A Dull Day At Work...?

9 October 2024 (Wednesday) - Turning Off Immunity?

Here’s something… two injured comb jellies have been seen to merge into one individual.

It’s been established that comb jellies do have an immune system, so what’s going on here. Clearly there is some mechanism in which the recognition of “non-self” is modified.

Could this have relevance to humans? Could this trick be used to increase the success rate of organ and bone marrow transplant? Will this herald a whole new era of lab tests for us to be doing?

7 October 2024 (Monday) - Learning Monday

It’s Monday – time to turn to the European Hematology Association’s “Learning Monday”.

Perhaps the start of learning is finding out what you don’t know.

Apparently Ruxolitinib is indicated in patients with symptomatic splenomegaly and/or constitutional symptoms due to IM-2 and HR PMF. Bearing in mind I don’t know what Ruxolitinib IM-2 or HR PMF are, there’s the start of today’s CPD…

6 October 2024 (Sunday) - BTLP-TACT Exercise

Well, it’s been a few days since I had a go at the BTLP-TACT, so I sparked it up. I was presented with one case – a twenty-seven year-old woman in maternity needing four units of blood.

The sample was completely unlabelled, so I rejected it. And I got the thumbs-up for doing so. Flushed with success I had another go.

I was presented with one case – a sixty year old woman needing two units of cryo for vitamin K deficiency.

She grouped as A Rh(D) Positive with a negative antibody screen, but with no more clinical information given I wasn’t going to waste valuable cryo when an injection of vitamin K would do the trick.

I got the thumbs-down. Apparently there was a labelling error. I didn’t spot it. I suppose that’s why two people check when we do this at work.

And so with one pass and one fail, I went on to see what two out of three would be. One more case – a ninety year old woman needing two units of blood.

She had an indeterminate ABO group but was Rh(D) Negative. The antibody screen was negative so I selected two units of O Rh(D) Negative.

And having got two right out of three I called that a day.

2 October 2024 (Wednesday) - Fritsma Factor Newsletter

Inhibitors, haemophilia and reptilase time (remember that?)… again the Fritsma Factor newsletter delivers. When you consider George is giving me something for nothing here, it is rather good value for money.

1 October 2024 (Tuesday) - More BTLP-TACT Frustration

Well… admittedly I’ve been off on holiday for a couple of weeks so I suppose that’s why I’ve been getting low participation warnings from the people at BTLP. Bearing in mind the debacle of the last exercise I’m not keen on doing any more… but if I am going to carry on in this line of work I have to do CPD.

Then again I’m not really keen on carrying on working at all. But for now…

I asked the BTLP-TACT software if I might have another go. It eventually presented me with one case – a forty-one year-old woman in the maternity department needing group & save.

I decided that the sample labelling was correct and told it so. After about five minutes it moved on to the next screen.

Actually requesting said group and save took another five minutes. Five more passed before I was able to see the result of the grouping

Both ABO and Rh group were indeterminate. It struck me that this was an AB Rh(D) Positive patient who had been transfused O Rh(D) Negative blood. In reality we would have this information.

And then the entire thing crashed in a server error.

I restarted it and eventually saw that the antibody screen was positive in cells 1 and 2.

I made a cuppa whilst I waited for it to allow me to request antibody panels, and drank the cuppa with a couple of biccies whilst waiting for it to show me the results of those panels.

The IAT panel was positive in cells 1, 2, 3 and 4 corresponding with anti-C and anti-D whilst not excluding anti-Cw. After another painfully long wait it again crashed in another server error.

I again restarted the thing and eventually saw that the enzyme panel was the same as the IAT panel. positive in cells 1, 2, 3 and 4 corresponding with anti-C and anti-D whilst not excluding anti-Cw. Once I’d given it the answer the software just hung.

After waiting for seemingly an age it gave me the thumbs-up.

1 October 2024 (Tuesday) - Westgard QC Update

The trouble with statistics in the lab is that the people using them aren’t mathematicians. I’ve got a degree in maths and often struggle with what the nice people from Westgard tell me…

Measurement of uncertainty for example. Surely common sense tells us that if you’re not measuring something very often then you will have more variability in your results than if you measure lots…

You can read the latest update from the nice people at Westgard QC by clicking here

23 September 2024 (Monday) - Transfusion Evidence Alert Update

Tranexamic acid features yet again… and an interesting article about transporting blood by drone. With the pitiful state of the road network round our way that could be the way forward?

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