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ECHO with Manual Gel as backup


tburl

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We have an Echo at our institution but we just use tube as a back up.  If you do an Echo with gel backup, you still need tube to backup gel as gel has its own interferences.  Plus that would make semiannual validations of methods a pain.  Just my two cents.

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We currently have tube as our backup. We are having an ongoing problem with techs overshaking the tubes. Missing positive DATs on cords, weak sub-groups, mis-identification of antibodies with weak reactions, etc. We are trying to educate but I have a staff of 25 with several in the field less than 5 years. Part of problem is we are level 1 trauma and staff gets slammed and they are trying to work to fast - can't shake gel away.

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Although it is not a requirement to have a tube backup, every hospital I know does since there are more interferences and "junk" that can be found in tube and gel, one of the reasons that reference labs only use tube.  I have bigger hospital blood banks around me that use all 3 methodologies, but that is just more of a headache as you would have to have competencies on all of those as well.  And with the new CLIA standards we know how more inconvenient they are.

 

Also something you might want to check into, usually if you are contracted through a company for reagents, you are requried to purchase a certain amount.  If you split between manufacturers, you might not satisfy that part of the contract and it costs you more money.

 

From my experience working with all three methodologies, combining solid phase and gel wouldn't make it easier.  It could end up making things difficult, and weak reactions on all methodologies can be subjective and hard to read.  What ever you choose good luck.  I know level 1 trauma hospitals makes things stressful enough!

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we use the ECHO for T&S and use gel for everything rlse- including ID for positive screens on the ECHO.  I would not have set it up that way, but it predates me.  We will probably move to more ECHO, less gel over time for a number of reasons, but we have so many other changes coming up (including a move to a new hospital!!) that we don't want to add anything else right now.

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We have 2 echos for our primary testing. As well, we use Gel, PEG and SIAT for secondary methods. We get samples referred to us from other hospitals who almost exclusively use Gel. We notice that the referring hospitals have pos screens by gel and that we identify various antibodies by gel (E, K, S) that are either completely missed by Echo (Neg screen/ Neg panel) or only found on the Echo by panel testing (Neg screen/pos panel). I have brought examples of these to Immucor tech support and they did not really give me a good reason as to why this is happening. Will continue to bring examples to them to see if they continue to give me the same responses.

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We use the ECHO for the majority of our testing with manual gel as a back-up for antiglobulin tests.  We are a smaller hospital where I am the only dedicated BB tech.  We perform basic antibody ids and antigen types.  Since we used manual gel for antiglobulin testing for several years prior to installing the ECHO, the generalists were competent and comfortable with gel so we just kept it as the back-up.  Any back-up methodology is going to have problems and require extra validation and competency testing.  I had originally dropped the 0.8% panel to use with gel (thinking we would just perform panels on the ECHO), but when we were having so many problems with the ECHO a little over a year ago, I started getting that again.   

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We have the ECHO and use Gel only as backup.  If we want to run something in tube, the 0.8% cell suspension must be concentrated to approx 3% for tube testing.  That is rarely done here.  We would send it to our reference lab for further investigation.

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  • 2 weeks later...

We use an Echo for T&S and antibody ID. Our backup is tube with PeG.

 

We didn't have the counter space to keep gel and I was vaguely dissatisfied with it, which is why I chose the Echo for automation. Competencies for three methods would be a major pain - all the techs working in Blood Bank (except me) are generalists.

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