24 December 2015 (Thursday) - Clexane

Clexane injection contains the active ingredient enoxaparin, which is a low molecular weight heparin. It is used to stop blood clots forming within blood vessels

What is it used for?

  • Treating deep vein thrombosis.
  • Treating pulmonary embolism.
  • Preventing thromboembolic disorders, particularly following surgery or in people bedridden due to illness.
  • Treating blood clots in the coronary arteries in unstable angina and myocardial infarction.
  • Preventing blood from clotting when it is filtered through a haemodialysis machine.

This isn’t new… I've been familiar with the stuff for a while. But a friend’s partner has recently been prescribed it.

It stings…

22 December 2015 (Tuesday) - Taking a Bung

It is no secret that large parts of the NHS are going out to private tender and blood testing is not exempt from this.

In America where blood testing has always been privatized a scandal has been exposed in which agents of private laboratories are bribing medial practitioners to use their services over and above those of their competitors.
Furthermore they were bribing doctors to perform unnecessary blood tests.

At the moment there is little market for this in the UK pathology scene. But when we are all privatized will things be different?

22 December 2015 (Tuesday) - NHSBT Update

The December communication to hospitals from NHS Blood and Transplant came out today

It covered topics such as:

1.1  Group A FFP in trauma where the recipient's ABO group is not known
1.2  Stock Management of platelets over Christmas and New Year
1.3  NHSBT plans to produce HEV screened negative components

2.1 Update of H&I User Guide for 2015 – 2016
2.2 Therapeutic Apheresis Services Officially Open Oxford Unit
2.3 Supply Chain Modernisation (SCM) Project
2.4 NHSBT Mass Casualty Plans
2.5 New Patient Information Leaflets and updated Educational Resource

3.1 Training & Education Events and Courses

Sometimes this update is interesting, sometimes rather dull. This was one of the better ones…

20 December 2015 (Sunday) - Theranos

Theranos started off as a serious concern to the likes of me; they were offering a revolution to blood testing; cheap technology undercutting the current market.
Now they have fallen foul of regulating authorities; their technology isn’t all it was cracked out to be.

Those who rely on the results of blood tests have found that a reliable reproducible result is far better than a randomly generated number.

But we’ve known that all along….

16 December 2015 (Wednesday) - Blood Alcohol Levels

Here’s food for thought:

There is a scandal in the American courts. Blood samples taken on people accused of drink-driving offences would seem to be giving rather different results between the initial testing and subsequent testing two years later.

Clearly storage of samples is everything. But this isn’t news. Is it?

15 December 2015 (Tuesday) - Unsung Heroes

Here’s an interesting article I found in Facebook (of all places) over brekkie:

It is no great scientific article, but it told the tale of the importance of the hospital laboratory.

A patient (on oral anticoagulation) had massive bruising. This bruising was put down to poor venesection technique. However laboratory testing showed a ridiculously high INR and subsequently it transpired that the patient had been massively overdosed by a mistake in the pharmacy.

The lab identified the problem, saved the day, and possibly the patient’s life.
It is a shame that this sort of thing never makes the newspapers….

14 December 2015 (Monday) - Blagging Results

Here’s an interesting article from today’s news:

Although it is about nurses rather than biomedical scientists it gave me pause for thought. Basically (among other misdemeanours) two nurses didn’t perform routine near-patient glucose testing; preferring to make the results up themselves.

In the first instance I can’t help but feel that were these tests done in a laboratory setting there would be an audit trail including analyser information which would make getting away with such fabrication of results rather more difficult.

However given a manual system with no such electronic audit trail surely it is actually far easier to do the test than to try to make up plausible results. Such blagged results are going to be rather obvious if and when the patient’s clinical condition deteriorates.

9 December 2015 (Wednesday) - Typanosomes

In the most recent parasitology NEQAS survey was a thick film for examination. I didn’t see any parasites in it; nor did any of my colleagues.

It turned out we were all wrong; there were actually trypanosomes in that film. I reviewed the film with a colleague and knowing that there were trypanosomes present they were eventually identified.
However on reflection they weren’t obvious. I can’t help but feel that thick films are a rather artificial preparation. A Google search found recommendation of reviewing buffy coat preparations rather than thick films. If nothing else they are more familiar in appearance.

