23 March 2018 (Friday) - DM 1801

I got the results of the NEQAS digital morphology DM1801 today.

"A man aged 45 new to the area attends the haematology clinic. Hb 118, WBC 4.6, Plts 202. A blood film is requested as part of his diagnostic work up."

Well, this information isn't really realistic, is it? People don't just roll up to the haematology clinic unannounced. Do they ?

 Initially this slide looks rather hypochromic and a tad microcytic with misshapen cells, red cell fragments seen and a nucleated red cell. There is some polychromasia and is that a couple of Howell-Jolly bodies or am I seeing poorly stained platelets? I think there are target cells there, but the slide is rather pale.

The neutrophils are right shifted too. the lymphocytes look a tad reactive, but don't they always?

 As for what it was.... was there some thalassaemic changes?

Turns out it was HbCC with iron deficiency. I didn’t see the HbC crystals. But then they aren’t something I see every day. I need to improve on that. But that’s what CPD is all about…

23 March 2018 (Friday) - Copper Deficiency

Here’s an interesting article. Short and sweet… a chap developed anaemia whilst hospitalised. The reason – copper deficiency. That’s rare… or is it?

22 march 2018 (Thursday) - HCPC Newsletter

The HCPC newsletter came into my inbox this morning. You can read it here. This newsletter touched a nerve… “In this month’s issue we focus on the importance of being open and honest when things go wrong in the care or treatment of service users and flag how discussing mistakes should form a key part of any health and care professional’s practice.”

Mistakes *do* happen. No one can pretend they do not. But after the immediate aftermath is dealt with, management has a choice.

On the one hand the error can be seen as an opportunity from which managers and practitioners can learn, and from which evidence can be garnered to improve the quality of the service provided.

On the other hand, the failures of the service which the incident highlighted can be ignored whilst the error is used as a weapon with which management can perform a character assassination on the one who slipped up.

It is a brave person who will speak up when they have slipped up and take the chance that the management will take the first choice and not the second. Perhaps this is a subject to which I am still too close?

Yes… seven years later and I am still *very* bitter…