Our Lives in the Hands of Robots.

Very occasionally I'm reminded why I love my job in transfusion science ... It's very easy to become detached from the patient and the full picture when you're down in the lab looking at numbers on a screen and pushing buttons of robotic analysers.... but this shift was different.
The Doctor in charge of this patient was so cooly in control he was able to fully explain exactly what was going on with his patient and what he needed from me to allow optimum care and management of this patients condition.... It made for a completely different experience.

The gentleman patient was a 55 year old Alcoholic presenting with a large GI bleed, he'd lost over 1500 ml of blood and was heading for theatres for an emergency laparotomy.
The team were well organised in that they had sent two sample for blood group and antibody screening.... In approximately 40 minutes I could supply crossmatched blood for this patient. This is the safest option and avoids using precious 'universal donor' O neg units.

Immediately after issuing 4 units of blood the doctor bleeped to inform me that he was activating the major haemorrhage protocol. This involves issuing 4x red blood cells, 4x FFP (fresh frozen plasma) and 1x platelets repeatedly until the patient is stable and the clinician in charge deactivates the MHP.
I asked the Dr the relevant questions (patients weight, medication, location), gave the Dr a projected time that the products would be ready and proceeded to prepare the FFP.

At the same time as this was going on a labouring lady of the same blood group was experiencing PostPartumHaemorrage and so I had issued my last set of A neg units to her.... In order to supply safe blood for the MHP guy I would have to issue O neg units - I wanted to avoid this to save these precious units. Here at PRUH we don't keep a stock of platelet so I needed to order some in, urgently. I also needed to replace the FFP that was thawing and order more A neg red cell units to see us through the night.


To give you a little back ground .... Clotting factors are the proteins in your blood that help to stop bleeding, these factors are produced in the liver. I mentioned that this patient was an alcoholic, and as we know alcoholism leads to liver damage reducing production of these clotting factors which contributes to greater blood loss in these patients. The FFP that I was thawing would replace these clotting factors and if the correct dose given, stem the bleeding. For effective management of bleeding patients it is important to monitor the patients haemoglobin, platelet count and clotting factors at regular intervals.

To calculate these parameters I rely on machines.....And this is where it gets interesting (I can say that with hindsight - at the time I was freaking out ) .......Analyser failure :-|

As I'd already issued 3 different products - blood, platelets and FFP....

The clinician would need to reassess the patients condition with interpretation of the results of my test..... Namely fibrinogen.

Fibrinogen is one of the key clotting factors found in FFP but it is more highly concentrated in Cryoprecipitate. Cryo is another frozen product available for the transfusion lab.... But it is only issued to patients when their fibrinogen levels drop below 0.5g/L ..... But without a working analyser how were we to know whether the patient required this product. To blindly give this patient Cryo could cause more harm that good, to not give Cryo or delay transfusion if the fib had dropped could also be disastrous...... I was starting to panic at this point and feeling quite guilty.

I did manage to get some results to come thru by stopping and starting the analyser ... Prayers, relief, excitement, frustration .... But it didn't allow me to clear the back log.... When ever I have a busy shift like this or something extra to deal with it's really important that I keep on top on the workload as the bleep just goes nuts with doctors and nurses asking for results for other patients if I don't authorise result quickly. Which obviously holds me up further.

Communication is essential so I'd phoned the site coordinator to inform him of the situation and again spoken to the consultant in charge of the bleeding patient.....This is where I was most impressed, it was at this point that he relayed to me the status of the patient, he explained that they had been able to stem the bleeding in theatre but that the fibrinogen level would still be very useful. He thanked me!!! Yes the doctor thanked me the BMS for making such an effort to get these results to the ward, he also sympathised with the predicament I was in, understanding that I was doing my best. And he cooperated completely, even offering to phone the Denmark hill site to arrange for testing to take place there instead to allow me to concentrate on the rest of the work.

