25 April 2024 (Thursday) - Finally Getting It Right

Bearing in mind that the last time I did a BTLP-TACT exercise I decided that I’d had enough of failing because of its vagaries it was with a heavy heart that I had another go this evening.

 

I had one case – a ninety-nine year-old woman with CVA who needed group & save.

She grouped as O Rh(D) Positive with a negative antibody screen.

 

I got a green light… the first for over a month.

 

23 April 2024 (Tuesday) - Westgard QC Update

The nice people at Westgard sent their update today. There was a lot of what I might flippantly call “blah blah blah”, but one article made me think.

Just what are the QC limits on our blood counters? I naively thought they were the standard two standard deviations. It would seem they might not be. It was claimed that some parameters have ranges of up tp 10 SD; MCV, and MCHC were quoted.

 

I’ve always worked in places that use the limits that the machine’s manufacturers give. Personally I haven’t a clue just how wide these limits are though.

Apparently globally, only about 42.4% of laboratories use such manufacturer-supplied control limits. 60% of labs surveyed in China use their own limits

 

I suppose that justifying making our own limits would be a regulatory minefield. CPA wouldn’t be at all keen. Mind you I wonder if they are aware of this article.  

I imagine those who make blood counters will have something to say about it… and about this article too.

21 April 2024 (Sunday) - Failing the BTLP-TACT Again

Time for another BTLP-TACT exercise. I was given two cases:
 
18673 – a ninety-three year-old woman in out patients requiring group & save
 
She grouped as O Rh(D) Positive with a negative antibody screen
 
14253 – a forty-two year-old woman needing two units of blood for tomorrow
 
The control being positive invalidates the entire group
 
The antibody screen was positive in cell 1. I performed antibody panels.
The IAT and enzyme panels were positive in cells 2, 4, 5, 8, 9 and 10
This looks like anti Jk(b) but doesn’t exclude Lu(a) or Kp(a)
Bearing in mind there was no suitable blood available I was bound to get a red light…
 
What was I supposed to do?

19 April 2024 (Friday) - IBMS Update

The IBMS sent its update today. You can read it by clicking here. Please do click there.

What is the purpose of the IBMS? I really don’t know any more.

I used to be a member of the IBMS as it was my professional body and in its monthly magazine it would come up with all sorts of useful articles to help me in my job.

Back then the IBMS Gazette was pretty much the only place that adverts for jobs in this line of work appeared.

Then the IBMS started offering professional indemnity insurance.

And now…

The IBMS hasn’t so much lost its way as gone the way it has been led by those who can be bothered to do the leading. However they aren’t leading it the way I would have done.

18 April 2024 (Thursday) - UKAS Update

The quarterly update from UKAS arrived in my inbox this morning. Yesterday I mentioned how the good old days weren’t that good. Another way in which they weren’t good is exemplified when I moved to a new place of work in 1984 after three years elsewhere.

“You can do blood groups?” asked the chap in charge of the blood bank.

“Yes” I answered.

“Get on with it then” he replied.

And so, with no written instructions I got on with doing blood groups in the way I’d been taught in the long-bulldozed Royal East Sussex Hospital. After a few weeks and months it turned out that how I was doing them was subtly different to colleagues who’d been taught in hospitals in London, Tyneside, and various other parts of the world.

Were we all getting the same results…? Who knows?

 

We all laughed at the idea of having standard operating procedures, and were horrified at the thought of facing accreditation when these were introduced in the early 1990s, but they were needed.

Thirty years later we’ve now got the UK Accreditation Service which seems to be trying to instill the same strange practices into the management structures of many and varied diverse lines of work. From my personal and narrow perspective it has lost sight of the frankly wonderful achievements of thirty years ago.

We all do blood groups the same way at work. But how we do them is still subtly different to how they are done in hospitals in London, Tyneside, and various other parts of the world. Perhaps we as a profession might be looking at standardizing nationwide and internationally? Is there any appetite for that? I doubt it

17 April 2024 (Wednesday) - The Good Old Days ?

On the week when I (finally) got hold of my pension the nice people at Lablogatory sent their update somewhat co-incidentally reminiscing about the good old days.

I remember the good old days. I originally wrote a diatribe about how things were so much better forty years ago… but then remembered a conversation with the boss at the time who said he was legally obliged to recommend that I join the pension scheme but he felt he would make the observation that people in this line of work usually died aged fifty-seven from something nasty they caught from the job. Was this true? “Uncle Cyril” actually told me that, and I took him at his word.

I’ll make the observation that had we had today’s health and safety legislation back then we wouldn’t have used post-mortem material to make reagents. And one of the girls with whom I went to college probably would still be alive.

15 April 2024 (Monday) - e-Learning

 

I did my Infection Control and Information Governance e-learning today. I passed both... as well I might.