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

3 July 2015 (Friday) - Massive Transfusions

I subscribe to the Facebook group “Medical Laboratory Professionalshttps://www.facebook.com/groups/medical.laboratory.professionals/

Someone posted "Question for my blood bankers....What is your protocol for massive transfusions? Do you feel like it is abused by physicians? I feel like 80% of our blood alerts(that is what they are called) are false. For example 1 recent blood alert they took 3 rounds. Each round gets a cooler of 6 rbcs, a cooler of 4 ffp and 1 platelet. A cryo is given every other round. The pt was given 2 rbcs and everything else was returned. It can be so frustrating."

It was interesting reading the subsequent discussion. No two people seem to do the same thing…

30 June 2015 (Tuesday) - NHSBT Communication

The June communication to hospitals from NHS Blood and Transplant came out on http://hospital.blood.co.uk/ today.

Information about the addition of HbS to the Electronic Despatch Note (EDN), new Histocompatibility and Immunogenetics (H&I) test request forms

For Information about the National comparative audit of lower gastrointestinal bleeding and the use of blood, BCSH Guidelines for Pre-transfusion Compatibility Procedures (2012), Scenarios for Defining a Historical Sample, the sending of Identifiable Information by Email, a new Acute Transfusion Reactions Elearning Module…. Really useful stuff for someone like me who has a lot to learn.

29 June 2015 (Monday) - An Email

I had an email to tell me “The UKNEQAS General Haematology Digital Morphology Scheme CPD Session has been closed.
Please login to http://ukneqas.digitalslidebox.com where you can now log in and review the overall submissions of all participants, the diagnosis and expert comment, and annotation of the original slide

So I logged in and was told “This CPD Module is closed and you did not participate. You can still click through on the folder to see information about the CPD case

That was odd. I make a point of doing microscopy CPD. Did I not get an email telling me about it? Mind you the software’s not user-friendly. Perhaps I got bogged down in it? Perhaps it didn’t record what I said. In any case I don’t remember.

CPD doesn’t always work. Must do something so this does work next time.