24 December 2015 (Thursday) - Clexane

Clexane injection contains the active ingredient enoxaparin, which is a low molecular weight heparin. It is used to stop blood clots forming within blood vessels

What is it used for?

• Treating deep vein thrombosis.
• Treating pulmonary embolism.
• Preventing thromboembolic disorders, particularly following surgery or in people bedridden due to illness.
• Treating blood clots in the coronary arteries in unstable angina and myocardial infarction.
• Preventing blood from clotting when it is filtered through a haemodialysis machine.

This isn’t new… I've been familiar with the stuff for a while. But a friend’s partner has recently been prescribed it.

It stings…

22 December 2015 (Tuesday) - Taking a Bung

Is this the future?

It is no secret that large parts of the NHS are going out to private tender and blood testing is not exempt from this.

In America where blood testing has always been privatized a scandal has been exposed in which agents of private laboratories are bribing medial practitioners to use their services over and above those of their competitors.

Furthermore they were bribing doctors to perform unnecessary blood tests.

At the moment there is little market for this in the UK pathology scene. But when we are all privatized will things be different?

22 December 2015 (Tuesday) - NHSBT Update

The December communication to hospitals from NHS Blood and Transplant came out today

It covered topics such as:

1.1  Group A FFP in trauma where the recipient's ABO group is not known

1.2  Stock Management of platelets over Christmas and New Year

1.3  NHSBT plans to produce HEV screened negative components

2.1 Update of H&I User Guide for 2015 – 2016

2.2 Therapeutic Apheresis Services Officially Open Oxford Unit

2.3 Supply Chain Modernisation (SCM) Project

2.4 NHSBT Mass Casualty Plans

2.5 New Patient Information Leaflets and updated Educational Resource

3.1 Training & Education Events and Courses

Sometimes this update is interesting, sometimes rather dull. This was one of the better ones…

20 December 2015 (Sunday) - Theranos

Theranos seems to be in trouble.

Theranos started off as a serious concern to the likes of me; they were offering a revolution to blood testing; cheap technology undercutting the current market.

Now they have fallen foul of regulating authorities; their technology isn’t all it was cracked out to be.

Those who rely on the results of blood tests have found that a reliable reproducible result is far better than a randomly generated number.

But we’ve known that all along….

16 December 2015 (Wednesday) - Blood Alcohol Levels

Here’s food for thought:

There is a scandal in the American courts. Blood samples taken on people accused of drink-driving offences would seem to be giving rather different results between the initial testing and subsequent testing two years later.

Clearly storage of samples is everything. But this isn’t news. Is it?

15 December 2015 (Tuesday) - Unsung Heroes

Here’s an interesting article I found in Facebook (of all places) over brekkie:

http://www.labtestingmatters.org/saved-by-the-lab

It is no great scientific article, but it told the tale of the importance of the hospital laboratory.

A patient (on oral anticoagulation) had massive bruising. This bruising was put down to poor venesection technique. However laboratory testing showed a ridiculously high INR and subsequently it transpired that the patient had been massively overdosed by a mistake in the pharmacy.

The lab identified the problem, saved the day, and possibly the patient’s life.

It is a shame that this sort of thing never makes the newspapers….

14 December 2015 (Monday) - Blagging Results

Here’s an interesting article from today’s news:

http://www.bbc.co.uk/news/uk-wales-35090879

Although it is about nurses rather than biomedical scientists it gave me pause for thought. Basically (among other misdemeanours) two nurses didn’t perform routine near-patient glucose testing; preferring to make the results up themselves.

In the first instance I can’t help but feel that were these tests done in a laboratory setting there would be an audit trail including analyser information which would make getting away with such fabrication of results rather more difficult.

However given a manual system with no such electronic audit trail surely it is actually far easier to do the test than to try to make up plausible results. Such blagged results are going to be rather obvious if and when the patient’s clinical condition deteriorates.

9 December 2015 (Wednesday) - Typanosomes

In the most recent parasitology NEQAS survey was a thick film for examination. I didn’t see any parasites in it; nor did any of my colleagues.

