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….