20 March 2026 (Friday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. It presented me with one case – a ninety-five year-old chap who was up for an autologous stem cell harvest (at that age?) who needed two units of blood.

 

He grouped as A Rh(D) Negative with a negative antibody screen. I selected two units of A Rh(D) Negative irradiated blood

 

I got the thumbs-up.

 

19 March 2026 (Thursday) - UKAS Update

The UK Accreditation Service sent their update today... I make a point of reading it because I don’t think many people actually do, and there is a load of misunderstanding and misinformation spread about the thing – in the past I knew of a manager who would get his own way by insisting that any way but his would go against MHRA requirements, safe in the knowledge that no one knew what MHRA required. Much the same is probably true of the UKAS…

But look at their update. How can I as a professional blood-tester be held to the same standards as someone operating a sexual assault referral centre? I really don’t know how, but I am. And that’s why I read the updates…

16 March 2026 (Monday) - I.T. Training

We’re getting a new computer system soon. Today I had some training on the thing. A bit of an introduction to show me the basics. The new one is rather different to what I’m used to; different enough to make my head spin.

Many years ago I did a post graduate certificate on distance based learning. Part of it focused on how people learn. I didn’t actually realise that I’m not very good at being taught anything new as I have the attention span of a gnat and my poor brain needs time to process new information.

I’m having another session on the computer tomorrow. Hopefully by then what I’ve learned will have percolated through my thick head…

15 March 2026 (Sunday) - I Disagree...

 Well… I wouldn’t have said that was hypersegmented. I would have said that was a botryoid neutrophil.
I think the take-home message here is not to judge on the strength of just one cell…

12 March 2026 (Thursday) - BTLP-TACT

Well I’ve made a few mistakes with the BTLP-TACT recently, so let’s try again…

It presented me with two cases:

 

22286 – a ninety-six year-old chap with bleeding varices needing four units of FFP. He grouped s A Rh(D) Positive with a negative antibody screen.

However FFP is NOT recommended for bleeding varices so I didn’t issue any.

 

 

26881 – a fifty-one year-old chap in ITU needing two units of blood. He also grouped as A Rh(D) Positive with a negative antibody screen.

I issued two units of A Rh(D) Positive blood

 

I got the thumbs-up. Bearing in mind I’ve had the thumbs-down for three of the last four I saw that as something of a result.

 

10 March 2026 (Tuesday) - The RDW

Here’s something I found randomly on my Facebook feed – a rather useful little dissertation on a much-overlooked blood count parameter; the RDW.

 

9 March 2026 (Monday) - NEQAS 2601DM

 

I got the results of 2601DM this morning. I did it a month ago when I was presented with an image of a blood film and this statement:

 

“A 60-year-old man had commenced treatment for a serious haematological disorder. His white cell count was raised, and platelet count reduced. He then became increasingly anaemic with changed blood film features. You are asked for your opinion. The film arrives outside of normal hours”

 

In my notes I wrote “Well, there’s a bit of everything in this film, isn’t there. The red cells show echinocytes, microspherocytes, blister cells, nucleated red cells, Howell Jolly bodies, rec cell fragments.

The white cells are a bit of a disaster – cerebriform/flower type lymphocytes, toxic granulation, vacuoles in monocytes and neutrophils, smear cells, target cells, pyknotic neutrophils, eosinophilia. 

The platelet appeared reduced, but we were told that anyway.

 

I didn’t fiddle about trying to get the observations in order… time was pressing.

As this arrived out of normal hours I would put it for the consultant to review in the morning… they don’t thank us for being bothered about this sort of thing… this sort of thing being a patient of which they are already well aware”.

 

The expert opinion was rather odd… it waxed on as it so often does but seemed to completely overlook the fact that this was in a patient with a known haematological condition.

But I spotted that which needed spotting and made the right decision