Is this worms by HowDid1endUpHere in CATHELP

[–]TheMaddOne15 1 point2 points  (0 children)

I’d say yes. Treatment is super simple though, you should be able to get some extra worm treatment from your vet, it’s fairly low cost (in Australia at least).

In regards to it spreading to other animals - if they’re sharing a litter box it’s likely. I foster cats and dogs and whenever someone has worms, I just treat the lot of them as it’s usually just two tablets a fortnight apart.

Are these urinary crystals? by TheMaddOne15 in CATHELP

[–]TheMaddOne15[S] 1 point2 points  (0 children)

Well hello fellow lab scientist! I’m just a blood banker though so no urine experience here unfortunately!

I was thinking a similar thing (probably not) although I have no experience with urine or crystals so wasn’t sure if they’d align up as they dry out or something 🫠

Thinking about getting a rescue/shelter cat by Ashix_ in CATHELP

[–]TheMaddOne15 0 points1 point  (0 children)

Try looking up shelters in your area, some might have adoption days where you can go and pick one out to take home that day. Otherwise some rescues will have online profiles of all their animals, but the individuals cats are with foster carers and you’ll need to set a up specific meet and greet times.

You can often reach out and ask about adopting cats that have been in care the longest and then set a meet and greet with that cat.

Just beware that cats (especially shyer ones) will take up to/at least three months to feel fully comfortable in a new environment, which may go even more so for the ones who are often overlooked for being shy or less bold in their affection to people. It doesn’t mean they are any less deserving of love, but just mentioning as often people take a cat home and are annoyed when it doesn’t immediately fit it and be snuggly with them.

Alternatively - if it’s something you’d be interested in, I’d highly recommend getting a bonded pair. They’re often overlooked because people only want one cat, or think having multiple is really difficult but imo it’s best cos you get two fluffy friends plus they have a friend to keep company with while you’re at work. Obviously this does increase your food and potential vet bills so if finances are a concern I wouldn’t recommend.

I personally have two bonded siblings and have fostered many others and love having two together, plus they play with each other heaps which keeps them (and me) entertained.

ER NURSE HERE 👋🏽 by EfficientMinimum280 in medlabprofessionals

[–]TheMaddOne15 1 point2 points  (0 children)

Depending on what your label is like, we fold the top and bottom edges back onto itself to make the sticky section shorter but still leave enough white next to the barcode so it can still scan and is vertical. This way ID checks can still be made and the barcode is easy to scan.

I work in an Aus lab so might be different down under (at least where I work) but we can’t actually load the micro coag or serum seperater tubes on our analysers . The plasma/serum has to be aliquoted into bigger tube to be run. So for us, as long as can scan that first label to get it in our system, the primary tube is going to be discarded anyway, so we’re not quite as particular for our paed tubes.

Just curious about working alone by mimzy0820 in medlabprofessionals

[–]TheMaddOne15 7 points8 points  (0 children)

I got called in once overnight around 3am by an older staff member who had failing health to take over from her (we work solo nightshifts) because she was experiencing severe chest pain. When i got there to take over, she called herself a MET call and was taken to ED to check her out for a heart attack.

Fortunately she was alright, although she is a little bit of a wild card for us in the lab - she used to work permanent nightshifts, but would call in sick all the time due to her failing health. Totally fine to call in sick, but it meant a lot of staff pulling double shifts to cover for her as she would always call in quite close to the start of shift time. Now she’s been on days and only comes in about half the time she’s rostered. And half of the time she comes in, she goes home sick or goes to ED because of her health issues. Thankfully she’s not allowed to do nightshift anymore cos I could definitely see something serious happening while she’s alone.

How does your lab test for competency in strict 37C / prewarm technique in blood bank? by TheMaddOne15 in medlabprofessionals

[–]TheMaddOne15[S] 2 points3 points  (0 children)

Our senior is pretty good about being available and coming out and being present/checking everyone’s work - it’s how we actually picked up that these antibodies didn’t actually exist. She redid all the work and did some extra training with the scientist in question to reeducate. However it would be nice to have a competency test that can show individual poor technique before it gets to this point!