It turned out we were all wrong; there were actually trypanosomes in that film. I reviewed the film with a colleague and knowing that there were trypanosomes present they were eventually identified.

However on reflection they weren’t obvious. I can’t help but feel that thick films are a rather artificial preparation. A Google search found recommendation of reviewing buffy coat preparations rather than thick films. If nothing else they are more familiar in appearance.

The next time we get a low parasitaemia I shall make and stain a buffy coat preparation and see…

4 December 2015 (Friday) - HCPC Newsletter

The December newsletter from the HCPC arrived this morning.

There was talk about the revised Standards of conduct, performance and ethics… but only talk. Not much in actual substance unfortunately.

HCPC HQ has new phone numbers

There was mention about a live webcast – HCPC update and disengagement in health and care. Unfortunately this is planned for Thursday 10 December 2015 at 12.30–1.45pm… not a convenient time.

There was talk about the HCPC’s involvement in fraud, corruption and theft in the NHS

There was a Fitness to Practice report for the year. After several clicks I got to it. I read a little… still a sensitive subject for me….

And there was a report on the first fifteen years of the HCPC – now that was interesting…

So often this publication is dull. This one wasn’t…

26 November 2015 (Thursday) - NHSBT Newsletter

The November communication to hospitals from NHS Blood and Transplant came out today

http://hospital.blood.co.uk/

At first sight it seemed rather interesting:

• For Action
  
  1.1  Stock Management of platelets over Christmas and New Year
  1.2  Customer Satisfaction
  1.3  Updated Patient Information Leaflets
  1.4  Points of note from the National Commissioning Group for Blood

• For Information
  2.1 Update on Extended Blood Group Testing for patients with Sickle Cell and Thalassaemia Disorders

• For Training
  3.1 Training & Education Events and Courses

It *was*….

20 November 2015 (Friday) - New Guidance

The NICE guidance on blood transfusion came out today:

http://www.nice.org.uk/guidance/ng24

This is the sort of thing that is so easy to overlook; but I really feel this is something that should be read; it is quite amazing how opinion had changed over the years. Consider the new guidance for red cell transfusion:

“consider a threshold of 70 g/litre and a haemoglobin concentration target of 70–90 g/litre after transfusion”.

When I was a lad the limit was 100; not 70. Quite a difference. And that’s just one example…

19 November 2015 (Thursday) - Useful Website

Here’s an interesting article:

http://www.transfusionevidencelibrary.com/

The last article I found on-line was rather depressing; this one’s going to be quite useful for my diploma in biomedical science.

I hope…

19 November 2015 (Thursday) - The Future?

Here’s an interesting article:

http://www.labtestingmatters.org/the-true-cost-of-quality/

Whilst in many ways it doesn’t actually say anything new (and could be construed as little more than a whinge) it is interesting that we seem to be members of a profession which is in a world-wide decline. There seems to be fewer and fewer people coming into this line of work, and precious little being done to halt the decline.

In retrospect I can see where (I thought) the rot set in. I said so at the time and was shouted down in a public meeting by the then President of the IBMS.

Can I do anything about this decline now? I don’t think so. Should I? Definitely… But I’m tired… Realistically if this job can see me to retirement.

Am I wrong to feel this way?

13 November 2015 (Friday) - Malaria - Where?

Something I find I struggle with is remembering which strain of malaria is endemic to which parts of the world. Here’s a website which may well help me out in future:

http://www.cdc.gov/malaria/travelers/country_table/a.html

12 November 2015 (Thursday) - Pre Reg Portfolio Reviews

I had an email from the IBMS today. It had feedback following the IBMS Education and Professional Standards Committee meeting.

Interestingly the key point for me was about pre-registration portfolio reviewing:

“blah blah blah…. The above statistics indicate a concern we have that increasing numbers are unable to fulfil the requirements of the verifier and/or examiner role. Over the recent summer in particular we have struggled to allocated verifiers.”

I’m just a little bit peeved by this. I’ve not done a verification for years. Because the IBMS tell me I can’t *until* I’ve undertaken the training that they simply aren’t providing