The next time we get a low parasitaemia I shall make and stain a buffy coat preparation and see…

4 December 2015 (Friday) - HCPC Newsletter

The December newsletter from the HCPC arrived this morning.

There was talk about the revised Standards of conduct, performance and ethics… but only talk. Not much in actual substance unfortunately.

HCPC HQ has new phone numbers

There was mention about a live webcast – HCPC update and disengagement in health and care. Unfortunately this is planned for Thursday 10 December 2015 at 12.30–1.45pm… not a convenient time.

There was talk about the HCPC’s involvement in fraud, corruption and theft in the NHS

There was a Fitness to Practice report for the year. After several clicks I got to it. I read a little… still a sensitive subject for me….

And there was a report on the first fifteen years of the HCPC – now that was interesting…

So often this publication is dull. This one wasn’t…

26 November 2015 (Thursday) - NHSBT Newsletter

The November communication to hospitals from NHS Blood and Transplant came out today

At first sight it seemed rather interesting:

  • For Action

    1.1  Stock Management of platelets over Christmas and New Year
    1.2  Customer Satisfaction
    1.3  Updated Patient Information Leaflets
    1.4  Points of note from the National Commissioning Group for Blood

  • For Information
    2.1 Update on Extended Blood Group Testing for patients with Sickle Cell and Thalassaemia Disorders

  • For Training
    3.1 Training & Education Events and Courses

It *was*….

20 November 2015 (Friday) - New Guidance

The NICE guidance on blood transfusion came out today:

This is the sort of thing that is so easy to overlook; but I really feel this is something that should be read; it is quite amazing how opinion had changed over the years. Consider the new guidance for red cell transfusion:

consider a threshold of 70 g/litre and a haemoglobin concentration target of 70–90 g/litre after transfusion”.

When I was a lad the limit was 100; not 70. Quite a difference. And that’s just one example…

19 November 2015 (Thursday) - Useful Website

Here’s an interesting article:

The last article I found on-line was rather depressing; this one’s going to be quite useful for my diploma in biomedical science.
I hope…

19 November 2015 (Thursday) - The Future?

Here’s an interesting article:

Whilst in many ways it doesn’t actually say anything new (and could be construed as little more than a whinge) it is interesting that we seem to be members of a profession which is in a world-wide decline. There seems to be fewer and fewer people coming into this line of work, and precious little being done to halt the decline.

In retrospect I can see where (I thought) the rot set in. I said so at the time and was shouted down in a public meeting by the then President of the IBMS.

Can I do anything about this decline now? I don’t think so. Should I? Definitely… But I’m tired… Realistically if this job can see me to retirement.

Am I wrong to feel this way?

13 November 2015 (Friday) - Malaria - Where?

Something I find I struggle with is remembering which strain of malaria is endemic to which parts of the world. Here’s a website which may well help me out in future:


12 November 2015 (Thursday) - Pre Reg Portfolio Reviews

I had an email from the IBMS today. It had feedback following the IBMS Education and Professional Standards Committee meeting.

Interestingly the key point for me was about pre-registration portfolio reviewing:

blah blah blah…. The above statistics indicate a concern we have that increasing numbers are unable to fulfil the requirements of the verifier and/or examiner role. Over the recent summer in particular we have struggled to allocated verifiers.

I’m just a little bit peeved by this. I’ve not done a verification for years. Because the IBMS tell me I can’t *until* I’ve undertaken the training that they simply aren’t providing

6 November 2015 (Friday) - Malaria

There used to be a really good on-line malaria atlas based out of an Australian university. I can’t find it, but I did find this link, and following on from it are links to other malaria-related websites.

Mind you they aren’t perfect. Perhaps I might design my own…

5 November 2015 (Thursday) - Major Bleed

Oh we had fun at work today. I came in for the late shift and checked off the morning’s blood groups. One was a pre-operative case; blood group O Rh(D) Pos with anti-Fy(a) antibodies.

