Same Day Slides

[MARINA]

What does your facility practice concerning repeat slide reviews/differentials on the same day. CBC's that are performed on chemo or bone marrow patients with critical counts that reflex review criteria. Do you look at several slide reviews on the same patient a day?

[Bill]

Slide review only once every three days unless significant change in measured parameters

[rravkin@aol.com]

Dear Marina,

I live your question every day. At my primary job there is no such criteria in place for performing manual differential and slide reviews in any given period. We perform as needed and/or required. At my pool position we will perform a manual differential and /or slide review once per week as long as certain criteria are met. I believe that the difference in practices here may reside in the instrumention used. My primary is still using the Beckman/Coulter LH ( they are looking to upgrade soon) and my pool position uses the ADVIA. The ADVIA is capable of being utilized in the clinical and research setting where as the LH is used mostly in the clinical setting. The ADVIA measures more parameters but requires more preset maintenance. I am not trying to sell you on either instrument, but from practice I think that the LH is the better of the two in the clinical setting. I hope this helps.

[SMILLER]

Here, we would rarely repeat a slide review on the same day or even during the same inpatient stay unless we saw some sort of change in the CBC where morphology comments added to the report would help in treatment or diagnosis (eg increase in neutrophil count on a post-op we may want to report toxic change if present). The only other reason would be if flagging on the analyzer makes it necessary (NRBC, platelet clumping, etc.)