sosier

At Northside Hopsital, the Hematology techs assist with the collection and processing of the bone marrows. We also have a Laboratory Assistant who works full-time in Bone Marrow. The technologists also read the bone marrows and report differential, M:E ratio, megakaryocyte estimation and any other condition observed, such as increased mast cells or marrow iron. The techs on day and evening shift are trained to do marrows. We get a lot of outpatient specimens in the late afternoon and evening. We use Wricht-Giemsa stain on a Midas stainer. We have a very active bone marrow transplant program and are up to 2500 marrows so far this year. Sue Osier

I've always thought of thromboelastography as a research lab type test and that you have to have a sprcial "aura" to interpret it. We do PFA and send out regular platelet aggregation to a place down the street. The interp. is usually done by cardiac surgeons or anesthesiologists, isn't it? Sue Osier Northside Hospital, Atlanta

You can use a document like CLSI H48A to determine reference ranges or you can use any that are published in the literature with the caveat about S.D.

We us 50x OIL (the objective is an oil one), and go to 100x for very cellular blood smears, Bone Marrows and cytospins.

At Northside Hospital in Atlanta, we have a page with each question on it and then following this, we have all the elements to aanswer the question: the Policy or Procedure, the evidence (worksheets, reports, LJ Charts, etc). It is a pain to set up, but after you have it, changes are easily handled . You can get as fancy as you want with the format.

We have a cut off at 5.0 seconds above the high normal limit. Look at "The Fritsma Factor" online. It is the best place for Coag questions and you may find yours already answered by gurus in the field.

I would suggest that you get hold of a copy of the CAP or JCAHO (or whatever agency your Lab uses for accreditation) Inspection Checklist and start at the beginning...... You have a great learning opportunity with this assignment!!!

I am doing some benchmarking. What are your refence ranges for the PFA? We are a three hospital system and our aggregate reference ranges are: EPI: 74-178 sec ADP: 55-103 sec Thanks in advance for your reply.

Third party companies like R+D Systems and Streck provide calibration material for different analyzers for Hematology. Precision Biologics and George King have assayed material for Coag. Bio-Rad is one for Chemistry. I'm sure there are more out there.

Years ago, I read all of Wintrobe, but there are a lot more texts and web sites out there now. Good luck!

Reject.

I wouldn't run them.

I do LBC on a Sapphire and am interested in hearing from others about your cut-offs. We have run over 60 samples and compared them to L/S ratio results and clinical outcomes to determine the cutoffs.

First I ever heard of this. What did CAP say?

We also use patient controls, not for mode to mode but for the shift QC. After a.m. Maintenance and Commercial QC (for calibration confirmation, we pick 2 bloods. one with low WBC and high HB and one with hige WBC and low HB. Therefore, we can sort of bracket the patient population range. Then we run them 3 times in a Library on the analyzer, hoping for CV <1.0 but it has to be <2.0. Then we run them at 1300, 1800, and 2300. Our analyzers (Abbott Saphires) do not require a mpode to mode since the pathwas is the same.

Pharmacy stores them at Northside Hospital in Atlanta. We used to but got rid of them for the reason you mentioned.

Have you thought of running fluids on the IRIS? Works like a charm!