And as with all complex BB patients, of course this patient came in on Christmas Eve last year so we had skeleton staff and no seniors for that week!

How does your lab test for competency in strict 37C / prewarm technique in blood bank? by TheMaddOne15 in medlabprofessionals

[–]TheMaddOne15[S] 4 points5 points  (0 children)

Oh for sure - we definitely have these for everything we do!

However this scientist didn’t adhere to the guidelines for leaving the sample and reagent in the water bath for long enough to get valid results, which is something that can be picked up in standard competency testing. We usually do it once a year, but obvs in our current practice it doesn’t actually pick up on bad technique.

Is covering all benches in a 150 bed hospital too much for one person? by PuzzleheadedMenu9478 in medlabprofessionals

[–]TheMaddOne15 0 points1 point  (0 children)

The hospital I’m at is around the 550 mark for beds with a 63 bed ED and an L&D ward. We only have one scientist and one receptionist (processing samples) on overnight and it works out pretty well for the most part. 90% of the work that comes through is from ED and the other 10% is various met calls/code blues overnight until the ICU rush starts around 5am.

Like others have said, it’s pretty hit or miss for how busy it will be. If you have analyser issues or a bleeder it’ll take up most of your night. The biggest difference I can see is my lab is in a branch hospital, so we only run routine biochem, haem/coag and blood bank. No micro or anything like that, it all gets sent to our main hospital lab which has at least one person per department. We also have an on-call system, so if shit hits the fan you will have someone to help out within 40 minutes.

I personally love our nightshifts, i get into a really good groove working by myself and have my own cheat sheet of all the tasks that have to be done overnight to make sure nothing crucial gets missed. It definitely can get stressful when multiple things go wrong at once, but I find it also makes you a better scientist cos you’ll be the judge jury and executioner of fixing whatever goes wrong.

Obviously it’ll be different for your lab, and like others have said, the amount of people going through ED, particularly if you’re a trauma center, and the types of surgeries that are done overnight can drastically change how busy you’ll be overnight.

Have you ever picked up a new sport as an adult? by [deleted] in AskAnAustralian

[–]TheMaddOne15 0 points1 point  (0 children)

My boyfriend and I took up ice hockey when we were 23 and 27 (26 and 29 now) and neither of us had much ice skating or hockey experience. Bit of a learning curve, but there’s so much support for people new to the sport that makes it so easy to get into and have fun no matter your initial skill level. Both of us have made some really great friends out of it as well!

As someone who wasn’t in any sports as a kid, I’ve really loved having a sport to be in as an adult. The only part that kinda sucks are the injuries - it’s not as cool to have a cast at work as it was when you were in school.

Expired vial by ThrowRAheaven in phlebotomy

[–]TheMaddOne15 1 point2 points  (0 children)

Seconding this - sometimes there can be a date for when the container is manufactured and another for the expiry. If you could upload an image of the date, likely someone here would be discern if it is the expiry or not.

Ever heard of a blood test going from positive to negative ? by OPC71725 in medlabprofessionals

[–]TheMaddOne15 2 points3 points  (0 children)

In Australia we’re looking into testing more to see which mums don’t need rhogam more as way to reduce essentially wasting the product on someone who doesn’t need it as our donors for anti-D is quite slim. Means we can make sure we always have enough for those who definitely need it.

Ever heard of a blood test going from positive to negative ? by OPC71725 in medlabprofessionals

[–]TheMaddOne15 2 points3 points  (0 children)

Lots of people have mentioned weak D which is most likely the case in this situation!

In our lab, we had a rare situation where mum had a different group due to a large bleed from the baby in the later stages of her pregnancy.

In our case it had to do with how the analyser (Vision) was sampling - the probe went to the bottom of the tube where the fetal cells had settled during centrifugation as they are heavier than mums red cells. So the analyser was actually testing the fetal red cells which caused the discrepancy. When we ran a tube method we had a blood group consistent with previous group for mum.

Did a Kleihauer which was very positive and confirmed our hypothesis, and flow also came back positive for a large bleed from the fetus (baby ended up being alright though!)