I would usually be very stressed and anxious in this situation but thanks the loveliest doctor, explaining the situation completely I managed to stay pretty calm!

Now obviously I didn't do anything differently, it wound be very unprofessional of me to change my actions because of a rude or uncooperative doctor but I definitely left work that morning feeling a greater sense of worth.......at the end of the shift this patients clotting result came back
fairly normal, his haemoglobin level was reasonable .... He'd stabilised.
Haemostasis had resumed the  coagulopathy had been managed (thanks to the FFP) and I could leave my shift with the confidence that those patients would be okay :-D

Would you date a married man?

Would you date a married man?

I was a little reluctant to write this blog post as it's quite a controversial subject, and I have to admit I've come home and poured myself a large glass of wine just so that I'd get on with it. It important to me that in this blog as a whole, I write about real things that are happening in my own life .. so here I am telling you how I ended up on a date with a married man.

Now I've been single for quite some time... which really suits me. I love my own company, I can hang out on my own and I don't worry about ending up alone. I'm 25 years old with a very busy life, an every growing career, the foundations of a great business, a packed gym schedule and plenty of friends to fill my time with.... there just isn't the room for men! That being said, if a seemingly nice guy asks me out for lunch... I'm in!!

I love the idea of chatting over a pizza, discovering new things in new people is very exciting. I'm not a shy person and will express my true self to anyone willing to listen. So after meeting somebody through friends at a club I attend and talking over social media it felt completely natural to accept his invitation to lunch, and get to know each other in person.

I'll just set one thing straight - I did not, and do not fancy this guy (although he most definitely fancies himself). I enjoy people. I think the best way to learn about yourself is to get to know other people, when you listen to other peoples stories and tell them your own, I believe it confirms your own thoughts and feelings about life and the things you do - and this can only be a good thing.

So this is how it went.... Mr.Z happened to have the same day off in the week as I, so casually asked me to lunch. Over email he flirted (at least I thought it was flirting) and referred to our 'date' - I'll also mention here that I have most definitely seen his picture on a dating website (yep I'm on tinder - I told you I like meeting people). So I had no reason to believe he was anything other than single, unattached and available.

After 5 or so minutes into our first meeting outside of the usual club, he mentioned his WIFE - I nearly chocked - His wife!!!! What the hell? He acts so single. What's he doing here with me? Does his wife know he meets girls for lunch on random Wednesdays? I'll bet my first locum pay packet she doesn't!!

As I tried to hide my shock & horror I felt an overwhelming wave of embarrassment. How could I be so conceited as to think this guy wanted to date me? He wants a mate, not a date! I didn't know what to say or do.

As our meeting/date/lunch with a friend went on I felt ever more confused... He made references to affairs, he commented on his and his wife's dislike for one another, complimented me at every opportunity and even suggested a weekend away!!?!! This is not appropriate from any man in holy matrimony. What was he trying to achieve (there I'm being conceited again).

I'd like to defend myself at this point, in case it isn't obvious - I had no idea this man was married.
Being a single girl with lots of male friends, I've experienced negative actions from girlfriends in the past. But I am not a home wrecker, Married me are not my thing! We've all seen the glamorous 'other woman' in the movies, but personally, I've seen it from friends and family alike and it's not something I'd ever want to be involved with - the other woman is always second best. After speaking to some friends about this it was even suggested that I contact this sleaze bags wife... but I wouldn't be able to live with the consequences.

I always struggle to conclude these posts and this one even more so, I could go on all night on the subject of trust in relationships. But husbands please.... If you could put half as much effort into making your wife happy and upholding a healthy marriage, as you do in finding any old girl to mess around with and seek attention from, I'm sure the world would be a better place.

It's safe to say my faith in men has plummeted to an all time low.  So I could not be happier to say my 'Man Ban' reigns on.

Feel free to comment on anything I've said today - your responses are most welcome!!

Have a great week everyone- lots of love Steph x