6 December 2021 (Monday) - Parasitology NEQAS

I got the results of the parasitology NEQAS today…

I was presented these films with absolutely no information whatsoever.  

2104PA1 

I couldn’t see any parasites – there weren’t any 

2104PA2 

This was a thick film. In all honesty the best I could say was that I saw some blobs of dubious significance.  It turned out these were parasites. Well… I saw them and had this been a genuine case I would have sought a second opinion.

The report said:“This thick blood film was from a patient on treatment for malaria. Small numbers of fine ring trophozoites typical for plasmodium falciparum were present on this film. The purpose of the thick film is to recognise the presence of malarial parasites rather than to confirm either the species or to quantitate the parasitaemia. This case as it happens ,was plasmodium falciparum and the contemporaneous level of parasitaemia separately determined by the reference centre was 0.1%”

I’ll take that as success…

6 December 2021 (Monday) - NEQAS Morphology

I got the results of the morphology NEQAS today…

2107 BF1 

 I was presented with a blood film ostensibly from a 61-year-old female with Hb 129 and Wbc 185 

The film showed lymphocytosis with many smear cells
There was some poikilocytosis with crenated cells   
The platelet count looked normal, but there were some clumps present

This looked to be a case of CLL… It was – and I’d spotted the salient features  

2107 BF2 

I was presented with a blood film ostensibly from a 67-year-old male with Hb 137 and Wbc 6.9 

There was a reversed neutrophil/lymphocyte ratio with reactive lymphocytes seen together with some smear cells and occasional sezary cells 
There were target cells and some echinocytes and Howell-Jolly bodies
There were giant platelets present  

This was possibly Sezary’s syndrome… this was actually a case of  Sezary’s syndrome. Again I’d spotted the salient features

6 december 2021 (Monday) - Consent for Transfusion ?

I did my “Consent for Transfusion” e-learning today. From my perspective it was somewhat academic; I just provide the blood that the clinical staff ask me for, but it made me think…

Obviously it is important that people should be aware of what treatment they get when in hospital, but are most people *really* able to form a considered opinion as to whether or not a blood transfusion is in their best interests? I really worry that most patients would value the opinion of “Karen from Facebook” over any professionally produced information with which they might be provided. 

And I must admit to a sly smile when I read the bit about telling patients that they have been given a transfusion when they were not in a position to know that they were receiving one. My father found out about his blood transfusion purely by accident… Should I put in a formal complaint with the hospital in question?