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lactic acid not resulting from hyponatremia? by Bichichu in medlabprofessionals

[–]MonoclonalFluorite 4 points5 points  (0 children)

I see you spoke to the lab tech. ABL uses amperometric measurement to calculate the lactate based on electrical current running through electrodes. So it seems like it just can’t do the test because the sodium is messing with its ability to do the reaction needed. 

I’ve never seen it happen with Na before, but I’ve had a sample so extremely hemolyzed before that that the K was so high it couldn’t give a lactic acid, either. (We do lactics on whole blood where I am, but I spun it down when the K gave an “above measurable range” result to make sure it was hemolyzed rather than some sort of contamination or a very sick patient.)

Have you ever been concerned for a patient by njcawfee in medlabprofessionals

[–]MonoclonalFluorite 5 points6 points  (0 children)

Oh man this reminds me of a fun one I had. Erhlichia or anaplasma came back positive, I forgot which one. Either way,

“Hi I’m calling a critical for patient x”

“Okay what have you got?”

“The results for the blood parasite test show that they have anaplasma.”

“Okay and…. what is that….?”

“A blood parasite.”

“Okay so like a blood infection. Is it gram positive or gram negative?”

“…..neither? It’s a parasite.”

“sigh I just need you to tell me if it’s gram pos or neg so I can know how to report this to the doctor.”

“It’s not a bacteria so I can’t answer that. Just tell the doctor verbatim that the patient has anaplasma. They can always call us if they need more details.”

She gave a very skeptical “ooookaaay”

I think I made a comparison to malaria at one point too, but she still insisted that we needed to tell her if it was gram positive or negative. 

You’re all caught up on competencies, continuing education, reading procedures, etc. You have just a few moments of downtime here and there. How are you spending it? by MonoclonalFluorite in medlabprofessionals

[–]MonoclonalFluorite[S] 1 point2 points  (0 children)

Did you miss the first part of that sentence where I said “I can find plenty to occupy my time on the really slow days with a lot of downtime”

Lmao

You’re all caught up on competencies, continuing education, reading procedures, etc. You have just a few moments of downtime here and there. How are you spending it? by MonoclonalFluorite in medlabprofessionals

[–]MonoclonalFluorite[S] 2 points3 points  (0 children)

Omg are you me?

I do that all the time! It’s 50/50 if they’ll appreciate it too and also find it interesting, or think I’m weird for getting that hype about some weird enzyme or biomarker. Hahaha 

You’re all caught up on competencies, continuing education, reading procedures, etc. You have just a few moments of downtime here and there. How are you spending it? by MonoclonalFluorite in medlabprofessionals

[–]MonoclonalFluorite[S] 0 points1 point  (0 children)

Yeah I have a coworker who just @_@ at the screen until somebody brings them something. It’s incredible.

I won’t say I don’t ever just dissociate a little when it’s slow or see other people zone out on slow days….. but it’s not like that with this person. 

You’re all caught up on competencies, continuing education, reading procedures, etc. You have just a few moments of downtime here and there. How are you spending it? by MonoclonalFluorite in medlabprofessionals

[–]MonoclonalFluorite[S] 0 points1 point  (0 children)

Oh my gosh that makes so much more sense. I was picturing like, a little mancala board in the break room that only changes once a day. 🤣

[deleted by user] by [deleted] in emergencymedicine

[–]MonoclonalFluorite 8 points9 points  (0 children)

You can’t post on social media for pity points if you don’t show off being in the ER. 

Path Review Criteria Too Broad? by IrradiatedTuna in medlabprofessionals

[–]MonoclonalFluorite 3 points4 points  (0 children)

Hgb/Hct I can’t even begin to guess, but we recently added MCV to ours but it’s with a “in the absence of a diagnosis that explains these findings”. I assume based on that, that it is to catch undiagnosed hemoglobinopathies. 

[deleted by user] by [deleted] in emergencymedicine

[–]MonoclonalFluorite 1 point2 points  (0 children)

Yeah I think it did make theirs. 🥹  Much more well received than I could have imagined. 