I thought nothing more of it for an hour or so until the phone rang. This patient was actively bleeding. The surgeons wanted six units immediately. They weren’t impressed when I explained that with this particular antibody “immediately” wasn’t an option. With (about) one unit in three being Fy(a) negative I told them we’d hopefully have something within the hour.
(If you tell them you’ll do it right away when you can’t, they think you are rubbish; when you say an hour and do it much quicker they think you are marvellous)

I had this plan to select six units and crossmatch and Fy(a)-type at the same time. Hopefully I’d get some units to tide them over. Bearing in mind the patient’s phenotype was C+ c- E- e+ K- I thought I’d select units of this phenotype and Fy(a)-type those. It was a good idea; it was a shame we had no such units. In the end I just typed those O Rh(D) Pos units which were labelled as K-Neg.

Bearing in mind the urgency a colleague did likewise, and when I had completed my first six units I did the same on another six units. Between us we tested eighteen units and got eight Fy(a)-Neg units in an hour. In t he meantime other staff phoned to put off other transfusion commitments and to postpone a visit by senior hospital management.

It was as well this happened during a routine working day; I would have struggled were I doing this as a lone worker.

But this made me think. Was I right to have (possibly) wasted time trying to find Rh-matched units? Have I made problems for the future if and when the patient might develop anti-E antibodies? Should we have crossmatched blood immediately on identifying an antibody?

This is one of those cases for which it is very difficult to make a specific plan in advance… I think we did right.

4 November 2015 (Wednesday) - WASPS Website

I’ve been taking part in the WASP scheme for some time now. For some reason it’s never occurred to me before that they might have a website. They do.
It has a rather good list of links to other websites of transfusion interest. That might come in useful…

3 November 2015 (Tuesday) - NBS Communication

The October (?!) communication to hospitals from NHS Blood and Transplant came out today http://hospital.blood.co.uk/

It covered some interesting points

  • NHSBT Launch its First Therapeutic Apheresis Service in London
  • New Phlebotomist and Porter learning pathways on learnbloodtransfusion
  • New OBOS version release
  • Improvements to NHSBT Recall Process – Stage One
  • Advanced 1 day course on ABO Blood Group Systems
  • Training & Education Events and Courses

Personally I was quite interested in the Advanced 1 day course on ABO Blood Group Systems. I wonder how much it would cost…

2 November 2015 (Monday) - Who's Doing What?

Here’s something else which made me think.

The article is basically focussing on the American laboratory system, but its arguments remain valid nonetheless. Especially as UK labs face privatisation and de-skilling.

Just who (exactly) is doing the blood test, and what controls are in place to monitor what they are doing?

30 October 2015 (Friday) - An Article

Here’s something which made me think.

At first sight it comes over as quackery, but it does make you think about reference ranges and whether or not tests are necessary, whether those interpreting the results are aware of the reference ranges, and whether having set profiles is a good idea.

29 October 2015 (Thursday) - IBMS e-newsletter

The monthly IBMS e-newsletter came out today. It focussed on the recent IBMS congress. I suppose that’s not surprising really. Mind you there were also other items of note including

  • IBMS winter events: from TB to venereal disease
  • Klebsiella from the dark side; agar art & leukaemia cells (from the Facebook page)
  • Listen online: cancer therapy and lab training
  • Researchers needed to evaluate pathology services across the UK

I was actually quite intrigued by the evaluating pathology services bit; but on reading the article it seems the closing date for applications is tomorrow. That’s a pain….

19 October 2015 (Monday) - http://www.haemspecialistportfolio.co.uk/

By popular demand I’ve resurrected http://www.haemspecialistportfolio.co.uk/ (it really is by popular demand – you’d be surprised how many people have asked for it).

Mind you at the moment it is a straight re-publish of what I had from four years ago. I need to seriously review it. I shall do so over the next few weeks and months….

