11 December 2024 (Wednesday) - It's Important !!!


Sometimes it is easy to forget exactly what it is we do for a living. Not so much the aspect that people’s well-being depends on us getting the answer right, but what we actually do. What we test. And where it comes from.

Many years ago one of the young ladies with whom I went to college died of a brain tumour. A rather obscure one which accounts for less than one per cent of all types of brain tumours. And three of the people she worked with at the time died of exactly the same sort of tumour.

Nothing was ever proved – things were different back then. When asking for a pencil sharpener in my first place of work I was given a scalpel.

When I first started I was advised to take out the works pension but the chap advising me to do so openly admitted that he did so because he was under orders to do so. He implied a pension was a waste of money and claimed that (at that time) the average person doing the job died three years before collecting their pension from something nasty they contracted doing the job.

Was he right? I’ve never fact-checked what he said. But this brings today’s missive from the nice people at Lablogatory into focus. Don’t roll your eyes at health and safety. It’s important.

10 December 2024 (Tuesday) - Westgard QC Update

The nice people at Westgard QC sent their update today. I’ve got a degree in maths and spent five years studying the subject and still I struggle with the sort of thing that comes in their monthly update.
I saw this piccie on Facebook the other day and thought it particularly apposite

 

9 December 2024 (Monday) - Learning Monday

Bone marrow transplantation… who would be the best donor? I was right in choosing option 2.
Back in the day bone marrow was the future for the lab in the district general hospital. We did autologous transplants for a few years, but allogenic transplantation would be in our remit. HLA typing and all the testing…
Didn’t turn out that way, did it?


8 December 2024 (Sunday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise… I was presented with two cases:
 

93347 – a forty-three year-old woman needing group & save. 

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

 

17507 – a thirty-three year-old needing two units of blood for a surgical procedure.

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

I selected two units of A Rh(D) Positive blood

 
I got the thumbs up.

6 December 2024 (Friday) - NEQAS 2407

I got hold of the results of NEQAS 2407 BF today…
 
2407 BF1
 
I said:
 

Rbc

 

Macrocytes

Anisopoik

Echinocytes

Rbc fragments

Nucleated Rbs

 

Wbc

 

Myelocytes (and pro-)

Dysplastic neutrophils

Bi-lobed neutrophils

Smear cells 

Vacuolation

Occasional blast

 

Plt

 

Low plts

Giant platelets

 

 
Top ten reported comments were
 
Nucleated RBCs
Thrombocytopenia
Blast Cells
Echinocytes/Crenated Cells
Left Shift
Promyelocytes
Myelocytes
Fragments/Schistocytes
Large/Giant Platelets
Acanthocytes
I felt this was a case of Myelodysplasia. It wasn’t – it was a case of severe sepsis. I spotted all the salient features, and can’t help but feel that (as is the case in all NEQAS exercises) we are deliberately hobbled by a total lack of clinical information and lack of blood count information.
 
 
2407 BF2
 

I said:
 

Rbc

 

Rouleaux

Tear drop cells

NRBCs

 

Wbc

 

Neutropenia

Blast cells

 

Plt

 

Low plts

 

 

Top ten reported comments were
 
Thrombocytopenia
Nucleated RBCs
Blast Cells
Neutropenia
Tear Drop Poikilocytes
Rouleaux
Polychromatic Cells
Poikilocytes
Hypochromic Cells
Macrocytes
 
I said this was “?? something nasty ? AML”.  
It was


3 December 2024 (Tuesday) - NEQAS 2404 PA

I got hold of the results of NEQAS parasitology survey 2402 today.
 
2404 PA1
"Returned from safari in Tanzania with suspected malaria"
 
I saw trypanosomes -  T. brucei
I was right
 
2404 PA2
"Fever on return from Thailand"
 
I said no parasites seen
I was right

2 December 2024 (Monday) - Fritsma Factor Newsletter

The Fritsma Factor newsletter appeared in my in=box today. You can read it by clicking here.
One article made me think…  how do you know if a sample has got a clot in it? Well, you pop it open and fish about with a wooden stick, don’t you? We’ve certainly been doing that since 1981. It would seem there’s no evidence that this doesn’t activate an otherwise decent sample…
So what are we supposed to do?