18 May 2026 (Monday) - BTLP-TACT Exercise

I had planned to mow the lawn, but it’s raining… so here we go. I was given one case – an eighty-two year-old chap with PR blood needing group and save.

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

I got it right.

15 May 2026 (Friday) - Religion (!)

Here’s an interesting post from the nice people at Blood Bytes Beyond. How do you proceed if someone has a religious objection to having a blood transfusion.

I find I have to stop myself and take a deep breath when it comes to deeply held religious views as I used to have them. Back in the day I was a Steward in the Methodist Church. I was one of a committee of four that hired and fired the vicar. And one day I suddenly realized that I didn’t believe a word of the nonsense that I was professing; I just desperately hoped that it was true as the alternative of a godless universe was rather scary.

 

Part of my religious life was a bible study class every Thursday evening in which we would read what appeared to be stark nonsense and try to rationalize it. It clearly says in the Bible that we should abstain from blood (Genesis 9:4; Leviticus 17:10; Deuteronomy 12:23; Acts 15:28, 29) but that means abstain from eating animal blood… which is possibly not a bad thing to do as uncooked animal blood can give you tapeworms. But I doubt very much if anyone writing the Bible all those years ago had blood transfusions in mind.

I’ve had this argument with Jehovah’s Witnesses who’ve come banging on my door. In my experience there are two types of Jehovah’s Witnesses…  

Those who feel that blood transfusions are utterly evil and sinful.

Those whose lives have been saved by them who take great pains to explain that scripture is open to interpretation.

 

And that’s where I fall out with religion. It is all so open to interpretation. Until such time as God leans over a cloud and bellows out instructions it is all guesswork, isn’t it? And the less evidence someone has for a religious standpoint, the more convinced they are that they are right.

 

15 May 2026 (Friday) - Horiba Update

The nice people at Horiba sent their update today. They sent a rather interesting case study… however the case study was rather biased towards people using their blood counters. Which isn’t entirely unreasonable of them, is it?

Keeping abreast of other technologies is never a bad thing though, is it? When I first started in this line of work no one in the UK did a blood count on anything other than a device made by the Coulter corporation. Then the H1 was released. I can remember the rep telling me that he’d been given a target of selling five across the South-East in one year and in a few months he’d shifted seventeen. And then the Sysmex XE came along…

Perhaps Horiba’s day will come. I just wonder if I will see it?

11 May 2026 (Monday) - BTLP-TACT Exercise

 

I’ve got backache and it’s raining. I might as well do a BTLP-TACT exercise, mightn’t I?

It gave me two cases:

 

44156 – a forty-two year-old woman with liver disease and bleeding needing four units of FFP.

The control well failed so the group was uninterpretable.

The antibody screen was negative.

I issued two units of AB FFP as there was only two units there.

 

34387 – an eighty-four year-old chap in A&E also with liver disease just requiring group and save.

He grouped as O Rh(D) Negative with antibody screen positive in wells 1 & 3 so I performed antibody panels.

The enzyme panel was negative throughout.

The IAT panel was positive in cells 1, 3, 4, 6, 8 and 10 corresponding with anti- s but not excluding anti-Kp(a)

 I got the green light.

11 May 2026 (Monday) - Iffy Valves

 

Looks like an iffy heart valve to me. The correct answer was:

 

“The correct answer is option 3. Revision of prosthetic valve. 

Mechanical hemolysis may results from malfunctioning prosthetic valves. Hemolysis is intravascular and may give rise to iron deficiency due to hemoglobinuria. Treatment is by correcting the valve malfunction”. 

 

Go me!!!

8 May 2026 (Friday) - BTLP-TACT Exercise

It can be no surprise to anyone that I’ve had yet another email from the nice people at BTLP-TACT whinging that I’m not doing enough exercises. So here we go again…

 

I was presented with two cases:

 

93449 – a sixty-nine year-old chap with sickle cell disease needing two units of blood

He grouped as O Rh(D) Positive with a negative antibody screen.

I selected two units of O Rh(D) Positive.

62030 – a sixty-eight year-old chap needing group and save for a fem-pop bypass.

He grouped as A Rh(D) Positive also with a negative antibody screen.

 

I got it right… I must admit I was amazed. The connection to the server dropped out several times…

7 May 2026 (Thursday) - Horiba Update

The nice people at Horiba sent their update today. I’ll say one thing for their update – its format seems to change from month to month.

This month featured Sezary syndrome, G6PD, and a quiz which was MAHA.

This is the sort of thing I want for CPD…