Tuesday, November 15, 2011

Blood bank


So now I'm in the blood bank, AKA Transfusion Science. Between this, my two part-time jobs, studying for the CSMLS exam in February and doing revisions on During the Fire, I've been too busy for anything else.

But as well as my blog being overdue for an update, I like to describe the behind-the-scenes work in the hospital. So... blood bank.

When a patient needs a transfusion, a sample of their blood is sent to us for a type and screen. Most people know their ABO and Rh type (e.g. A negative, O positive), but pregnancy and previous transfusions can complicate matters. Being exposed to foreign antigens - and yes, a baby's can be treated as foreign by the mother's body - makes a patient's immune system react by producing antibodies, and this can lead to a bad reaction if they're given blood that hasn't undergone further screening. That's another thing the blood bank checks.

Then the blood can be further treated (e.g. irradiated to kill donor white blood cells which might otherwise attack the recipient) before being labeled and allocated via the computer system. It took me a good few days to become at all familiar with the computer system where everything that happens to a unit of blood has to be documented. I've never worked anywhere where accountability and cross-checking were more important.

Which is understandable. Issue the wrong unit and a patient could die. That's another thing the blood bank does - investigation of transfusion reactions, when a patient has a bad response to the blood they've received.

The Transfusion department also handles blood products (platelets and plasma) and recombinant products like clotting factors for people with hemophilia. It's a fascinating place to work, and the staff are friendly. The teaching tech assigned to us, though, is a bit of a prankster. One day I was in the walk-in freezer, getting some immunoglobulin to be issued to patients. The light switch is outside the freezer, so he crept up and turned it off.

I was so startled I swore. Naturally, he thought that was hilarious. Thankfully I didn't drop the bottles of immunoglobulin, which would have been somewhat less hilarious.

Off to work now.

6 comments:

Angela Ackerman said...

Wow you are one busy lady. :) Now you'll have to think of some way to prank that guy back! :)

Angela @ The Bookshelf Muse

gypsyscarlett said...

That's really interesting!

And yeah, I'd enjoy hearing a revenge tale against that guy. ;)

Mary Witzl said...

I'm thinking a whoopee cushion or the old cockroach-in-an-ice-cube trick. Predictable, but effective if you do them right -- and they're tried and true.

Whenever I donate blood here, I'm always amazed by how many times they ask me my name, age and address -- at least half a dozen at the very least, until I could scream. But it's much better than getting something wrong.

colbymarshall said...

Crazy! Would you be up for questions regarding some blood work I have in a novel? I'd love to pick your brain some time! :-)

colbymarshall said...

That is a scary world...I don't know if I could handle that sort of pressure!

Marian Perera said...

Angela - Now if only we had a walk-in autoclave...

Tasha - It's a real pity that turning empty specimen bags into impromptu water balloons would just not be professional.

Mary - absolutely. You wouldn't believe the amount of cross-checking that gets done behind the scenes. I'm in the final rotation now, and there's just as much emphasis on making absolutely certain the right tests are done on the right specimens which have the right name on them.

When we were in college, transcription errors on a lab report carried a 50% deduction in marks, which was scary enough at the time. But not as scary as the possibility that someone could die thanks to a mistake I made.

Colby - Tweeted you. :)