Condensed Case

A routine CBC was received in the clinical laboratory on a patient who had been receiving daily blood work. On this particular day, the computer flagged (delta checked) a variety of parameters pertaining to the CBC. The parameters that were flagged were: WBC, Hemoglobin, Hematocrit, and MCV What are the steps needed to investigate the discrepancy in this patient's results?

Answer

1. Realize that the delta check is the historical reference on the patient. If the results are flagged, then there is a discrepancy in patient results.

2. Visually inspect the CBC tubes, and peel back the label looking for identification.

3. Check the sample for a clot.

4. Re-run the sample to ensure that there is the proper amount of sample and proper mixing.

5. Check whether there is a transfusion history on the patient.

6. Call the floor and ask how the sample was drawn.

After performing these steps, decide on a course of action.

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