16 October 2015 (Friday) - New BCSH Guidelines

An email came today telling me of new guidelines that have recently been published:

  • Use of JAK inhibitors in the management of myelofibrosis - revised
  • Modification of BCSH diagnostic criteria for essential thrombocythaemia
  • Interim statement BCSH CLL guideline
  • Diagnosis and management of Aplastic Anaemia
  • Guidelines on the identification and management of pre-operative anaemia
  • Investigation and management of Nodular Lymphocyte predominant Hodgkin's Lymphoma
Some are of direct relevance to me; others not so. But one of the more informative emails I’ve received recently

15 October 2015 (Thursday) - BBTS Newsletter

An email from the BBTS “Bloodspots”. As newsletters go it didn’t really have much to say for itself. In many ways I saw it as a sales pitch.
For all that I’d like to improve my knowledge; and there are some glaring gaps in my blood transfusion knowledge, these courses they are pushing aren’t cheap:

  • The Uncertainty of it All”  £90

  • “Spotlight on Platelets” £90 / non-members £95

  • Red Cell Special Interest Group”  £45.00

  • Specialist Certificate in Transfusion Science Practice £891

Time was work would pay the course fees. Perhaps I’m just an old leftie?

13 October 2015 (Tuesday) - BT NEQAS Report

There was a rather interesting discussion on the report of the latest blood transfusion NEQAS report:

Where antibody identification cannot be concluded using the patient phenotype and results of testing all available panel cells by IAT and enzyme, additional techniques can be used to make progress. E.g. the presence of anti-M can be excluded or confirmed using an antibody panel by direct agglutination at room temperature.

Although anti-K would normally be expected to react in a 2-stage enzyme technique, it is advisable to exclude its presence by IAT, since the sensitivity of the 2-stage enzyme technique can be variable.

Positive identification requires at least two positive reactions with red cells that express the corresponding antigen (and are antigen negative for other specificities potentially present), as a single positive reaction could be a false positive or
be due to an antibody to a low frequency antigen
When interpreting antibody identification results, all available information should be reviewed, including results of all techniques and of the screening panel1, to ensure that all possible exclusions are made and that there are no reactions unaccounted for by the antibodies identified.”

I need to think outside the box a little more in cases like this…

7 October 2015 (Wednesday) - Lunchtime Lecture

At rather short notice I was invited to go to a talk over lunchtime. A presentation on the new coagulation analyser which we should be getting some time in the next few months.

In retrospect I rather resent having given up my lunch break. To be fair to the rep perhaps she wasn’t aware of the exact demographic of her audience. She spent an hour trying to sell me the machine. I wasn’t buying it; the sale has already been made. I wanted to know all about the machine itself; not the corporate drivel about the company.

Oh well… CPD isn’t always successful

3 October 2015 (Saturday) - A Reflection

I subscribe to the “New Medical Laboratory Scientist” Facebook group. Sometimes there are articles of note on there, sometimes it is just one big squabble.
I was amazed to see this post today from someone in the USA. 

I honestly don’t think the A&E people would know who I was if they saw me. That’s not being rude to them; just stating a fact. We are physically a long way apart and never come into contact.

Amazing how this job varies round the world.

2 October 2015 (Friday) - HCPC "In Focus" Magazine

The HCPC “In Focus” e-magazine arrive by email today. I don’t want to sound cynical, but it started with the new chair writing a lot of words to not actually say very much.

There was then a reminder about renewals; biomedical scientists are up for renewal. I have renewed. There was also guidance for the unlucky 2.5% that are picked to have their CPD efforts reviewed. For all that I actually do CPD and make the effort to be seen to be doing so (hence this blog) I’m glad I wasn’t picked.

The article on health and disability being a barrier to becoming a health care professional was interesting, but whenever I read that sort of thing I can’t help but wonder if anyone has an axe to grind; I’ve met so many banging these drums before; each one with an “agenda”.

There were a couple of articles about consultation for revisions to documents. I find these dry documents rather dull; consultations about them even more so… (sorry)

And the magazine ended with a list of upcoming events for employers, planned CPD presentations, and a list of council meetings.

I must admit I was glad to see they seem to have dropped the list of upcoming disciplinary hearings….

1 October 2015 (Thursday) - UKAS Standards

The Boss circulated the standards under which the lab will be inspected over the next few weeks.

