7 October 2025 (Tuesday) - BTLP-TACT Exercise

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

49272 – a twenty-two year-old woman with renal failure requiring group and save. She grouped as AB but with an indeterminate Rh group but the antibody screen was negative.

08570 – a seventy-six year-old chap with iron deficiency anaemia also requiring group and save. He grouped as O Rh(D) Positive with a negative antibody screen

I got this one right…

7 October 2025 (Tuesday) - NEQAS 2506 BF

I got the results of NEQAS 2506 BF today…

 

2506 BF1 was in my opinion unremarkable. It was the blood film from a healthy 53-year-old woman who had a full blood count as part of pre-operative assessment before routine elective surgery. The numerical parameters of the full blood count were all within normal limits, as were the blood film appearances.

2506 BF2 I said:

 

Fragments (Consensus finding #1)

Thrombocytopenia (Consensus finding #2)

Acanthocytes (Consensus finding #4)

Hypochromic/polychromatic (Consensus finding #3) 

Spherocytes (Consensus finding #6)

 

This was the blood film from a 57-year-old man with a Thrombotic microangiopathy (TMA) – i.e. the combination of a microangiopathic haemolytic anaemia (MAHA) and thrombocytopenia.

 

One needed action, one didn’t. I spotted the salient features. I’m claiming that as a result.

6 October 2025 (Monday) - A Morphology Quiz

I had another go at The Mislabelled Specimen’s morphology quiz. I got two wrong…

 

The one on the left is a rubricyte. No – I’d never heard of it either. Apparently in some schools of thought red cells progress from rubriblast through prorubricyte, rubricyte and metarubricyte to erythrocyte.

There’s several stages of what I would can a nucleated red cell. I suppose that makes sense.

And the one of the right was my usual error of mistaking a promyelocyte for a myelocyte.

This is a mistake I’ve made before…  

 

But I’ve learned something…

 

2 October 2025 (Thursday) - Fritsma Factor Newsletter

Quality management, AI and platelet counts, case studies… again the Fritsma Factor newsletter is a little gem.

 

2 October 2025 (Thursday) - Digital Footprint

I’ve signed up for (and started) another Coursera course. Digital Footprint…"the data you leave behind when you go online”.

So what does this have to do with CPD?

 

The CPD rules say that we have to do CPD, but how we record it is up to the individual.

Back in the day when I first started recording my CPD in the form of a blog, the management where I used to work was unanimous in their disdain of it.

Possibly because I wasn’t using the templates that they’d spent months arguing about.

Possibly because it was an idea I’d had, and I was never flavour of the month with them.

Possibly fear of the Internet… as one of them once told me “You never know who’s reading what you write”.

Which is why I am rather cautious about exactly what it is that I write on here. But for all that the title up above says “anonymous biomedical scientist who works somewhere in the south of England” it wouldn’t take anyone with any IT skills more than a couple of minutes to work out who I am and where I work, would it?

 

As someone who has been all over the Internet pretty much since it started my digital footprint is quite immense. Have you ever Googled yourself? I have. If you peer into the Internet there’s photos of me holding snakes, looking through telescopes, drinking far too much, in Star Trek costumes, in a mankini, with cub scouts, flying kites, fishing, walking through the countryside, with dogs, geocaching, and even occasionally performing a blood test…

That’s the kind of guy I am.

But I know that whenever I post anything to the Internet it is there for keeps.

That’s why this diary is incredibly dull, and my personal diary (see the “other biomedical blogs of note” section) is far more of a hagiography (look it up!) than a biography.

 

It would seem that quite a few people are ashamed of who they used to be and are frightened about what they might be perceived to be…

Like all Coursera courses, this one is rather interesting. It’s reminded me to be circumspect in what I post on here, and I’m hoping to learn one or two new things.

I’ve passed the first module, so here’s hoping.

2 October 2025 (Thursday) - Seriously?

I’ve had yet another email about my “need to complete further TACT participations to improve your engagement target with the system”. So let’s review my “engagement with the system” last month.

I logged into the system on six different occasions, and as you can see, everything is in the green and I got absolutely nothing wrong…. Even though it failed me for not issuing plasma on a mislabelled request on September 20^th.

So, bearing in mind that the system is still very much a work in progress I pressed the “Start new scenario” button and wondered what might happen.

 

It presented me with one case – a forty-five year-old woman with post operative anaemia needing two units of blood as soon as possible tomorrow (Have I ever mentioned that I suspect the system leaves a little to be desired?)

 

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

I selected two units of AB Rh(D) Positive K Negative blood

 

I got it wrong… but I’ve worked out how to call up the pictures of completed exercises. This Rh(D) group is supposedly uninterpretable…

Seriously?

1 October 2025 (Wednesday) - The Same (only different)

A colleague had a request for cryo yesterday which rather flummoxed him. He was asked for ten units of the stuff.

That’s a lot…

However when you read the factsheet it says:

 

“Cryoprecipitate is available as a single unit, or as a pooled product made up of five single units. Pooled units are more commonly used to treat adult patients”

 

It turns out that what I call one unit of the stuff is actually five. Where the medics wanted ten I would issue two and everyone would be happy.

One lives and learns.

Much the same happened when I was recently asked for prothrombin complex concentrate. I was asked for “one unit” and I inadvertently caused confusion by pointing out that the smallest amount I had was two hundred and fifty units. The poor doctor wanted “a therapeutic dose”.

 

There’s quite a bit of confusion caused by the use of the words “unit” and “therapeutic dose”. They mean different things to different people.

Maybe someone might standardize the terminology.

I wonder who that person might be…

(We’ll gloss over FFP which is prescribed per millilitre but comes in varying amounts of about 250-300 ml depending on the individual unit…)