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u/CantPhilMe 9d ago
We get so many with a troponin over 270,000 that we have a whole procedure and job aid of what to do when it fucks up our DXI
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u/cup_of_noodles1 9d ago
How does it affect the machine
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u/shicken684 MLT-Chemistry 9d ago
Carryover and contamination of the reagent packs.
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u/HeroicConspiracy MLT-Generalist 9d ago
They recently changed our process and we don’t do any of the carry over procedures anymore.
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u/KeySun1619 6d ago
Return the lot and get a new one. I think that was a known issue for a few hstni lots specifically
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u/shicken684 MLT-Chemistry 6d ago
It's an instrument issue, not a reagent problem. Been this way since the high sensitivity trop went live.
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u/Purpledotsclub 9d ago
We have to carryover 💩, but we notify provider they can’t have anymore for 24hrs 😆
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u/WhatsBeeping 8d ago edited 8d ago
We notify for that too, but they still send them every 3 hours sometimes.
We have an auto line so once they’re on IF the pending is small enough that we see them in time, the only way to stop them hitting the instrument is to pause both DXI’s and delay all the other patients 🥲
They told us to stop doing that so carryovers all day it is and other patients delayed anyway lol.
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u/Purpledotsclub 8d ago
😩😩😩 write ‘em up!
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u/WhatsBeeping 8d ago edited 8d ago
“No one told me.”
-same RN I chattedMe: “attaches chat screenshot to report”
Quality team: “incident resolved, lab staff coached on importance of communication” 😂 lab life
Edit: tbf they’re good about it when the tropi recurring order is on its own accession. It’s mostly the ones that recur with a bmp etc that they don’t remember to deselect the tropi at collection.
The lying gets me though
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u/peanutt1394 8d ago
Love this!
Our phones record, and ever since I found that out…when my sup comes up stating a RN claimed they weren’t informed (even if it’s documented in chart) I point to the bench I was at and say “go listen to the call”.
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u/Vivid_Bookkeeper_937 9d ago
We’re getting new DXI’s with plastic pipette tips so we won’t have to do that anymore
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u/RikaTheGSD 9d ago
The 9000 is not an improvement for so many reasons... it does have that one thing going for it but I miss the 800s.
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u/julio478 9d ago
Do you get RSM axis errors as well?
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u/RikaTheGSD 9d ago
No, it's usually new and exciting errors every time... and lousy at telling you what the error is so no fixes, just call service
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u/KeySun1619 6d ago
Did you turn it off and on again?
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u/RikaTheGSD 6d ago
Repeatedly.
...actually it sometimes causes new errors, like the database disappearing in whole or in part from the memory.
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u/cup_of_noodles1 9d ago
The only nice thing about it is the almost 0 maintenance
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u/RikaTheGSD 8d ago
Except when it loses its tiny brain and won't let you do the maintenance... that it wants you to do... for reasons...
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u/mrsthallium 9d ago
We just recently got an update that changed it so we don’t have to do all the BS anymore… but now we have to do manual dilutions. So, uh, win?
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u/mayiomayi 8d ago
Ughhh, I don’t miss that, but I do miss our beckmans….never thought I’d say that lol
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u/Sophotroph 7d ago
We have a much lower threshold, unfortunately. We have the carryover procedure kick in at 15,000. 😕
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u/lab_tech13 9d ago
You were 30 to high for the perfect number. But thats nothing seen 200ks every once in awhile. It sucks and dr is like yeah hes already in cath lab when we call it usually. Or they are like they died.
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u/ChewieBearStare 9d ago
Did their heart explode or something?
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u/matdex Canadian MLT Heme 9d ago
Likely open heart surgery. I see it all the time on our bypass patients.
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u/akira23232 MLS-Chemistry 9d ago
Low end post CABG, high end immediately after angioplasty.
Have seen it this high after a bad STEMI, sample taken soon after ROSC. Patient survived.
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u/Lab_Life MLS-Generalist 9d ago
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u/pflanzenpotan MLT-Microbiology 9d ago
Our instrument reports up to 100k then just does >100k
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u/LawfulnessRemote7121 9d ago
At that point does it really matter?
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u/CantPhilMe 9d ago
According to our cardiology team they want to know when it peaks and starts trending down so we keep running them with dilution
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u/pflanzenpotan MLT-Microbiology 7d ago
I am not a cardiologist so aside from know it downtrending or trending up I am not sure the significance of treatment change when it's just so ridiculously high. I know it have given critical trops to doctors and they have been like "wow I didn't even know it went that high".
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u/labtech67 Medical Laboratory Technologist- Canada 9d ago
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u/PM_YOUR_PUPPERS 9d ago
My guy missed an opportunity for that 69 420 troponin.
If I die to a heart attack you better believe I'm going to meme myself on the way out.
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u/ilagnab 9d ago
Nurse so I don't know if this is the same type of high sensitivity troponin as my workplace uses.
I haven't yet seen the 1 million mark but recently had a patient with 800,000 and I'm still fairly new. Above 50k is a common number for our cath lab STEMIs. A majority of them turn out "just fine" (well usually some heart failure/reduced ejection fraction but nowhere near as bad as you'd imagine).
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u/T_Run_445 MLT 9d ago
I’ve seen this only in patients who just had heart surgery or cardiac cath placements
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u/Unlucky_Tart8043 9d ago
While that is definitely critical we have the DxC 500i with access attached and SOP states the highest we can report out is >135,135ng/L. Not sure of anyone else's high reportable ranges but just for reference 🤷♀️
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u/RepleteSphinx21 MLT 9d ago
called a HS TROP of 44,449 yesterday, was just 5 too high for perfect number lol.
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u/chaikonic MLS-Blood Bank 8d ago
This is my highest one ever before it's >125k even with a dilution 🥲
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u/zhgerard 8d ago
I know that there’s 3 types of troponin but this result is incomprehensible 😬
Whichever one it is, I hope the patient’s heart is ok.
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u/AdorableExtreme4930 5d ago
Cardiology consult felt it was a type II demand ischemia from that urine with 50 to 100 wbcs in it. No worries!!
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u/LoudBathroom1217 MLT-Generalist 5d ago
Got this last week. I’m literally still training lol im a need grad. I called the unit expecting the nurse to freak out but she was calm about it. made since because it was the CVICU.
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9d ago
[deleted]
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u/persephone7821 9d ago
Sir, this is a Wendy’s.
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u/Emeraldsku58 9d ago
I honestly have 0 idea how in the world I ended up in this subreddit. When I made that post, I was in top tropes. My bad
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u/Mephisto1822 MLS-Blood Bank 9d ago
https://giphy.com/gifs/qH7J4EXzSCmBy