Immediate spin under microscope?

[Desoki]

IS it recommended to see result of immediate spin, tube IAT or DAT under microscope?

[Eagle Eye]

You should be looking at your dat's under microscope for mixfield reactions.

Follow manufacturer's package insert.

[Mabel Adams]

Reading routinely under a microscope will mostly make you crazy, find a lot of junk that isn't significant, delay transfusions, cost money for additional testing and not provide any useful information. And that is just at IAT--I can't imagine what you would expect to find routinely reading IS under a microscope. The exception would be DATs for transfusion reactions where finding mixed field could be important and sometimes to get more information for an IAT test that shakes off rough. Oh, and you could read IS microscopically if you need to check for rouleaux due to apparent positive reaction.

[mrmic]

Is it recommended anywhere to routinely use a microscope for BB? Me thinks not. If there is a significant reason to look for mixed field agglutination and one cannot see it macroscopically, then a microscope in the bb lab can be used. But a microscope at every workstation will lead to techs' overuse and reading at immediate spin......most "true" microscopic only reactions have limited clinical significance and use in a transfusion service should be limited. However, in a Reference Lab we did use it for specimens sent to us, trying to duplicate what the tech in the field was seeing..... An exception, as always, would be; What is written as your SOP...

[KKidd]

Is it recommended anywhere to routinely use a microscope for BB? Me thinks not. If there is a significant reason to look for mixed field agglutination and one cannot see it macroscopically, then a microscope in the bb lab can be used. But a microscope at every workstation will lead to techs' overuse and reading at immediate spin......most "true" microscopic only reactions have limited clinical significance and use in a transfusion service should be limited. However, in a Reference Lab we did use it for specimens sent to us, trying to duplicate what the tech in the field was seeing..... An exception, as always, would be; What is written as your SOP...

I whole heartedly agree! We have not had a microscope in the Blood Bank in years. When we need one, we go to Hematology to check things out. Techs have driven me crazy trying to look at things too closely. You can generally find something if you look close enough, but is it significant? I try to remind my staff that you can drive yourself crazy looking for the answer to a problem that doesn't exist.

:crazy::crazy::crazy::crazy:

[Malcolm Needs ☆]

Peter Issitt agreed; indeed, he put it in print in several editions of his book.

[Lcd221]

IS it recommended to see result of immediate spin, tube IAT or DAT under microscope?

Hi !

I'm Elsie, in Houston at the VA Hospital. Prior to instituting the electronic XMA's (last month), we routinely checked a 'rough' result under the scope on IS just to confirm rouleaux, then followed that up with a saline replacement to rule it compatible. However, now we are doing eXMA's and it's pretty much inconsequential.

We do scope the tube IAT/DAT.

Respectfully,

elsie lucas

[adiescast]

We mostly use the scope for fetal screens. I tell my techs that they aren't seeing anything significant for a crossmatch or antibody screen unless they see boulders in the field. Some people like to call it positive if they see a few cells kissing. I tell them they are being voyeurs and they need to quit peeping!

Seriously, I only had problems here with one older tech who was absolutely reliant on the microscope. She looked at everything under the scope. I finally did an exercise with her to improve her confidence in her reading skills and then had her keep a log of when she used the scope and what she saw. We discussed it weekly for a month. We made a pretty significant reduction in her use of the microscope before she retired.