Now I know it’s not my place to have an opinion, but what is a reflective journal for if not to reflect…. Over the last twenty years labs have done their level best, then once every five years they have an epic herculean effort to achieve accreditation standard. Everyone knows this is not maintainable in the long run, and in five years time they knacker themselves again for when the inspector calls.

Surely it would make sense to have standards which reflect on how the actual job is done, not on in which colour ink a trivial piece of paper is printed, and having set achievable standards then have unannounced inspections?

30 September 2015 (Wednesday) - NBS Communique

September’s communication to hospitals from NHS Blood and Transplant came out today.

The first two items: addition of HbS to the Electronic Despatch Note  and changes to Adverse Incident Reporting were rather dull

The “For Information” seemed more relevant to me, covering the roll-out of pooled platelets in additive and plasma, the Electronic Requesting & Reporting for Blood Transfusion, Revised BCSH Guidelines on Group A Plasma and LIMS functionality and the British Committee for Standards in Haematology Guidelines on the Identification and Management of Pre-Operative Anaemia.
Mind you the NBTC/NHSBT National Patient Blood Management Survey - October 2015 and the RCI Quarterly Update were rather dry

I had high hopes for the bit about Training & Education Events and Courses, but (usually) the courses are rather impractical. This time none were listed Which is a shame

22 September 2015 (Tuesday) - Another One

Following on from yesterday here’s another on-line resource

21 September 2015 (Monday) - A New Journal

A colleague told me about bloodjournal – there’s a lot of interesting stuff there. I shall have a look-see when time allows. If nothing else it will be something to do if the early hours of the night shifts are dull.
An example of the sort of thing is here:


20 September 2015 (Sunday) - Mott Cells

This picture was posted on the New Medical Laboratory Scientist Facebook page

It’s a Mott cell; a plasma cell with plentiful vacuoles. Don’t see them very often…

10 September 2015 (Thursday) - A Word of Thanks

An email received after a little episode in the blood bank:

Dear Dave  

Yesterday I received a compliment from Dr –X- with regard to the support that they had received in theatre from the laboratory team. The patient underwent an open AAA 4 units. He was impressed with the speed of response to the bleep and the provision of components.  He felt that the prompt provision of components made a significant difference to the patient’s outcome. The patient has come through the surgery and is starting his recovery on ITU. Well done to all involved.

Kind regards

This is what it is all about, isn’t it? 

8 September 2015 (Tuesday) - IBMS Newsletter

The IBMS e-newsletter came today… in the past I’ve been rather scathing about the IBMS e-newsletters. This one (I’m afraid) did nothing to change my opinion of the publication. With articles on HCPC renewals, IBMS congress, IBMS degrees and IBMS training courses, IBMS courses for support staff… there wasn’t actually anything of note for me personally.  

3 September 2015 (Wednesday) - Food for Thought


Here’s food for thought….. so often I sit in the lab seething about what I see as the failings of the ward staff, the porters, the drivers, and everyone else. It is very easy to get blinkered and forget we’re all on the same side; just with different priorities

28 August 2015 (Friday) - IBMS Newsletter


The IBMS on-line newsletter came out today. In the past I’ve been less than enthusiastic about the thing.

This one started off well with an interesting article about on-line morphology training. However it did gloss over the cost. When I looked into this four years ago it wasn’t cheap.
There were then reminders about HCPC registration and IBMS Congress which really didn’t grip my attention.
It ended with a summary of the most popular posts on the IBMS’s Facebook page. I follow the IBMS on Facebook…. I suppose there were one or two snippets over the last month. None really come to mind. If they had I would have posted them here already.

27 August 2015 (Thursday) - Digital Morphology

The NEQAS digital morphology scheme answers became available today….

