30 August 2023 (Wednesday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise… I was presented with one case – a ninety-year-old woman with sepsis requiring group & save.
She grouped as A Rh)D) Positive with a negative antibody screen.
I got the green light…

25 August 2023 (Friday) - Googling Stuff...


Here’s something to bear in mind… as I peered down my microscope I saw a few eosinophils. The patient’s diagnosis “on methotrexate”.
I’ve seen that a few times recently so I typed “methotrexate eosinophilia” into Google… and took a screen shot of what I got.
On the one hand it is extremely rare with only three reported cases.
On the other hand it is not an uncommon finding.
So… beware of the Internet…

24 August 2023 (Thursday) - Transfusion Evicence Alert Update


The nice people at the Transfusion Evidence Alert sent their update today. Again loads to take in, but (in all honesty) just lately I’ve been struggling to get CPD stuff… there’s loads here with which I can overload my poor brain…


Recombinant von Willebrand factor and tranexamic acid for heavy menstrual bleeding in patients with mild and moderate von Willebrand disease in the USA (VWDMin): a phase 3, open-label, randomised, crossover trial.Ragni, M. V., et al. (2023). The Lancet. Haematology.PICO Summary available



What influences decisions to donate plasma? A rapid review of the literature.Berger, M., et al. (2023). Vox Sanguinis. [Record in progress].Effect of early erythropoietin on retinopathy of prematurity: a stratified meta-analysis.Fischer, H. S., et al. (2023). Neonatology. [Record in progress].Plasmapheresis to remove amyloid fibrin(ogen) particles for treating the post-COVID-19 condition.Fox, T., et al. (2023). The Cochrane Database of Systematic Reviews.The restrictive red blood cell transfusion strategy for critically injured patients (RESTRIC) trial: a cluster-randomized, crossover, non-inferiority multicenter trial of restrictive transfusion in trauma.Hayakawa, M., et al. (2023). Journal of Intensive Care.Cost effectiveness of different platelet preparation, storage, selection and dosing methods in platelet transfusion: a systematic review.Laermans, J., et al. (2023). PharmacoEconomics - Open. [Record in progress].Definitions of massive transfusion in adults with critical bleeding: a systematic review.Lin, V. S., et al. (2023). Critical Care.Comparison of quantitative and calculated postpartum blood loss after vaginal delivery.Madar, H., et al. (2023). American Journal of Obstetrics & Gynecology MFM. [Record in progress].Do anemia treatments improve quality of life and physical function in patients with myelodysplastic syndromes (MDS)? A systematic review.Mo, A., et al. (2023). Blood Reviews.

Maternal anaemia and the risk of postpartum haemorrhage: a cohort analysis of data from the WOMAN-2 trial.WOMAN-2 trial collaborators (2023). The Lancet. Global Health.

21 August 2023 (Monday) - Case Study


A couple of days ago I ranted about how disappointed I was at the newsletter of my professional body. Today the nice people at Lablogatory sent me something really useful – a case study on P. vivax.
You can read it by clicking here.
This is the sort of thing I want (and need) for CPD purposes.

19 August 20 23 (Saturday) - IBMS Newsletter


The IBMS Newsletter for council and fellows arrived in my in-box today. You can read it by clicking here.
At the risk of sounding reactionary, I wouldn’t bother…
Lessons learned from the pandemic” was something really interesting… for senior managers.
“New novel device for diagnosing Tuberculosis” was also very interesting… for those  who diagnose tuberculosis.
DNA Test could Broaden Access to Cervical Cancer Screening” also had no application to my daily round.
The Pathologist's Power List 2023” was particularly divisive. By highlighting the efforts of some it belittled the efforts of others.
It was at this point that I gave up.

17 August 2023 (Thursday) - Getting it Wrong (Again)


Following yet another email about low engagement I thought I’d better do a BTLP TACt exercise. I had two cases
63469 – A thirty-five year-old woman in maternity requiring group & save. She grouped as B Rh(D) Positive with an antibody screen positive in cells 1 & 3.
I performed an antibody panel. The enzyme panel was negative in all cells. The IAT panel was positive in cells 1, 3, 6, 9 and 10 which corresponded with anti-Fy(a) but didn’t rule out anti-Lu(a)
51926 – a fifty-three year-old chap on the cardiac unit also requiring group & save/ He grouped as O with an uninterpretable D group and a negative antibody screen.
I got the thumbs down – the positive control in the group made the entire group uninterpretable. I made this mistake in July, didn’t I?

