Untold Stories of the Clinical Laboratory

We got down a sound culture swab from a female patient in the ER with no specimen source on it.

I called the nurse of the patient, a male, to ask what the source was.

He acted a tad flustered, and said “Well, it says it’s genital here, umm, yeah… genital. I mean, I think she has an abscess…”

I thanked him, and checked the accession number in the computer to find that the source was listed as “vulva”.

The nurse just didn’t want to say the term out loud, I guess. haha

“Hurtin all over” - I live in the south.

“Right heart failure” - Doctor?!

(thank you internet)

My biggest issue was the waste of donor red blood cell units. I can’t stop thinking about the poor person who went to donate blood, overcoming fear in the hope of helping another person through open heart surgery or replacing blood lost after a motor vehicle accident.

But no. Their blood went to a selfish teenager who drank the blood in order to give birth to her half-vampire baby. And then she spilled a whole unit on the floor.

Also, I wonder if the baby minded the CPDA-1 preservative (or maybe AS-1) in which the packed RBCs are stored. Did the baby not like that it wasn’t whole blood? Should they also have made Bella drink plasma? Do vampires only utilize the RBCs? Am I thinking into this too much?

It should be noted that the quality of my stream was not good, so it could have been whole blood. I also couldn’t read the ABORh type. The label on the bag looked very much like a red cross label, though. I bet the ARC was thrilled by the shot with all of the empty bags in the trash can.

And I remembered I still hadn’t listened to the new Wombats album. So I looked at the track listing, and was pretty amused by “Anti-D”.

I thought for a second they were talking about Rh typing, but then realised it was about anti-depressants.

Not as much fun.

I made a test patient so I could practice entering a patient with an antibody into the LIS.

The name: River Song.

I debated for a while with myself over the DOB. Finally I just put my grandmother’s birthday. I thought the computer would freak out if I tried to put a date in the future (like the 51st century…).

I laughed every time I said something along the lines of “well it looks like River has an anti-Kell…” to my trainer.

I wanted to upload a photo of the label but I was worried that would somehow violate confidentiality. Oh well.

Our open heart surgery patient (normally given freshest type-specific blood and generally put first ) was a Jehovah’s Witness. They were still written on the calendar, but the patient was not typed or allowed to have any blood products.

I looked on the Watchtower website and read an article detailing how dangerous transfusions are. The article is riddled with quotations from medical journals, but all of the articles are from before I was born (1989). Interesting, since testing for HIV and Hepatitis has gotten infinitely more sensitive in the past 22+ years. However, I understand from my internet searchings that the choice to not receive blood products comes not from fear of its safety, but it is influenced by the belief that blood is sacred.

Anyway, I respect the patient for sticking to their faith and being brave enough to go into open heart surgery knowing they couldn’t take any red cells, plasma, cryo, or platelets. I don’t think I could ever go into surgery knowing something like that.

We got a call from the ER in Blood Bank today, asking for 6 emergency O Neg units for a male (meaning we could give O Pos). So I got to put together the coolers with the emergency unit packs and hand them to the winded nurse before she ran off back to the ED. The guy had a “stab wound; suicide attempt” diagnosis. The OR called down later, asking us to set up 6 more units on the guy later on. Never found out how the patient fared.

I heard about a guy over the weekend who came into the ED after drinking a large amount of gasoline, roughly 2 times the amount considered to be fatal. It was too late to save him, so the staff just had to wait until he passed away. I was a bit disappointed I didn’t get to see his chemistries. Hm.

Every time I see the term “Blood Status Update” in blood bank, I think of Harry Potter. I feel like I should enter “pureblood” or “half-blood”.

fyeahmedlab:

Red cell count: 4.5-5.9/4.5-5.1 x 10^12/L

Haematocrit: 42-54/38-46%

MCV: 80-96 fL

MCH: 27-34 pg

MCHC: 32-36 g/dL

RDW: 11-15 

Platelet count: 140-400 x 10^9/L

I’ve spent most of the last 3 days reading procedure manuals. Since Blood Bank is serious business (you need a prescription to get what we give out), there are 4 huge manuals to read/know. Fun times.

I have gotten to do a few simple blood types (with no typing discrepancies or positive antibody screens), confirm unit typings, and issue a few units. So it’s not all reading at a desk, which is nice. :)

I can’t wait to do some antibody panels, though. Those are more fun than sudoku.

But not after a ridiculous urine-filled day in hematology yesterday. It felt like I did 50 urine microscopics. Ok it was closer to 20… still.

One patient’s urine had white chunks in it, and I wondered what it was since it was a catheterized sample. After doing the chemical tests manually due to the small amount of specimen, I put an aliquot under the microscope.

EVERYWHERE YEAST. EVERYWHERE HYPHAE.

Seriously, I could barely see the white cells in the background, her urine was so overrun with yeast and hyphae. I got my trainer to come look too; it was that gross.

I changed my gloves after that one. That poor woman.

We had one patient with “facual droop”. I am going to assume that means facial droop.

Another patient from the ER “hit head on Sunday”. Today is Tuesday. His labs were all normal. Not sure why he didn’t come in on Sunday…

Seen today while resulting out CBC and Diffs: “nerves”

Not entirely sure what that means.

Also, we had a few people come in the ER with seizures today. Interesting.