My answers

Morphological Feature
Participants who selected this feature
Blast cells
Nucleated RBCs
Howell Jolly Bodies
Target cells
Smear/smudge cells

Everyone else said:

Morphological Feature
Participants who selected this feature
Nucleated RBCs
Target cells
Howell Jolly Bodies
RBC Fragments/Schistocyte..
Polychromatic RBC

Could do better…. I’m intrigued by the software that said I didn’t actually participate yet it gave me what it said I reported. Having reviewed the film I’m more in agreement with the consensus than with what I supposedly said. I say “supposedly”…. I can’t remember what I put in the first place as it was so long ago, and as the software’s clearly made an error in say ing I didn’t take part and yet it assigned answers to me, I wonder if it recorded what I said correctly

19 August 2015 (Wednesday) - Tan Tops

Chatting with the boss it seems that certain parts of the world use “tan-top” bottles as a safety measure in blood transfusion.
It is standard practice not to issue blood until (at least) two blood groups have been performed on a patient at different times to get round the seemingly eternal problem of the possibility of the wrong patient having been bled.

Apparently in the “tan-top” scheme blood will not be issued until a blood group has been performed on a tan-topped sample bottle; such bottles are *only* available from the blood transfusion department, and are only issued immediately prior to transfusion.

Is it a good idea? In theory yes. In practice… it is *if* there is time to fart around like this. It strikes me that this idea would be rather impractical in any urgent case.
I can’t help but think that it speaks volumes that I an’t find any reference to the scheme on-line…

13 August 2015 (Thursday) - S.H.O.T. Guidelines

Here’s an interesting article; unlike so many other websites this spells out in words of one syllable exactly what is and what is not reportable to the nice people at S.H.O.T. (Serious Hazards of Transfusion).

Another useful page is here; this one explains the big words used by S.H.O.T. On reading it I get the impression that S.H.O.T. actually *is* a sensible idea and not just the unnecessary regulation I initially thought it was.

I will need to find out more about this….

12 August 2015 (Wednesday) - BBTS Event

The BBTS Red Cell Special Interest team are holding a one-day scientific conference. It actually looks to be quite interesting with talks on erythropoesis, malaria, and red cell dynamics. Just recently I’ve whinged here about how irrelevant I find the mailings from the IBMS and the HCPC. Here’s something which looks interesting….


If this had been done as a newsletter or e-bulletin it would be fine. However it’s a one-day seminar. Forty-five quid’s not cheap, and it’s in Bristol.
Perhaps they will publish edited highlights of the day on-line eventually. I hope so.

11 August 2015 (Tuesday) - The Dombrock Blood Group System

I came across this article today: http://www.britannica.com/science/Dombrock-blood-group-system  - not too in-depth, but it never hurts to be aware of the more obscure blood group systems.

8 August 2015 (Saturday) - Granulocyte Transfusions

I've absolutely no experience of granulocyte transfusions. 
http://labmedicineblog.com/2015/07/28/five-things-to-know-granulocyte-transfusions/  was an easy to read introduction to the topic

7 August 2015 (Friday) - HCPC Newsletter

The HCPC newsletter came today. There is a new chair of council, some professions were told  their registrations are up for renewal, blah-de-blah.... it was rather dull.

Mind you they did have news about a survey that has been done about their newsletters http://www.hcpc-uk.org/assets/documents/10004C9EReportonthefindingsoftheHCPCInFocusfeedbacksurvey2015.doc

It speaks volumes that for all that there are tens of thousands of people registered with the HCPC, there was only about a hundred people filled in the survey.

6 August 2015 (Thursday) - WASPS

Every few months I get to take part in the WASPS scheme in which I perform some serological screening and compare my scores with everyone else across the country.

My results are in agreement with the majority view. I'm pleased about that...

5 August 2015 (Wednesday) - Daratumumab

On the one hand daratumumab is seen to be rather promising in the treatment of myeloma. On the other hand it (apparently) interferes in performing blood groups on automated systems as it causes panagglutination.

Apparently we are going to be involved in an international study.... I wonder how this will pan out

3 August 2015 (Monday) - IBMS Newsletter

"This month has seen two fascinating insights from IBMS members into the work of our profession. Allan Wilson discusses misconceptions about public screening while Becky Haywood is raising money for Ebola orphans after working in Sierra Leone. Amongst biomedical scientists there are thinkers, doers, communicators, teachers and pioneers. It’s why we ask you to help find the UK’s leading practising scientists in 2015.
Congress 2015 is shaping-up to be a huge success with 1,600 scientists already attending the 3 day event. In July we announced a career expo for students and a programme of talks exploring emerging technologies that will transform pathology.  This is in addition to our quality conference and programmes of scientific events. It is a Congress for everyone involved in biomedical science"
I'm sorry... I still find it all rather irrelevant to my daily round. Perhaps I should contribute something to it myself rather than just grumbling?

