People often ask me “so what exactly does a transfusion consultant do?” (and often I ask myself the same question!). This week I have…
Seen and spoken to patients with congenital bone marrow disorders, iron deficiency, myeloprofilerative disorders, ITP, secondary polycythemia, autoimmune neutropenia and a variety of abnormal counts
Given advice around blood provision for a patient undergoing bone marrow transplant with a D mismatched donor
Virtually met with my PBM practitioner and Customer Services Manager at NHSBT to review regional use of blood and recovery plans. O neg is going up disproportionately to recovery in activity and it’s important for us to understand why.
We also brainstormed how we are going to run our RTC educational activities over the next few months (we’ve got a plan; watch this space!)
I also:
Caught up with a couple of the “junior” doctors I supervise to review their progress and ongoing needs. I have some fantastic trainees and it’s been more important than ever during Covid to keep in touch and make sure they are supported.
Investigated an incident of an unnecessary transfusion and liaised with the ward manager and my haematology colleagues to try to understand why it happened, as well as to put in measures to reduce the chance of it happening again
Had a telecom to help plan the Advances in Transfusion Medicine virtual meeting on 26th November. It's looking good! We have extended the abstract deadline to 20th Sept - free registration and publication in Transfusion Medicine up for grabs! rcpath.org/event/advances…
Listened to the latest recording of a @blooduction byte on haemolytic anaemia (we are finally getting there with remote recording and will be releasing some new podcasts soon!)
Been involved with discussions around improving transfusion pathways for bone marrow transplant patients in our recently merged trust
Met with the transfusion practitioners to review transfusion reactions and adverse incidents, deciding on any further investigations, appropriate treatment for the patients and whether they needed to be SHOT/SABRE reported
Met with the transfusion biomedical scientists to discuss interesting and unusual cases. We have a few patients requiring washed and/or HLA selected platelets at the moment so we checked in on them too
Spoke to a cardiac anaesthetist about blood prescriptions on cardiac ITU and ironed out a few issues about their communication between cardiac ITU, cardiac surgery and blood bank. Ahem!
Taught the West Midlands #haemSpRs about platelet refractoriness and platelet provision
Chaired the NHSBT Patient’s Clinical Team telecon where we discussed recovery plans from Covid, convalescent plasma, the impending revised @BritSocHaem guidelines on irradiated blood use, and had brilliant CPD session on fibrinogen vs cryo prepared by one of my colleagues
Interviewed for a new senior biomedical scientist in transfusion
Reviewed the draft paper for our feasibility RCT of red cell thresholds in AML with the @NHSBT_CTU statisticians
Worked on the statistical analysis plan for our granulocyte registry, ProGrES. Thanks to hospitals around the country, we have information on more than 200 patients and are working with @LSHTM to see if we can do anything clever around association and causation. Exciting!
Reviewed an audit one of my excellent middle grades has done looking at whether we should remove the “irradiated flag” on the LIMS for patients who no longer need irradiated blood following BMT. Spoiler alert: the ones who no longer need irradiated components don’t need blood.
Had a discussion with one of our large regional hospitals about normovolaemic haemodilution (NB we don't endorse this routinely)
Went for a walk around theatres with one of my transfusion practitioners so I can visualise how things are changing post Covid. We have SO MANY satellite fridges I cannot get my head round where they are all moving to! 🙈
Worked with the IT team on an automated email to be sent blood bank when daratumumab is prescribed. A #haemSpR's audit showed some “gaps”; we need to be better esp as dara moves up the treatment algorithm and when we have the antiCD47 agents (which are a lot less forgiving)!
Next week I’ll be updating our major haemorrhage protocol following extensive discussions across our newly merged (now enormous and even more complex) trust, reviewing some of the revised content for the @PBM_NHS non medical authorisation of blood course, being on call for...
...NHSBT, delivering more teaching, doing another clinic, and as always fielding a whole host of stuff I never saw coming!
I have had a number of #haemSpRs tell me they think they’d be bored “_just_ doing transfusion” and there are definitely times when I miss being a “real” haematologist, but there are also times when I know I could never do anything else.
Most of all I know how lucky I am to work with so many people in different organisations, different specialities and different professions and they are all awesome. You know who you are!
But also I am excited to spend my weekend with this one! Happy weekend everyone 🥰
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