Part 1 Level 3 Dxh Competency

Mark should repeat the latron with a new vial because the current vial is out of specification again. This implies that there may be an issue with the vial itself, and using it again could lead to inaccurate results. Therefore, using a new vial would be the appropriate course of action to ensure accurate measurements.

The first step for Mark, the DxH operator, is to check the specimen for clots. This is important because clots can interfere with the accuracy of the analysis and may need to be addressed before proceeding with the testing. By checking for clots, Mark ensures that the blood sample is suitable for analysis on the DxH.

Mark should reject the specimen because the presence of numerous fibrin strands indicates the presence of clots. Clots can interfere with the accuracy of the test results and may lead to incorrect diagnoses. Therefore, it is necessary to reject the specimen and obtain a new one for testing.

The most likely cause of the fibrin strands is poor collection technique. This is because during the collection process, if the technique is not performed correctly, it can cause trauma to the blood vessels. This trauma can lead to the activation of the coagulation cascade and the formation of fibrin strands. High platelet count and high fibrin content in the blood may contribute to the formation of fibrin strands, but poor collection technique is the most likely cause.

Since Mark has already tried running the latron again with the new vial and it is still out, it suggests that there may be a technical issue with the machine. Therefore, the best course of action for Mark would be to call the service for assistance in resolving the problem.

Mark should repeat the Saline Replacement procedure from the beginning with a new aliquot of the lipemic specimen.

When a Saline Replacement procedure is used during testing, the comment "Saline Replacement performed" must be appended to the results. This comment serves as an indication that a saline replacement was done during the testing process. It helps to provide context and transparency regarding any interventions or modifications made during the testing, which may have affected the results.

Mark should run the CBCD and after it is resulted, give the specimen to Chemistry. This means that Mark should prioritize running the CBCD as it is needed, and once the results are obtained, the specimen can be handed over to the Chemistry department for further testing or analysis.

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In this scenario, the latron is out of specification after a shutdown. To troubleshoot the issue, Mark should first repeat the test with the same vial. This is because the problem may be temporary or caused by a minor error during the initial test. By repeating the test with the same vial, Mark can determine if the issue persists or if it was just a one-time occurrence. If the problem persists, Mark can then consider other options such as repeating with a new vial or calling for service.

In order for the testing to be valid after performing a saline replacement on the lipemic specimen, the RBC count on the treated specimen must match the RBC count on the pre-treated specimen. This is because the RBC count is a crucial parameter that needs to be consistent in order to accurately interpret the test results.

When there is a flag indicating possible platelet clumping on the printout of a CBC run on the DxH, the first step Mark should take is to check the specimen for clots. Platelet clumping can occur due to the presence of clots in the specimen, which can interfere with accurate platelet count results. By checking for clots, Mark can ensure that the specimen is suitable for analysis and determine if platelet clumping is indeed the cause of the flag.

Mark should TNP (do not process) the platelet count and request a blue top tube for the platelet analysis. This is because the specimen has been found to have platelet clumps, which can interfere with accurate platelet count results. By requesting a blue top tube, which contains an anticoagulant called citrate, it can help prevent platelet clumping and provide a more accurate analysis of the platelet count.

Mark did not notify the ER doctor that the TAT would be increased due to the lipemia. This is something that he should have done to ensure that the doctor is aware of the delay in results and can adjust their plans accordingly.

Mark should first centrifuge a small aliquot to check for lipemia. The presence of lipemia in the specimen can cause the H & H Check Fail flag. By centrifuging a small sample, Mark can visually inspect for any signs of lipemia, such as a milky or turbid appearance. This will help determine if lipemia is the cause of the flag and guide further actions or investigations.

Mark should reject the specimen because the presence of fibrin strands indicates that it is not suitable for testing. Removing the fibrin strands and repeating the testing may not provide accurate results, and requesting a blue top tube is not necessary in this case. Therefore, the best course of action is to reject the specimen and request a new one.

Before performing a saline replacement on the lipemic specimen, Mark must make a slide. This is important because making a slide allows for proper visualization and examination of the specimen under a microscope. It helps in identifying any abnormalities or specific characteristics of the specimen that may require further analysis or intervention. Making a slide also ensures that the specimen is properly prepared and ready for the saline replacement procedure.

The DxH will run the specimen using the default settings but it will not automatically cross the results to Remisol. This suggests that the DxH machine will analyze the specimen, but it will not transfer the results to Remisol automatically.

After bleaching the appertures, Mark must do a Shutdown and run Daily Checks. This is necessary to ensure that the appertures are properly cleaned and ready for further use. The Shutdown process involves shutting down the system and performing necessary maintenance tasks, while the Daily Checks help in verifying the overall functionality and performance of the system. By doing these steps, Mark can ensure the proper functioning and cleanliness of the appertures, maintaining the quality of service provided.

Mark should reject the specimen because the presence of fibrin strands indicates interference, which can affect the accuracy of the TNP platelet count. It is important to obtain a new specimen without any interference to ensure accurate results. Cancelling the specimen and noting that the redraw must be done through venipuncture is not necessary in this case.