1 August 2015 (Saturday) - Inflammatory Markers

ESR or CRP? It's an argument which has been going on for some time. there's a place for each.


25 July 2015 (Saturday) - On the Night Shift

It is 3.34 am and I’m on the night shift. I've just had a request to perform blood count and a chemistry profile on an eighty-six year old lady who is “drowsy”.

It is 3.34 am…. So am I !!!

24 July 2015 (Friday) - Money I Haven't Got

I had an email from the BBTS today.

This month's Bloodspots brings you an events special. With three exclusive scientific meetings taking place through October and November, we are sure that every one of our members will find something of interest.  We also invite abstract submissions for two meetings, details of which can be found below.

Red Cell Special Interest Group
30th October 2015 | £45.00
NHSBT Filton will pay host to this year's Red Cell SIG.  Topics covered include Erythropoiesis - regulation and cell lines, Malaria - adhesion and invasion, Red Cells - properties in stress and disease.  

The Uncertainty of it All
10th November | BBTS members £90 / non-members £95
UK NEQAS (BTLP) & BBTS Blood Bank Technology Special Interest Group.  Topics include 'Motivating Staff' and 'Anti-D, Anti-G and All That'.

Spotlight on Platelets
11th November | BBTS members £90 / non-members £95
Throwing light on a variety of specific questions about the use of platelet transfusion in medical & surgical practice, particularly in areas of controversy or little evidence.

They all look very interesting but these meetings aren’t cheap, and they aren’t especially local either. By the time I’d got there I’d be rather out of pocket.

I wonder if they couldn’t do this sort of thing as a podcast?

16 July 2015 (Thursday) - Ehrlichiosis

Something else from the Facebook group “Medical Laboratory Professionalshttps://www.facebook.com/groups/medical.laboratory.professionals/

Someone posted the above photo. It was a new one on me – Ehrlichiosis - Ehrlichiosis is a tickborne bacterial infection caused by bacteria of the family Anaplasmataceae, genera Ehrlichia and Anaplasma. These obligate intracellular bacteria infect and kill white blood cells.

The average reported annual incidence is 0.7 cases per million people. Apparently. I wonder if that is in the USA… I’ve never heard of it. I shall keep an eye out for it…

14 July 2015 (Tuesday) - Malaria Course

I went to London today for a practical course on the identification of malaria… I won’t say “what a waste of time” but it could have been better.
The session started with a lecture about various blood-borne parasites. Personally I would have benefitted from the slides having had a few less words and a lot more pictures.

And as for the practical session… The girl sitting next to me in the practical session was grumbling that what she was seeing down the microscope was shaking. She was genuinely surprised when I pointed out that everyone's microscopes were shaking because she was rhythmically bashing the bench in tune to the strange music in her head.
Another woman was employing a novel way to identify blood-bourne parasites. Rather than attempting to recognise salient features and elucidate a clinical history, she was making moral judgements. Apparently it stood to reason that God wouldn't allow humanitarian aid workers to contract malaria (!) and she got quite irate with the lecturer who dared to say it happened on a regular basis.

I must admit I did get a lot out of having the opportunity to spend uninterrupted time at a microscope with various slides of parasite films. But I could have got a lot more had I actually been able to get any time with the experts

8 July 2015 (Wednesday) - CPD Presentation

I gave a little presentation to my colleagues today about a case study from a few years ago in which a patient was mistaken for someone else. Nothing really new or scientific, but a refresher and reminder is always good.

Mind you research http://www.ncbi.nlm.nih.gov/pubmed/12823729 shows that about one sample I test in every two thousand is from the wrong patient.

That’s two or three every week….

6 July 2015 (Monday) - Massive Transfusions revisited

On Friday I was pondering on massive transfusions. Today the BCSH published guidelines on the matter