15 August 2023 (Tuesday) - HCPC Hearings

My professional regulator (the health and care professions council) is very keen to ensure that it keeps its own house in order, and has a website which is open to all which documents those people who are being (or have been) called before their tribunal for investigation into their alleged professional misconduct.
Some people come before the tribunal accused of falsifying blood test results.
Some people come before the tribunal having made a genuine mistake.
I can understand that these cases need investigation by the professional regulator. However more and more people are being investigated for their character rather than their professionalism.
Looking at the archive one case involved someone having a friend phone in sick for them when they are actually in prison. Should they be struck off? Possibly…
Someone else got struck off for dodging paying parking fees. Should they be struck off? Arguably.
Another was struck off because of his political views. Should he have been struck off? Absolutely not.
And now there’s one up before the tribunal for looking at pictures of nudey ladies.
I’m going to go out on a limb here… there must be more to this last case than just looking at pictures of nudey ladies. Surely this could have been dealt with by a quiet word?

9 August 2023 (Wednesday) - Stago Newsletter


The monthly update from Diagnostica Stago appeared in my in-box today. You can see it by clicking here.
Sadly it focused on trying to sell me stuff… On the one hand I really need to be aware of what analysers are on the market; on the other hand… do I really? I need to know the limitations of the analysers I use and what to do with the numbers the generate.
Interestingly there was an article on the medical laboratory scientists Facebook group today asking for advice on best coagulometers. Twenty years ago Stago was everyone’s choice… from what I saw today, not any more.

9 August 2023 (Wednesday) - Fritsma Factor Newsletter


The Fritsma Factor newsletter appeared in my in box today. You can read it by clicking here. It’s a very useful source of CPD focusing on haemostasis, and I’ve now discovered their educational module.

Very useful…

9 August 2023 (Wednesday) - IBMS Newsletter


The IBMS newsletter appeared in my in-box today. You can read it by clicking here.
As usual there was very little of note for CPD purposes, but the first bit made me think.
Become a biomedical scientist”… seriously? Part of the article said: "While it is every individual’s own responsibility to inform themselves and make their own decisions when embarking on their career, as a professional body we have a greater responsibility to enable our future members to make the right choices at the right moments in their lives".
With that in mind I really can't get involved with this initiative.
Have a look at this table which compares the average pay rates for different careers (the data comes from official UK big data sources). What I do isn't listed (no surprise there) but the average pay for someone in my job is not much different to that listed for rail travel operatives, road construction operatives and office managers. But the average pay rate of what I do is after several years in post following a minimum of four years at university and includes (frankly rather poor) enhancements for working outside of "routine" hours.
I don't want to appear negative, but anyone considering the "right choices at the right moments in their lives" must consider money and work-life balance.
On the one hand people can choose to go to university for years and run up massive debts to then take on a job which involves being contracted to work at any time of night or day on any day of the year.
On the other hand people can choose not go to university and have a job which gives them evenings and weekends either free, or paid at sensible overtime rates.
There are those who might claim "there is more to life than money". But in my experience they are either rather naïve and impressionable youngsters with no experience of life, or those with far too much money.
Knowing what I know now, I would never work anywhere that doesn't periodically put up a "closed" sign.
But as part of my CPD I have to do stuff which will improve the lot of the service users (i.e. the general public) and saying “don’t touch this job with a barge pole” doesn’t do that, does it? What can we (I) do to improve the lot of the average biomedical scientist, make it a more attractive career, and actually have a pathology service for future generations.
The answer is obvious… make the job competitive. More money; less hours. How do we achieve this… I don’t know.

8 August 2023 (Tuesday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise…
32773 – a thirty-nine-year-old woman booking at the ante-natal clinic requiring group and antibody screening
Her blood group reacted in every single well and so was uninterpretable but her antibody screen was negative.
89530 – a twenty-eight-year-old woman with sepsis requiring group & save
Her blood group was A Rh(D) Positive with a negative antibody screen.
I got the green light.

6 August 2023 (Sunday) - Heparin Induced Thrombocytopenia

The nice people at Research and Practice in Thrombosis and Haemostasis sent a rather good article on heparin induced thrombocytopenia today. You can see it by clicking here.

The article had clear and concise diagrams, was easy to follow… this is what CPD should be. If only it was. I subscribe to every mailing list known to science in the hunt for CPD. I get half a dozen CPD-related emails every day most of which are sadly of no use at all to me.

This one was good.

(I seem to have mis-dated recent blog entries...)

4 August 2023 (Thursday) - Healthcare Science Bulletin

The August edition of the Healthcare Science Bulletin arrived in my in-box this morning.
It said a lot… without (sadly) saying anything that was of interest or use to me.

3 August 2023 (Wednesday) - OMG!!!!!


This photo appeared on the Facebook Hematology Interest Group page this morning. At first sight I almost laid an egg… then read the caption which said it was a composite made up from many other photos…

How many anomalies can you see?