18 May 2025 (Sunday) - Slide Challenge Saturday

Well… it *is* platelet satellitism… I’d spotted that. But it’s not a good example of the phenomenon really. And the photo comes from a part of the film with is too thick really.
I’m more intrigued with that neutrophil. Something’s going on there – it don’t look right.
But free CPD is always good…

15 May 2025 (Thursday) - Neutropenia

Here’s an interesting article on the treatment of symptomatic neutropenia. Reading this makes it pretty clear that genetics has moved on a lot since I was at college, and this is why I need to do CPD.

I can’t pretend to understand the article entirely, but some of it stuck.

14 May 025 (Wednesday) - BTLP-TACT Exercise

Well, I was at a bit of a loose end, so I sparked up the BTLP-TACT thingy. It gave me one case – a seventy-eight year-old chap under the medical people who had coffee ground vomiting who needed group and save.

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

 

I got the green light so, flushed with success I had another go. This time it presented me with one case – a ninety-seven year-old chap needing two units of cryo for vitamin K deficiency.

 

The control well was positive, so the entire group was invalidated. Fortunately for my nerves the antibody screen was negative.

 

https://www.sciencedirect.com/topics/nursing-and-health-professions/vitamin-k-deficiency implies cryo is indicated in cases of vitamin K deficiency, so I issued two units of AB cryo.

 

I got the thumbs down… Apparently cryo isn’t indicated in cases of vitamin K deficiency.

My mistake… now I’ve had the thumbs-down I 've realised that I was thinking of Factor V.

Mind you, I have to wonder what the nice people at Science Direct were thinking of.

13 May 2025 (Tuesday) - Horiba Newsletter

A blood film from someone with thalassaemia major, and a little review of platelets. Guess the cell (stab cell), and I got last month’s question right (positive bias).

There wasn’t *loads* in Horiba’s monthly update, but little and often works well for my poor brain…

 

12 May 2025 (Monday) - BTLP-TACT Exercise

Is it really a week since I last had a go at the BTLP-TACT thingy?  It gave me two cases:

 

50265 – a thirty year old woman in the haematology clinic needing four units of FFP for a Factor V deficiency.

Great Ormond Street say they use FFP to treat Factor V deficiency, so if it is good enough for them, it is good enough for me.

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

I issued four units of A FFP

11250 – an eighty-nine year old chap in the out patients requiring group and save

He too grouped as A Rh(D) Positive but with an antibody screen positive in cells 2 & 3. I requested antibody panels.

The IAT and enzyme panels were positive in cells 1, 3, 4 6 and 7 corresponding with anti-Jk(a)

 

I got it all right.

8 May 2025 (Thursday) - Peri-Natal Complications

One of the reasons that I don’t like being seconded to our sister laboratory is that their hospital has a maternity unit. And when pregnant ladies need the blood bank it can be quite scary for all concerned.

Here’s a little article from Blood Bytes and Beyond about managing peripartum complications in the blood bank.

 

The take-home messages are

 

·       Anticipate haemorrhagic risk in patients with placenta accreta spectrum, previa, abruption, or uterine rupture

·       Tailor MTP for obstetrics: early cryoprecipitate and TXA are critical

·       Differentiate causes of thrombocytopenia: preeclampsia/HELLP vs. TTP vs. aHUS dictates treatment

·       Monitor for DIC in any critically ill pregnant patient

·       Provide close antibody monitoring: alloantibodies may impact future pregnancies

 

I’ve not long signed up to Blood Bytes and Beyond. So far, so good…

6 May 2025 (Tuesday) - Fritsma Factor Update

The nice people at The Fritsma Factor sent their update today. You can read it by clicking here. As always there’s quite a bit of interest, and all for free.