Question about clotted sample

Question about clotted sample Posted: Thu May 30, 2019 7:39 pm
Greetings everyone,

I am currently a student considering being a medical lab technician. I work part time in the lab as an LA/LAS at a hospital setting. I know as much as anyone here that sometimes conflicts may happen about opinions especially when the SOP is general or in some areas gray. So I come to ask a situation or question I encountered between workers.

The situation was based on hematology where a specimen was clotted. Now I know if a cbc was to run the results would be unacceptable due to the effect of the platelet count, wbc, rbc, and mean corpuscular indices being affected, but the only order was a hemoglobin hematocrit. The machine we use is the syssmex hematology analyzer and I vaguely remember being told the Hgb is read based on lysing the red cells so I think a clot will not matter, but will the hematocrit be affected (I am unsure how the syssmex reads the Hct).

The tech that day ordered a redraw, but in turn another tech said it was alright since it was an H and H. Both techs told the nurse different things and the nurse yelled at the tech who ordered a redraw saying she should "explore her options etc.).

I wanted to ask you more experiences tech who was right in this situation?

Some things to note the patient is a hard stick and is sickly so a redraw is really asking a lot
Although an HH was ordered what if an addon was done (That was one of the reasons the tech who redrew justified her situation as well)
Is it not standard protocol to reject any specimen that falls into the criteria of being faulty or erroneous despite the test ordered or is it one of those situation like an icteric or lipemic specimen where it's alright cause it falls in the line of "nothing we can do about it just make the most of it"

Much appreciation everyone
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Re: Question about clotted sample Posted: Wed Jun 05, 2019 5:59 am
If unfortunately as you stated, your lab SOP is vague on this subject, I would suggest that you look at the instrument manufacturer's recommendations regarding clotted samples. CLIA regulations stipulate you must follow the manufacture's recommendations for specimen integrity. In my experience this sample would have been rejected and a new specimen drawn. If the patient was a "hard stick", you can always do a finger stick.
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