Within the last year we recently switched from a Red top to a Pink top for our blood bank specimens, with some resistance from the older techs. Recently some of our techs have been having problems with the Pink tops. They say that there is some "grainy-ness" in the front types. An older tech actually went up and drew a Red top on a patient to do his testing. They are saying they would rather go back to the clot tubes, which I REALLY do not want to. Has anyone else had any problems with using the Pink top EDTA for BB testing?

We are testing 200-300 specimen daily for ABO/Rh,ABS, (IAGT/AGAT) and observed nothing like that by DiaMed ID cards.

We've accepted EDTA samples for years, and, apart from obvious problems, such as cold agglutinins (which would affect clotted samples anyway - more so, in fact, because of the active complement) we have experienced no problems whatsoever.

We have been using purple top EDTAs for years now and I would so hate having to go back to getting all of our ONC and Cardiac pts to clot - that was so messy. What you are probably seeing is more rouleaux. We have had more rouleaux with the plasma tubes, but with some training in saline replacement or saline dilution (just add the 2-3 drops of saline to the tube instead of removing the plasma) you shouldn't have any problems (if you are indeed using tubes!). I'm not sure what you mean by "graininess" in the front types though. I did have some problems with unit rescreening the other day - a couple of my A units were having a weak reaction with our Anti-B. I have never seen that before, but discarded the open vials of Anti-B and opened new ones and the problem went away. Very weird.

We started using EDTA samples for blood transfusion testing in 1996 and experienced no real problems, and I think you would class me as an older tech at 58 next month. How old are your older techs??

Steve

:D:D

Ancient Steve, ancient; you are 9 months older than me!!!!!!!!!!!!!!!

I talked to a colleague of mine, and she thinks that we weren't spinning our tubes fast enough or long enough. So... I "borrowed" a centrifuge from Chemistry for a while and see if that helps things. Also, we had some problems with our Anti-B and so did my colleague. She said they are just washing their patients' cells if they get a unexpected reaction with the Anti-B and repeating the front type. Usually fixes the problem. Thanks again for you help!

And I'm only 25, so pretty much all of the techs are older than me... Haha

Ancient Steve, ancient; you are 9 months older than me!!!!!!!!!!!!!!!

Maths was always one of my strong points!!!!!!!!!!

I mean a YEAR and 9 months!

:boogie::boogie:

A silly question - sorry for my ignorance, I've been out of routine labs for 20 years now. What is the difference between a pink top EDTA and a purple top EDTA? I've only ever seen the purple topped ones.

Also, miniBB, if you and your colleague are having to wash lots of samples to get rid of odd results with anti-B then there clearly is a serious problem somewhere! Washing the samples is just hiding the problem, not solving it

Believe it or not the only difference is the color of the top and the size of the tube.

I never switched to the pink tubes. Thought it was silly. One more thing to have to teach somebody.

We have been using the pink tops for several years and have not seen any problems. We are currently validating a Greiner pink top since it is less expensive. Did you see any problems when you validated the pink top tubes?

Our institutions have been on pink top tubes for well over 10 years with NO problems. Depending on the methodology you are using, if it's tube I find it really hard to believe there is grainy-ness in your forward types. Maybe a different reagent is being used?

If you are gel users you want to stay away from the plasma/cell interface as the WBC's in the buffy coat can cause "boogers" in the gel tubes sometimes.

Since you mention older techs, of which I am one, maybe your staff is just trying to get you to go back to "the way we always did it before".

Drag them kicking and screaming into the new milenium, don't go back to clot tubes!!!!

The switch to Pink tops was underway when before I stepped foot in this place. It's a known problem with this vendor's Anti-B and it's being addressed. I'm pretty sure I'm going to to be forced to have a Red and a Pink drawn for every BB specimen, because they don't want to have to do a saline replacement every time they see rouleaux. I'll be monitoring this, but my hands are sort of tied..

We have been using the pink top tubes for BB ever since we switched to the Echo for the bulk of our testing. We have had no problems at all, in fact, we have fewer problems than we had with red tubes.

:blowkiss:

I would switch anti-B reagent and send coustomer complaint to the manuf.

you guys are only babes . . .

Ancient Steve, ancient; you are 9 months older than me!!!!!!!!!!!!!!!

We switched to the Pink top tubes about 7 0r 8 years ago when we went to the gel system and have not regretted it since. I like the pink top because they give me more specimen to work with, especially with nurse draws and such because accoring to them we do not need that much blood to work with.:cool:

Believe it or not the only difference is the color of the top and the size of the tube.

I never switched to the pink tubes. Thought it was silly. One more thing to have to teach somebody.

We switched to pink tubes because we had too many problems with people expecting us to share the CBC tube for crossmatch. Unfortunately, often the sample had no blood bank bracelet, or they gave it to use first (we spun it down and then Hematology couldn't use it for a CBC), or they needed blood fast and we couldn't get the sample fast enough. When we changed to the pink top tube our sample sharing problems went away completely. The only other test in our lab that uses a pink top is a BNP and no one has expected us to share that sample!

We have not observed any typing problems with the pink top tubes. We have been using them for several years.

I've been using pink tops for a longgggg time - tube, gel and solid phase. I have seen no problems and get no staff complaints. Sounds like a people (staff) problem to me.

you guys are only babes . . .

David, I hardly think Malcolm and I would consider ourselves babes (no comments from you Rashmi), we have both seen each other in person many times, 'spring chickens' maybe!!!!

Steve

:giggle:

Within the last year we recently switched from a Red top to a Pink top for our blood bank specimens, with some resistance from the older techs. Recently some of our techs have been having problems with the Pink tops. They say that there is some "grainy-ness" in the front types. An older tech actually went up and drew a Red top on a patient to do his testing. They are saying they would rather go back to the clot tubes, which I REALLY do not want to. Has anyone else had any problems with using the Pink top EDTA for BB testing?

If you are using automation then you need to stick to EDTA samples, too many problems otherwise. We have used EDTA samples for Years++++ and no problems- in fact I would say that manual grouping is much easier- no squishing around a clot trying remove some cells to group...and sometimes when you took the cap off, a great big "slug" of a clot would slide across your finger...URRRGGG!!!!!

Hello - You mentioned you might not be spinning your tubes "fast enough or long enough". What rmp's are you using and how long are you spinning?

That sounds like a centrifuge calibration issue... Technical Manual has the procedure... quite a dreadful procedure but it will clear up any question you may have with spin time etc..

David, I hardly think Malcolm and I would consider ourselves babes (no comments from you Rashmi), we have both seen each other in person many times, 'spring chickens' maybe!!!!

Steve

:giggle:

I think "venerable" describes us quite nicely........

Since EDTA chelates calcium ions, and calcium ions are needed for the complement cascade and membrane attack complex to progress to hemolysis, should we discontinue using hemolysis as an endpoint when using EDTA anticoagulated blood for tube testing? (Our old (clot tube) SOP's say, observe for hemolysis and/or agglutination, but they also say "serum" not "plasma".)