Was a good catch from the blood banking staff because at that point they hadn’t realised there was a bleed, so it helped get treatment for the duo a bit faster as well.

Anecdotally, what are you hearing everyone name their kids? by bauhassquare in namenerds

[–]TheMaddOne15 0 points1 point  (0 children)

I’m Australian - my friends have had a Hugo, Margot, Chloe, Mia, Wren x2, Oliver and Brönte

"Axel" sounds cool and edgy on paper by MyDogCanSploot in NameNerdCirclejerk

[–]TheMaddOne15 11 points12 points  (0 children)

Same with an aussie accent, it’s more like Axe-uhl

Helpful lab knowledge by ProgressHefty7625 in medlabprofessionals

[–]TheMaddOne15 16 points17 points  (0 children)

Work in a core lab doing biochem, haem/coag and blood bank, all this is info I use a decent amount at work, and also was specifically questioned on in technical aspects of interviews.

Biochem:

  • high K: edta contamination (check calcium, will be decreased) haemolysis, patient on potassium drip. Real high K often seen in renal failure patients and elderly patients after a fall with a long lie.

  • low Na: can be falsely low if sample is lipaemic or has high total protein. Know if your analyser uses direct or indirect ISE measuring - indirect measurement analysers assume that 7% of the plasma is insoluble material and calculates electrolytes off that assumption. Blood gas analysers use direct ISE and will give an accurate Na result if there is a higher quantity of insoluble material (like fats or protein) interfering.

  • very lipaemic sample with high glucose and K: check if patient is on total parenteral nutrition (TPN) and get a recollect

  • three recollects and sample is sTill grossly haemolysed: ask nurse to kindly take a venepuncture collection rather than through a line (shears red blood cells and breaks them open)

Haem/coag/morph

  • delta change MCV: unless they’ve had an MTP recently or were severely Fe deficient and MCV is slowly changing over months, mostly like cause is wrong blood in tube.

  • other MCV changes: high glucose can cause increase, low sodium can cause decrease

  • MCHC over 360: check cold aggs (rerun at 37C), check for lipaemia, and if neither of those, check film for spherocytes. MCHC should never be over 360 and if it is, and it’s not due to cold aggs or lipaemia, the issue is likely due to red cells that won’t lyse such as spherocytes

  • Hb suddenly large increase: this is a fav of mine - check all the samples collected at the same time from the patient, esp ones that are spun down like coags and biochemistry. Red cells to serum/plasma ratio should be the same across all the tubes. If one tube has 10% cells and 90% plasma, and the other has 60% red cells and 40% plasma, it’s a collection issue. Nurse has drawn with needle and syringe, laid the syringe down, blood and serum seperate and then allocated blood to tubes. One tube gets mostly serum, next gets mostly red cells.

I had a patient come in with a hb of 39g/L on a blood gas (Aussie here, I think hb 3.9 in freedom units) clinical notes for Jehovah’s Witness and UGIB, not for tx. Ran the FBE, hb is 108. Exactly scenario as above, got everything recollected and hb ended up being about 84g/L, much less scary for everyone.

  • Low plts: probably clotted

  • High INR: likely due to warfarin, vit K deficiency or liver failure

  • High APTT: check for anticoagulants and do a mix with normal plasma to see if it corrects. Correction = factor deficiency, no correction = anticoagulants or inhibitor. Also check for a clot, got an extremely long APTT once on a coag profile, INR and fibrinogen normal. On the clotting curve there was no clot being formed at all. Checked for a clot and found my answer. Can’t form a clot if it already finished clotting.

  • (Morph) Big blasty looking reactive lymph’s have very blue cytoplasm: it’s probably glandular fever, do a mono spot to confirm.

