25 June 2014 (Wednesday) - Bombay Blood

As a lad I can remember getting a copy of the Guinness Book of Records one Christmas. It told me the rarest blood group in the world was "Bombay Blood". At the time only thee people in the world were known to have that blood type (according to that year's Guinness Book of Records).

I can remember on my first day working in a blood bank (in February 1982) in an impromptu tuorial being told that I would never ever in my working career either encounter an example of "Bombay Blood", or meet any other biomedical scientist (or medical laboratory scientific oficer as we were known then) who had.

Today whilst working alone on the late shift I had a patient with a positive antibody screen. The confirmatory panel was positive (4+) in all cells in both IAT and enzyme techniques. There was a historical report on file:

JANEWAY, KATHRYN 20/06/1987 CMCBC O+ 25.02.14 Anti-H present. This lady types as the very rare Oh (Bombay) phenotype. If blood is required for this patient, it will need to be sourced from the frozen blood bank. Contact NHSBT with as much notice as possible if a requirement for blood is anticipated. Rh/K Phenotype: C+ c+ E- e+ K- (20.01.14) NHSBT Extended Phenotyping: M+ N+ S- s+ P1+ Lu(a-b+) K- k+ Kp(a-b+) Le(a+b-) Fy(a+b+) Jk(a+b-) Cw- H-

"Bombay Blood" - as rare as rocking horse poo. But I've now seen it.

17 June 2014 (Tuesday) - Anti-M

 

Another strange result when performing a blood group. Supposedly A Pos; what's happening with the A cells?

... anti-M - an antibody which works at room temperature. There's far more to blood groups than just sticking the samples on an analyser...

9 June 2014 (Monday) - HPC Newsletter

The latest "HPC in Focus" magazine came out via email today. It seems there's to be a revision to the Standards of Practice for biomedical scientists like me.

The new stadards can be seen here.

I can't help but feel that whilst there is a serious need to document exactly what is expected from a healthcare professional; it's perhaps not such a sensible idea to try to have a "one size fits all" approach with the standards. A healthcare professional who has face to face contact with patients constantly (such as a chiropodist or a physiotherapist) will have different expectations and requirements to someone who does not (such as a pharmacist or me!!)

Take for example the new standard #5 "be aware of the impact of culture, equality and diversity on practice". Someone who has face to face contact with people must be far more aware of the diversity of their patients than I am because they actually see that they are a diverse bunch... to give but one example.

3 June 2014 (Tuesday) - Another Discrepent Blood Group

A discrepant blood group. Historically known to be blood group AB Pos, today we had dual populations in anti-A, anti-B and both anti-D. It transpired that the patient had received a blood transfusion of O Neg blood yesterday.

Name:     PENDING, Pat                  Group & Abs AB+ DoB: 01/02/1903 Sex: F                   Pat No:123456      Requested 11:20 02/06/2014 Specimen No : TK440311H    Blood Transfusion              <PgUp/PgDn> for more ------------------------------------------------------------------------------ 02/06/2014 11:20  Clotted Blood Diamed Group                   Clinically Approved By David Styles Confirmed Group                AB Rh(D) Positive Crossmatch                    Clinically Approved By David Styles G052 514 179 609 1       O-                 RBC IN OA LEUCODEP      05/06/2014 Issued         (U) G052 514 344 908 R       O-                 RBC IN OA LEUCODEP      05/06/2014 Issued         (U) Antibody Screen Clinically Approved By David Styles Antibody Screen Negative ------------------------------------------------------------------------------ 1 Spec  2 Patient  3 Date  4 pRint  5 cUm  6 DFT  7 Verbose  8 Options 9 eXit X                             Cursor Down for more

30 May 2014 (Friday) - Bone Marrow Transplants

I had a couple of rather odd blood groups this week. Having torn my hair out and cried, it transpired that both cases were both post bone marrow transplants.

The first was blood group O Pos which is in the throes of becoming B Pos

The second was A Neg which is going to end up as A Pos but has somehow lost the naturally occurring anti-B along the way.

 

Fortunately for my sanity the reference laboratory sends detailed instructions on how to consider the patient and on what blood products they should be given.

22 May 2014 (Thursday) - A Useful Resource

I found this link today. I was actually looking up articles on weak expression of the D antigen. My old ideas of D and D^u would seem to have long been superceded. In my researches I've found several mini-lectures. They might not be the most high-powered presentations, and they are a couple of years old, but they are ideal for someone returning to the field who is just a little bit rusty.

21 May 2014 (Wednesday) - A Day Off

OK - it's not original.... but I did have enough pride to correct the spelling mistakes in the version which is currently circulating on Facebook.

(I'm having a day off today...)