Haematology

Latest news from the Haematology Department

23
November
2017

Notification of Change: Measurement of Glucose-6-Phosphate-Dehydrogenase (G6PD)

From Monday 27th November 2017, the Haematology Department will perform G6PD Assays for all G6PD requests using an assay kit from Pointe Scientific. Previously a screen was initially performed to identify if the activity was normal or reduced followed by an assay only in the event of a reduced screen. The assay method will also change from a manual method (30oC) to an automated method (37oC) on the Abbott Architect platform.

The reference range will change and will be displayed on the report.

There is no change to sample type or volume required.

G6PD assay analysis will be performed in batches, twice weekly during routine hours. If a time critical result is needed please contact the laboratory (40908 / 0121 424 0908) and ask to speak to a Biomedical Scientist before sending a specimen to ensure that your sample is dealt with promptly.

The assay has been assessed by UKAS against ISO 15189 standards in October 2017 and is awaiting accreditation confirmation.

Categories: Haematology

01
September
2016

Group and Save - Two Sample Rule

With effect from 1st September 2016, Blood Bank are introducing the two sample rule for requests for blood and blood components (blood, fresh frozen plasma, cryoprecipitate, platelets, granulocytes).

What is the two sample rule?

Blood Bank need to ensure that there are two distinct samples from a patient that have generated the same blood group from both samples. If Blood Bank have seen the patient before and already have a historic blood group (after 20th October 2015) then you only need to make a request for group and save or X-match as you normally do. If the patient has no previous records in Blood Bank then you MUST repeat the group and save or X-match with a second sample.

Why is this rule being introduced?

Wrong blood in tube (WBIT) is a 'never event', it should not happen, however on occasions it does. The consequences of transfusing somebody with blood of the incorrect blood group is very serious and can lead to death. WBIT is a SHOT (Serious Hazards of Transfusion) reportable  incident. The two sample rule is a national guideline to improve patient safety when receiving transfusions.

How does the two sample rule work?

If the patient is not known to Blood Bank then the two sample rule is invoked. The two samples must come from separate venepuncture events and ideally should be carried out by two different people. Separate request forms should be completed for each sample. It is NOT acceptable to take two samples at one venepuncture event and send them to Blood Bank on separate request forms. This will not negate the possibility of WBIT. There is no limit on the time between samples as long as Blood Bank have a historic blood group on record after 20th October 2015.

How will I know if a second sample is required?

If you are unsure if Blood Bank already have a historic blood group you can check iCare or ICE for requests after 20th October 2015. If you are still unsure then please telephone Blood Bank on 40706 (BHH), 47279 (GHH) or 44527 (Sol).

What happens in an emergency situation?

If blood is required in an emergency eg massive bleed procedure invoked, the two sample rule will not apply however a second sample should be sent as soon as possible. Blood will be issued as per the massive bleed procedure and will not be delayed.

 

Categories: Haematology

27
April
2016

Change to Feto-Maternal Haemorrhage (FMH) Anti-D Calculation

From 25/04/16 we have adjusted the way Anti-D is calculated in our FMH screen by flow cytometry. The bleed is still reported in millilitres as previously however the suggested dose of Anti-D required to cover the bleed also takes into account the uncertainty of measurement of this technique in our laboratory. This may result in a slightly higher dose than expected but will ensure that bleeds are appropriately covered, especially those requiring multiple injections. For further information click here or contact the laboratory on 0121 42(40704)

Categories: Haematology

08
January
2015

Guidance on Testing for Paroxysmal Nocturnal Haemoglobinuria

Guidance on Testing for Paroxysmal Nocturnal Haemoglobinuria

Paroxysmal Nocturnal Haemoglobinuria (PNH) is an acquired haematopoietic stem cell disorder resulting in a partial or total deficiency of proteins normally linked to cell membranes by a glycosylphosphatidylinositol (GPI) anchor. Classical features are;

  • intravascular haemolysis
  • bone marrow failure
  • thrombotic tendency
  • may also include abdominal pain, dysphagia, erectile dysfunction, renal failure, lethargy

It can often go undiagnosed for months or even years. Flow cytometry can provide a definitive diagnosis.

Click here for further guidance on PNH testing. Contact the laboratory on 0121 424 0704.

Written by: Mark Hill Categories: Haematology, General

29
May
2014

Laboratory Information System Migration

Laboratory Information System Migration
In order to bring systems in line with the restructured laboratory services the Laboratory Medicine directorate will be migrating to new Laboratory Information System Databases for Blood Sciences and Microbiology.
 
The migration is due to commence at 8am Monday 2nd June.
 
No downtime is anticipated but there may be some temporary disruption as the migration progresses.
 
The Blood Sciences System will replace what is currently the separate disciplines of Chemistry, Haematology and Immunology as a single department. As such the ICE Reporting System will display reports as Blood Sciences (Orange highlighting).

Categories: Blood Sciences, Microbiology, Cellular Pathology, Haematology, Immunology, Biochemistry, General

19
October
2017

Update on Blood Films

Blood smears are normally spread and stained using a process on an automated platform which has been accredited to ISO 15189 standards with UKAS. In the event of analyser failure blood smears are manually spread and stained using manual techniques which has been validated against the automated method but is not yet accredited by UKAS. This does not affect the interpretation of the morphology.

Categories: Blood Sciences, Haematology

27
May
2016

Change to Haematology Reference Ranges

Please note from June 1st 2016 the reference ranges for the full blood count will be changing, the most notable of which include haemoglobin, red cell count and neutrophil count.
New ranges:
RBC Male 4.3-5.7 *1012/L
Female 3.7-5.1*1012/L
Hb Male 133-166 g/L
Female 110-147g/L
Neutrophils 1.5-4.7 *109/L

 

The Erythrocyte Sedimentation Rate (ESR) reference ranges will also be changed from June 1st to reflect the new method used in the laboratory. These are as follows:
Age
2-14   2-34
15-50 (Female) 2-39
15-50 (Male) 2-30
51-70 (Female) 2-45
51-70 (Male) 2-44
>70 3-55

 


For more information regarding these changes please  contact the laboratory on extension 40908

 

 

Categories: Haematology

30
March
2016

Apixaban & Rivaroxaban

Haematology are now offering assays to measure the new oral anticoagulant drugs Apixaban and Rivaroxaban. Both drugs are direct factor Xa inhibitors. Apixaban is recommended by the National Institute for Health and Clinical Excellence for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation and at least one of the following risk factors: prior stroke or transient ischemic attack, age 75 years or older, diabetes mellitus, or symptomatic heart failure. Apixaban and other newer anticoagulants (dabigatran and rivaroxaban) appear equally effective as warfarin in preventing non-hemorrhagic stroke in people with atrial fibrillation and are associated with lower risk of intracranial bleeding. For further information please contact the laboratory on 0121 424 0908 (internal ext 40908) or for clinical advice please contact the On Call Haematologist via switchboard.

Categories: Haematology

08
January
2015
31
August
2013

New Laboratory

New Laboratory

A video of the new laboratory at Birmingham Heartlands Hospital

Written by: Craig Webster Categories: Haematology, Biochemistry, General