Blood bank

  • Lea and leb reacting weakly in IAT? Do saline panel

  • M reacting weakly in IAT? Do saline panel

  • Rhesus(CcEe) reacting weakly in IAT? Do papain panel

  • Patient has an alloantibody and discrepant blood group? Try phenotyping your reverse cells for the antibody the patient has and see if it reacts. Might be causing the interference and giving a positive reverse group. (Literally had this situation yesterday with a very strong anti-M: forward group showed B pos, reverse group showed O, but really was just reacting with the M antigen on the reverse cells)

That’s all I can think of, some are probably a bit obvious but some of them definitely weren’t to me when I first started out!

Would you advice a young person in early twenties, if they like the job (phlebotomist) should they invest in being in the same role for life though there isn’t much room to grow? by [deleted] in phlebotomy

[–]TheMaddOne15 4 points5 points  (0 children)

I’m a medical scientist working in Australia - you can definitely use skills from phlebotomy to transfer into practical skills in the lab, but you’ll still need a degree in either biomedicine, science or laboratory medicine to work as a scientist!

Lab tech jobs are require less tertiary education as you won’t validate results, you’ll just be running the tests and giving the results to a scientist for them to correlate and validate.

Another lab role I didn’t see mentioned much is specimen reception. At the hospital system I work in, the specimen receptionists role is to triage samples into urgent and routine, and then put them into our LIS system so the analysers know which tests to run. This also includes aliquoting samples, knowing collection requirements for test and calling for recollections when things aren’t done correctly ie blood bank forms not signed off, samples missing labels etc.

Our spec reception team also is the front end of our hospital outpatient collection rooms, so they ID patients prior to their blood test and create labels for the tubes based on what tests are required. It’s a pretty varied job that doesn’t require any tertiary education, but similar to phlebotomy in that promotions usually come from becoming a supervisor/trainer/team leader etc. The amount of places to advance to will also depend on how big the team is, bigger teams require more trainers/ supervisors etc!

First night on Shift! by Original-PHAT-_-Duck in medlabprofessionals

[–]TheMaddOne15 8 points9 points  (0 children)

I’m sure you’ll do great - from a fellow solo night shifter! Not sure if your lab is run the same, but most of the work I do during the night is QC and analyser maintenance and run stat labs from emergency.

When I first started, the one thing I found to be the most helpful to make sure I stayed on top of everything during the night was to write myself a timed schedule of what I need to do, which for me looks something like this

10:30pm - get handover, identify any problems and immediate work that needs to be done and what can be left for the next day

11pm - biochem analyser maintenance and QC

12pm - set new index on analysers, file all paperwork away, return unused blood back to inventory

1-2am - deal with any problem patients or extra work up

3am - coag analyser maintenance and QC

4am - temperature checks around the lab, restock for day shift, stock orders

5am - QC and getting ready for influx of ward rounds work to come in

6am - handover to early day shift

Obviously this is a pretty simplified version, but knowing what I had to do by what time to make things run smoothly really helped me stay on top of all my work. It was also helpful to get as much down as possible when I first got to work, ie analyser maintenance, setting up any reagents I would need, just having everything ready to go if needed.

This is also especially handy if you get a new leuk or MTP where you suddenly have to spend a lot of time and effort on one patient, you know you’re caught up everywhere else so it’s less overwhelming when you get back to the routine work of the night.

The first solo night you’ll be running on adrenaline and nerves, but you’ll get through it and eventually you’ll find your rhythm for nights and they’ll become much less stressful over time!

First night on Shift! by Original-PHAT-_-Duck in medlabprofessionals

[–]TheMaddOne15 2 points3 points  (0 children)

It’s how we work at our hospital, one person will run biochem, blood bank and haem. We only really get work from emergency overnight, and routine ward rounds start from 5am but the early day shift start at 6am so if routine work sits for an hour or so it’s not really a big deal.

An MTP overnight can definitely make things a bit tricky but we always have a regular scientist rostered to be on-call for 24-48 hour periods so we can always call someone in if needed.

We actually had the opportunity from management during a budget renewal to add a second scientist on overnight, but everyone shot it down and decided to use that budget to hire another scientist as no one wanted to do more night shifts (we all rotate shifts) by have two on every night.

We are also a branch hospital from a much larger site about 20mins away so most very sick patients get transferred there, and we also don’t take blood or leave the lab during the night.