28 December 2019 (Saturday) - BTLP-TACT Exercise

With a couple of minutes spare I thought I might do a BTLP-TACT exercise.

I had two cases:

81327 – a ninety year old male in the out-patients department requiring two units of blood within two hours

The ABO group was A; the Rh group indeterminate. The antibody screen was negative
I selected two units of A Neg

56046 – a thirty year old female in the theatre requiring four units of blood tomorrow

This patient was A Pos with no antibodies detected.
I selected four units of K-Neg A Pos blood

I got the red light… 
In the first instance the entire group was supposedly uninterpretable.
In the second instance “The issued component does not meet specific requirements for this patient.” – I wonder why not…

I tried again.

One patient – a fifty year old male requiring two units within two hours. The labelling of sample did not match that of the form. I rejected it. Green light !!

27 December 2019 (Friday) - Malaria Detection

There was an interesting post on the Facebook Haematology Interest Group today. Some references were given, and then there was a rather interesting discussion about how we all test for malaria. Opinion was divided.
Some use the new technology because it is far more sensitive than the old-fashioned microscopy. Some have even abandoned microscopy altogether.
Some stick to the microscope because the new technology doesn’t actually work (!?)





27 December 2019 (Friday) - Lymphocytosis

I’m sure we’ve all seen these cases… raised lymphocyte count for no adequately explored reason. What do you do?

This flow chart gives a useful way to proceed.

26 December 2019 (Thursday) - BTLP-TACT Excercise

I last did a BTLP-TACT exercise on 11 December – that’s less than three weeks ago. But I got a reminder today that I “may need to complete further TACT participations to improve your engagement target with the system”.
So I did one…

I was presented with one case – a ninety-five year old lady with GI Blood requiring four units of blood as soon as possible.

She grouped as AB Positive with a negative antibody screen.
There was only two AB Pos units available so I left them and issued the four oldest A Pos units that weren’t specified to be HbS negative.

I got the green light.

23 December 2019 (Monday) - ASH Update

The American Society of Hematology sent their update today. You can read it by clicking here.
I must admit it was rather dull. The A.S.H. update seems to treat finance and politics with as much importance as they do scientific, technical and medical matters.

21 december 2019 (Saturday) - Elliptocytosis

Look at this !!!  A ten-year-old child turned up at A&E this afternoon with a fever. The blood count was rather unremarkable, but my colleague made a blood film purely because the patient was a child. Rather unscientific perhaps, but I must admit that I tend to err on the side of caution.
But look at those red cells…

I’ve seen elliptocytosis before. The case which I remember most was an eighty-six year old chap with a chest infection. Just like today’s case the elliptocytosis was seen as a chance finding and is benign.

I couldn’t really find any decent complete references on the Internet; Google Scholar requires me to pay good money for access to the more academic articles, but (for all that it is frowned upon), the Wikipedia article does give a good summary.

20 December 2019 (Friday) - UKAS Newsletter

The UKAS sent their newsletter today. I read it… it was rather dull. Just lately it has been suggested that I might reconsider taking on a managerial role again. In all honesty it is publications like this which make me realise I would not be a good manager in today’s climate…

Is that wrong of me?

20 December 2019 (Friday) - Red Cell Folate

Today our department stopped performing red cell folate assays. This decision has been taken following on from review of the clinical utility of the RCF test in comparison with serum folate assay.

Now I was always of the opinion that serum folate just showed you how much folate was in your last meal whereas red cell folate gave you a reflection of folate intake over the last few months. It would seem that opinion has changed.

One lives and learns...