Wednesday, February 22, 2012

Plasma Transfusion Presentation

I know that I owe everyone more than just a few posts. I'm working on some stuff, but in the meantime, I wanted to point you to an excellent online presentation from Dr. James Stubbs (Mayo Clinic) summarizing the poor effect of plasma transfusions on both laboratory correction of mild to moderate INR elevations and bleeding outcomes. You can view the presentation by clicking this text.

Keep watching this space for more posts to come.

Friday, September 16, 2011

Take Note!

For the last 16 years, I have been privileged to be the primary transfusion medicine lecturer for the Osler Institute Pathology Review Course. I have interacted with thousands of pathology residents and practicing pathologists, and I'm convinced that I have taken more away from those interactions than I have given. One of the great things about doing the course is that it forces me to update my blood bank review notes on a regular basis. I'm happy to announce that the latest version is now available for download, at the bargain price of (wait for it....) FREE!

Wednesday, August 31, 2011

Don't Over-React!

Some time ago, I published a chart on the Blood Bank Guy website that summarized the basic facts about the major transfusion reactions in a one-page, easy to carry, easy to memorize pdf file. I hadn't looked at it or really even thought about it for years, until someone recently e-mailed me and told me that it had been extremely helpful to him during his residency. I was horrified, to be honest, because I knew that it really was out-of-date! He assured me that he hadn't harmed anyone, and we parted as friends.

However, the e-mail conversation got me thinking about the chart, so I broke it out and looked at it again. I liked many things about it and was embarrassed about others, so I took the time to review each and every entry and update it with the most current information I have. Today, I am happy to announce that I am re-publishing a better, more clear, and up-to-date Blood Bank Guy transfusion reaction chart (you will have the best results by getting the chart on the BBGuy site, where it is in pdf format and you can print it yourself, or you can click the image below to see it now with lower resolution). As before, the chart is designed for quick reference, or for inclusion in your on-call notebook, or as a quick way to review stuff before an exam, or for whatever purpose you think fits best (paper airplanes, anyone?). I hope that it is helpful and useful to you!

Thursday, August 11, 2011

G Whiz!

As medical director of an AABB-accredited immunohematology reference laboratory, I and my colleagues get to see our fair share (or more) of complex red cell antibody problems. I am blessed to have a brilliant team of techs and leaders in the lab that handle most of these issues with ease, but I do get questions about red cell antibodies at work, on the Blood Bank Guy web site, and especially when I am giving blood banking review lectures. One of the most frequently asked goes something like this: "What the HECK (or words to that effect) is anti-G?!" If you have asked that question (even if it has been answered and you can't remember the answer!), this post is for you!

Friday, July 22, 2011

So Long, Walter Reed!

I have been following the news of the impending closure of Walter Reed Army Medical Center in Washington, DC, from afar for several years. I have very mixed feelings right now about the whole thing.

I spent the majority of my time in the military, from 1991 to 1999, at Walter Reed, first as a pathology resident, and later as a staff pathologist and medical director of blood services. While I and everyone who has ever worked there would tell you that it was FAR from a perfect place, I can say with certainly that the medical and nursing staff that I dealt with were incredible! There was so much skill, so much caring, and so much passion for giving soldiers and dependents the best possible medical care that you couldn't help but go home every day full of pride. At the same time, the frustrations regarding cuts in support staff, facilities that were aging badly, and the results of seemingly millions of previous poor administrative decisions on everything from computers to lab equipment became exhausting.

Despite all of the frustrating parts of being at "Walter Wonderful," I can honestly say that my time there was among the most important and beneficial of my career. I was forced (sometimes against my will) to make leadership and medical decisions that I wasn't sure I was ready to make, and the resulting experiences have stayed with me and guide things that I do today. The Army was great to me, and my memories of Walter Reed are mostly very good.

If you read the article I linked above, you will see that the comment section contains thoughts about Walter Reed that are decidedly mixed. That is understandable. Anyone who spent any time there knows that the place had flaws, sometimes big glaring flaws. I would bet, however, that most of us would also say that we are better healthcare providers as a result of the experience we gained at Wally World. I will miss the place, and cherish the memories of the people that I knew there.

Thursday, March 31, 2011

Total Eclipse of the...Virus

Terminology can get a bit confusing when discussing different stages or "periods" of viral infections in relationship to transfusion-transmitted infections. I've tried to simplify some things in this post, to help you understand the differences between "windows" and "eclipses!

Monday, March 14, 2011

Perils of Poly(agglutination)

OK, here's one for all you immunohematology geeks out there (I say that with all admiration and respect, by the way)!

Not long ago, the immunohematology reference lab at the blood center where I work received a sample for a lectin workup from a patient suspected to have polyagglutination. The patient was a child, and had recently been diagnosed with sepsis secondary to Streptococcus pneumoniae. This situation led me to think about polyagglutination and summarize it for you.