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The Essence: The Best of June 2019

By Anne-Margaret Olsson posted 07-02-2019 11:56

  
The Essence: The Best of June 2019

The Artery is a great resource to all AACC members, a place where you can ask your questions and receive detailed prompt responses. This past month there were several solutions shared including, “QFT Gold Plus – Do You Collect Four Tubes or One Tube?”. Read on for our editor’s picks of the best discussions on the Artery in June.


QFT Gold Plus – Do You Collect Four Tubes or One Tube?
Initiated by @Jennifer Thebo, PhD, MT (ASCP)

One respondent’s lab collects a single tube. When they used to collect four tubes, they were sending a lot of QFT tubes to clients and not getting all of the tubes back before they expired. With four tubes, her lab was also getting more indeterminate results that may have been due to irregularities in sample processing. Importantly, part of what made the switch to one tube possible is the recent FDA approval that allows refrigeration of these tubes for up to 48 hours with no minimum amount of refrigeration time.

Pseudohyperkalemia
Initiated by @Laurie Veal, ASCP, MT (ASCP)

Why might a non-compliant diabetic patient spuriously present with elevated serum and plasma K+ levels? One respondent noted that she once observed a patient present with elevated K+ when tested in the morning and normal K+ when tested in the afternoon. After investigating potential confounding preanalytical factors, the respondent discovered that the cause of the spurious K+ value was the patient’s daily breakfast of potassium-rich tomatoes, consumed for their anti-inflammatory properties. Given the high cost of insulin, the diabetic patient might similarly be resorting to home remedies that interfere with testing.

PH Paper QC Frequency
Initiated by @David Alter, MD, DABCC

One Joint Commission-accredited lab performs quality control (QC) checks on pH papers every day – is this necessary, and is there a way to make this process more efficient? Two respondents indicated that under the Joint Commission accreditation guidelines, labs are only mandated to perform QC checks on each new shipment of pH paper. One of those respondents suggested retesting papers every 30 days if they are used infrequently. Another respondent, however, performs QC checks on pH papers daily, like the original poster.
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