20 September 2021 (Monday) - Getting It Wrong (?)

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…


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