23 May 2024 (Thursday) - BTLP-TACT Exercise

I thought I might as well do a BTLP-TACT exercise. It gave me two cases

 

82403 – a twenty-six year-old chap with sickle cell disease needing eight units of blood for an exchange transfusion.

His ABO group was uninterpretable, but the Rh group was clearly negative. I took a screenshot as this is the sort of thing where BTLP is at odds with reality.

The antibody screen was positive in cells 1 and 2 so I requested antibody panels.

The IAT and enzyme panels was positive in cells 1, 2, 3 and 5 which corresponded with anti-D and anti-E but didn’t rule out anti-Cw.

So I needed eight units of ORh(D)-Neg E-Neg which were also HbS negative.

There were only two units of ORh(D)-Neg E-Neg which were also HbS negative… so (to be blunt) WTF was I supposed to do? 

02162 – a seventy-eight year-old woman in A&E with epistaxis needing group and save

She grouped as A Rh(D) Positive with a negative antibody screen

 

I got the thumbs down… partly my mistake as one of the two HbS units wasn’t E-Negative. But this exercise set me up to fail, didn’t it?