26 July 2024 (Friday) - At A Loose End

With my car in for service and what was supposed to be a two-hour service now taking all day, and everything I had planned for the day needing a car I thought I might as well do a BTLP-TACT exercise.

I was presented with two cases.

 

93476 – a sixty-year-old chap in A&E needing group & save for a fractured neck of femur.

He grouped as AB Rh(D) Negative with antibody screen positive in cells 1 and 2. I requested antibody panels. The IAT and enzyme panels were positive in cells 1, 2, 3 and 4 which corresponded with anti-C and anti-D but didn’t exclude anti-Cw

 

86139 – a thirty-two year-old chap in the haematology clinic needing two units of irradiated blood within the hour.

He grouped as O Rh(D) Positive with antibody screen positive in cell 2. I requested antibody panels. The IAT and enzyme panels were  positive in cells 3 and 5 corresponding to anti-E.

I selected two units of irradiated O Rh(D) Positive E Negative blood

 

I got the green light.

23 July 2024 (Tuesday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. I had two cases:

28671 – a forty-six year-old woman in the maternity unit needing four units of CMV-negative blood for tomorrow. She grouped as A Rh(D) Positive with a negative antibody screen.  I selected four units of A Rh(D) Positive K-Neg CMV-Neg.

98423 a fifty-five year-old chap in the orthopaedic department. Recently transfused he needed four units of blood for today. He had an inconclusive ABO group presumably an AB person having been given O blood, and his Rh group was negative. However his antibody screen was negative. I selected four units of O Rh(D) Negative

 

I got the green light.

22 July 2024 (Monday) - Learn Haem

Whilst rummaging about on the Internet whilst I should really have been doing proper work I discovered this web site. There’s all sorts of tutorials and lectures on there, complete with quizzes.

I did one, and learned quite a bit. Hepcidin was only discovered twenty years ago.

I shall do more of these.

22 July 2024 (Monday) - NEQAS 2403 DM

The results of NEQAS DM 2403 became available today. I thought the case was a case of Hb SC disease with an utterly unrelated lymphoproliferative condition – probably a myeloma.

I would seem to be in agreement with the consensus. I’ll take that.

21 July 2024 (Sunday) - In The Future

Here’s something that made me think. What will the effect of AI be on what we do?

When I first started in this game forty-three years ago I spent a few months in each part of pathology to get a feel for what I might like to do.

At the time I was told that clinical chemistry was ripe for automation but it would never happen with haematology. I’m reminded of Arthur C Clarke’s comments about the failure of imagination; the people with whom I worked all those years ago wouldn’t recognize where I now work.

I’m not saying that AI will wipe out biomedical scientists.

I’m not saying that biomedical scientists will be safe from AI.

I am saying that the future won’t turn out anything like we imagine it will.

As the Hitch Hiker’s Guide to the Galaxy said about grammar in the future, “the term "Future Perfect" has been abandoned since it was discovered not to be.”

18 July 2024 (Thursday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. I was presented with two cases:

 

87818 – a fifty-year-old chap in the outpatient department needing group & save.

The ABO group was inconclusive, but the RH(D) group was negative.

The antibody screen was positive in cells 1 & 2 so I requested antibody panels. The IAT and enzyme panels were positive in cells 1, 2 and 3 corresponding with anti-D but not excluding anti-Cw.

 

48596 – a fifty-one-year-old woman also in the outpatient department needing two units of blood. Sadly the NHS number on the blood sample was completely different from that on the accompanying form so I rejected the request.

 

I got the green light.

Mind you, I find myself wondering just how much use this simulator is to me. It doesn’t really simulate what I do at work on a daily basis. If I make a mistake at work (which we all do from time to time) I would be mortified, and fret about it for weeks. However I get this thing right with a sense of serious achievement and amazement.

18 July 2025 (Thursday) - Oncology Central Update

The most recent Oncology Central newsletter appeared in my in-box this morning. You can read it by clicking here. I had a wry smile at the bit about acupuncture having a role in modern medicine. Back in the day this would have been laughed out. Nowadays people would seem to be doing what science should be about – seeing that something happens and finding out why rather than just laughing because it doesn’t fit the theory.

To be honest this is something of which I am guilty. We all know that dowsing is a load of rubbish and has absolutely no basis in science… it really annoys me that I can do it.