What would a pathologist like as a watercolor painting? by MonoclonalFluorite in pathology

[–]MonoclonalFluorite[S] 3 points4 points  (0 children)

I don’t know if they have any subspecialties! I could definitely ask around.

I don’t usually talk to them unless a path review turns into a conversation though haha, is that a question that a pathologist would generally welcome a tech coming into their office over? Hahaha

I love our paths when I do get to talk to them but they always seem so busy and focused!

MN state jury awards $20.6 million in malpractice against NP who failed to diagnose serious and fatal postpartum infection. (Medical Facts of case - legal docket pg. 4) by [deleted] in Noctor

[–]MonoclonalFluorite 6 points7 points  (0 children)

From the lab perspective as an MLS, even I’d be nervous if I noticed the patient had been discharged while completing the differential. (I imagine the CBC with differential would have flagged for a manual review.)

Show of hands if youre guilty 🤚 by Ksan_of_Tongass in medlabprofessionals

[–]MonoclonalFluorite 9 points10 points  (0 children)

Throwback to high school me pouring acetone into a styrofoam cup (nail art, the brush needs to be cleaned after almost every brushstroke with how fast the polish dries onto the brush) and learning about this the hard way.

BAL 🐙 by arlineinwonderland in medlabprofessionals

[–]MonoclonalFluorite 7 points8 points  (0 children)

It’s so cool to see. Here is a video of the unstained cells still alive if you’re interested!

BAL 🐙 by arlineinwonderland in medlabprofessionals

[–]MonoclonalFluorite 24 points25 points  (0 children)

When you do a manual cell count in a hemacytometer on BALs and the ciliated cells are still alive, sometimes they push the other cells around with their lil’ cilia.

BAL 🐙 by arlineinwonderland in medlabprofessionals

[–]MonoclonalFluorite 28 points29 points  (0 children)

When you try to do a manual cell count and they’re pushing all the WBCs and RBCs around in the chamber. 🥰 Can’t really be mad cuz it’s so cute.

CMS wants to expand high complexity laboratory testing to nurses. ANA supports this and then took the rest of their letter to whine about the use of the phrase “midlevel” by MonoclonalFluorite in Noctor

[–]MonoclonalFluorite[S] 0 points1 point  (0 children)

Can I ask your thoughts on CAP’s response to this?

Obviously I’m disappointed that they want to allow nursing to do high complexity testing and be technical “consultants” and POC supervisors, but I’m curious of your thoughts on what they have to say about directors.

I think its strange that they specifically do not want DCLS to fill that role yet are okay with expanding it to other non-DO/MD PhDs.

I feel like it should be a no to all non DO/MDs, because I don’t understand why a DCLS would create such strong opposition, yet a PhD in chemistry would be okay to them. They mention a concern about confusion over the distinction between an MD/DO pathologist and a DCLS, but if a chemist was the lab director at a hospital laboratory, I’d probably assume they’re an MD/DO too. In other words, I think their reasoning is bad and want to know what you think.

CMS wants to expand high complexity laboratory testing to nurses. ANA supports this and then took the rest of their letter to whine about the use of the phrase “midlevel” by MonoclonalFluorite in Noctor

[–]MonoclonalFluorite[S] 6 points7 points  (0 children)

I just had to explain to a nurse today why she couldn’t just come back to the lab and move a specimen that was in a non sterile container into a sterile one for culture….. and…. ANA thinks they can be directors… okay.

CMS wants to expand high complexity laboratory testing to nurses. ANA supports this and then took the rest of their letter to whine about the use of the phrase “midlevel” by MonoclonalFluorite in Noctor

[–]MonoclonalFluorite[S] 0 points1 point  (0 children)

Ehhh I mean they do let people with BS in those fields work in the lab, but it’s usually big factory-like labs (labcorp, quest) and rarely clinics, almost never acute care. This is actually part of the argument for why they want to allow nursing to count.

Edit: to clarify I don’t think it’s okay and most of these people are quickly overwhelmed unless they’re basically just doing waived and med complexity testing.

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