With a few minutes spare I thought I might have a look at the BTLP-Tact simulator…
I was presented with one case – a sixty-year-old woman on the medical ward with a GI bleed needing four units of blood tomorrow.
She
grouped as B Rh(D) Positive with a positive antibody screen (positive in
cells 1&2). I requested antibody panels.
The
IAT panel was positive in cells 2,3,5, 7 & 9 which corresponded with anti-S
but didn’t exclude anti-E or anti-Lua
The
enzyme panel was negative in all cells. Was this supposed to say there was no
anti-E there? There’s plenty of anti-E that don’t work by enzyme…
The
Lua didn’t appear in the screening antigram – was it supposed to be negative in
that?
In
any event there was not enough blood in the stock fridge that was both S- and
Lua- negative.
I didn’t make the guess that the simulation had an error and that Lua could be excluded from the antigram, or that the enzyme panel ruled out anti-E because that would have killed in real life. So I selected no blood at all and exited knowing I’d get a red light, wondering what I was supposed to have done.
One
or both of the anti-E and anti-Lua antibodies weren’t there. I wonder which
one, and how I was supposed to have known that.
This
simulator isn’t all it might be…
