4 December 2018 (Tuesday) - Blood Film NEQAS

The results of the latest NEQAS morphology became available to me today. I looked at the films a month ago and can’t really remember much about them but:

1807 BF1

I said “Film is poorly stained, but: Macrocytosis with target cells and Howell-Jolly bodies and nucleated red cells. Also a mild lymphocytosis. Some look odd, but is that the staining? Some neutrophils are right shifted, but not many. Also platelet count is OK.

*Possibly* megaloblastic, but more likely liver disease or haemoglobinopathy - clinical details would have helped.. “

It *was* a haemoglobinopathy…

1807 BF2

I said “Again film is poorly stained, but: Fragmented, echinocytic and spherocytic red cells with some Howell-Jolly bodies seen and some nucleated red cells. Reduced platelet count. 

?MAHA and/or DIC”

It was a case of TTP – I’ll take that.

Again I don’t think these exercises are a fair assessment. We are provided with minimal information and expected to come up with a comprehensive diagnosis.

3 december 2018 (Monday) - Infection Control

I did my clinical infection prevention e-learning refresher today. As a learning experience it didn't really tell me anything new, but a refresher is always a good thing.

3 December 2018 (Monday) - ISI

There was a discussion today on the Haematology Interest Group about how much variation there is between analysers when producing an INR; particularly with the higher values.

I always thought that we took the trouble to calculate an IS for each analyser with each reagent to avoid such a problem... Can a manufacturer-provided ISI *really* work? It strikes me that the evidence says it doesn’t.

2 December 2018 (Sunday) - Sickle Cell Crisis

Here’s a link to a rather interesting photograph of something that someone saw looking down their microscope. Sickle cell crisis…

29 November 2018 (Thursday) - Past It ?

The nice people at Lablogatory sent their latest offering today. Some of their stuff is really useful. Some isn’t that relevant. Just recently they’ve taken to sending a lot of stuff written in “management-ese”

Today’s article started with “Traditionalists are the oldest working generation in today’s professional environments. They bring a wealth of information, knowledge, and experience with them.” Well, that’s me. One of the old ones…

The article then went on to paint a picture of decrepit Luddites who prefer to speak face to face as a telephone is too high-tech, let alone use email or anything web-based.

I took offence, and have told them so. I wonder if they will reply.

29 November 2018 (Thursday) - Clinical Governance

I did my annual clinical governance e-learning today. The subject *isn’t* that tricky – why do people try to confuse it and make it more complicated than it is.

Be careful with confidential data… think what you are doing with it…

29 November 2018 (Thursday) - How Old?

The Transfusion News email arrived today. One thing caught my eye:

Older RBCs Associated with Increased Risk of Death Among Trauma Patients

Should we be giving fresher blood to older recipients? Ironically that there was something on the Facebook “Blood Bank Interest Group” about increasing the shelf life of donor units.

Older, fresher… which is correct?