhappy when they have to redraw for other reasons, I can't imagine what they'd say if I called requiring a completely full sample! Their fragile stick patients may not be happy either...

This might be a stupid question, but do you accept EDTA tubes that are expired? I would always reject these no matter what, but I have two techs that insist on pouring it off to another in-date EDTA tube and another that says, "but do they really expire though?" 

I gave it a thought that its probably stable past expiration date, vacuuming capability will probably be decreased and red cell morphology can get affected... but does this affect any blood bank testing? 

 

 

Thanks in advance. 

14 hours ago, JeanB said:

This might be a stupid question, but do you accept EDTA tubes that are expired? I would always reject these no matter what, but I have two techs that insist on pouring it off to another in-date EDTA tube and another that says, "but do they really expire though?" 

I gave it a thought that its probably stable past expiration date, vacuuming capability will probably be decreased and red cell morphology can get affected... but does this affect any blood bank testing? 

 

 

Thanks in advance. 

Quality in the Blood Transfusion Laboratory is key in all things.  The wrong can, and does kill.  If there is an expiry date on the EDTA tubes, it must be there for a reason.  I am not an expert on how this date is established, but I would suggest that someone within the manufacturing company is, and it is they who have established the date.

Were I inspecting the laboratory and saw that expired tubes were being accepted, whatever the excuse put forward, it would be an immediate non-conformance.

4 hours ago, Malcolm Needs said:

Quality in the Blood Transfusion Laboratory is key in all things.  The wrong can, and does kill.  If there is an expiry date on the EDTA tubes, it must be there for a reason.  I am not an expert on how this date is established, but I would suggest that someone within the manufacturing company is, and it is they who have established the date.

Were I inspecting the laboratory and saw that expired tubes were being accepted, whatever the excuse put forward, it would be an immediate non-conformance.

@Malcolm Needs Thanks so much for your advice. I absolutely agree with you. I will share this with my colleagues.

4 hours ago, Malcolm Needs said:

Quality in the Blood Transfusion Laboratory is key in all things.  The wrong can, and does kill.  If there is an expiry date on the EDTA tubes, it must be there for a reason.  I am not an expert on how this date is established, but I would suggest that someone within the manufacturing company is, and it is they who have established the date.

Were I inspecting the laboratory and saw that expired tubes were being accepted, whatever the excuse put forward, it would be an immediate non-conformance.

As much as I liked to consider myself a nonconformist back in the day, I even was not considered for a job because the medical director running the interview considered me to much of a "cowboy", I must agree with Malcolm on this one.  I'm afraid that no amount of logic or rational thought will justify the use of an expired tube.  I once heard that the human mind is extremely capable of rationalizing just about anything to fit the need.   Now, having said that I would be surprised if a manufacturer could come up with a legitimate explanation for how they came up with the expiration date other than some regulatory agency required one.  Hope I'm wrong about that but I am skeptical.  

 

Yes as long as there is enough plasma for performing the screen and back type(we still use tube for the ABO). If there ends up being an antibody the patient is redrawn. And I never thought of looking for expiration dates as I been relying on the lab assistants her check the expiration dates on their supply and Material Services to check the expiration dates on the nursing units. 

I'm not concerned with how full the tubes are as long as I have enough specimen to work with for required tests. I would reject an expired tube unless it was some kind of emergency situation that pretty much prevented redraw. And if I did make an exception, it would be as a deviation from SOP that would require an explanation as to why the tube was used and a signature from the BB medical director.