Bloody Minded

Have you been asked to call for a Haematology consult and are now considering hiding in a toilet? Never fear! You can listen to this podcast from the hospital bathroom AND learn some fantastic tips and tricks to help us help you! Dr Alison Chandler is back in the studio and we're aiming for future consults with at least 50% less crying – and that’s not just for the Haem AT carrying the consult phone! 

Timestamps:

00:54 - Nick is MIA
03:06 - Picking up that phone
06:44 - Consult 1) New Thombosis
19:50 - Consult 1.1) Superficial Thrombophlebitis
22:40 - Consult 2) Deranged Coags
31:35 - Consult 3) Cytopenias
49:27 - Bonus Consult: Thrombocytosis
52:14 - Summaries

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Bashar was tasked with finding an expert to talk to about blood banking. He decided to cold-email the best transfusion-educator in the world who is probably responsible for hundreds if not thousands of haematology trainees understanding blood banking. Turns out he's an absolutely lovely guy who decided to spend an hour of his Monday morning chatting to us about podcasting, education, IgA deficiency and all the wonderful aspects of the blood bank. Join us for an hour with Dr Joe Chaffin MD, much more widely known as "The Blood Bank Guy".

For more of Dr Chaffin's excellent work, check out www.bbguy.org & The Blood Bank Guy Essentials Podcast wherever you get your podcasts

Timestamps

1:00 - Containing our excitement
3:38 - The Joe Chaffin story
8:15 - Getting into education
17:40 - Surprising moments in podcasting
22:45 - How to improve transfusion teaching
27:50 - The Blood Bank/Clinician interface
38:31 - What scares the Blood Bank Guy?
46:42 - The future of blood banking
49:53 - What to unlearn
57:19 - TA-GVH made easy
1:01:24 - Final words of wisdom

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Red cells. White cells. Platelets. Plasma. Proteins. By your powers combined I am Captain… Whole Blood? Wouldn’t it be so much easier if we could work with each of these blood components individually. After all, we have to get them in a bag to donate to people. Before we swear off transfusion for the time being, join the Bloody Minded Crew as we learn the get back to basics of the apheresis machine, the concept of plasma exchange and how the magic of technology allows us to manipulate these components separately. Why keep all of your humours mixed together if you don’t have to? Hippocrates could never.

Timestamps

0:55 - Our stupidest and best intro to date
3:10 - What is apheresis?
8:05 - Indications for apheresis
13:21 - Mechanism of apheresis
17:52 - Replacement fluids
19:23 - Physiology in plasma exchange
22:13 - Complications of plasma exchange
30:50 - Take home messages

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Join our visiting expert Dr Eoghan Molloy - Multitalented transfusion medicine specialist and consultant haematologist at Cork University Hospital to teach us how to cross the ABO Rubicon and provide transfusion support in ABO mismatched transplantation. Visit the lab and see what happens to the forward and reverse group when you're in the middle of changing groups. Brush up on your major, minor and bidirectional mismatches as the generally mismatched Bloody Minded Crew learn from a real expert again. 

PS Nick had his microphone set to ASMR so there are a few hiccups in the audio quality but the content was too good to miss

Timestamps:

0:59 - Nick's real overseas friend
2:52 - Intro to Dr Eoghan Molloy
9:10 - ABO incompatibilities in transplant
15:19 - Graft manipulation
17:47 - Patient preparation in ABO mismatch
20:44 - Provision of blood products in transplant
32:51 - Red cell aplasia in transplant
38:16 - Passenger lymphocyte syndrome
40:37 - CMV in transplant
46:06 - Irradiated products
52:12 - Clinical case and wrap up

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

FOUR Antibodies. THREE Animals. TWO Crying Haem Registrars. ONE TEST - The MAIPA. Actually maybe more than two crying haem registrars. How many antibodies are too many antibodies to have inside a lab test? One? That’s just a DAT. Two? A mere sandwich ELISA. But the Monoclonal Antibody Immobilisation of Platelet Antigens (MAIPA) - that’s not just three but FOUR separate antibodies in the same test. If somehow you’ve made it this far thinking there wasn’t enough immunohaematology for you then it’s time to join the Bloody Minded Crew as they wrestle with the most anti-bodied of tests. Oh and we look at other platelet antibody testing too.

Timestamps

00:52 - Thanksgiving in the lab
03:42 - Platelet antigens refresher
06:10 - FNAIT
10:55 - Transfusing in FNAIT
20:18 - Testing for FNAIT
26:56 - The PIFT
29:39 - The MAIPA
37:20 - Take home messages

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Have you ever looked at your wallet after a big night out and seen that all your dollars have been conjugated to alloantibodies and phagocytosed by macrophages? Then you know what it’s like to transfuse a platelet refractory patient! Join us as we take a tour of platelet refractoriness and do our best to find some HLA-matched dollars for rent this week.

Timestamps

00:52 - Bashar lives near a nuclear reactor
2:03 - Clinical case
5:38 - Defining platelet refractoriness
7:46 - Calculating platelet increments
12:42 - Causes of refractoriness
18:10 - Immune mechanisms of refractoriness
21:23 - HLA in detail
25:03 - HPA antigens
27:39 - Testing
31:46 - The Luminex assay
34:00 - Managing immune refractoriness
43:26 - Take home messages

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Has this season been too simple? Want to up the difficulty? First of all you have issues, but second of all, welcome! It’s time to talk about all the things we don’t tell people about in the wider hospital - rare blood groups, subgroups, laboratory tips, tricks and more on this bumper In The Lab episode. 

Timestamps:

0:52 - How to get rich quick
3:58 - Episode overview
4:50 - The other blood groups
9:07 - Kell
11:37 - Duffy
13:54 - Kidd
16:53 - MNS
18:46 - ABO subgroups
22:28 - D variants
28:29 - Enzymes in pretransfusion testing
33:35 - Elutions
37:46 - Adsorptions
44:05 - ABO discrepancies
47:01 - Take home messages

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

What’s scarier than picking blood for one patient? Picking blood for TWO patients where one of them is inside the other (or only very recently outside). Obstetrics isn’t immune to the acronym train so join Nick, Cale and Bashar as we talk about HDFN, RhD prophylaxis and that OMG sensation that comes when looking after some of our smallest patients. 

Timestamps:

0:58 - Trust me this is worth it
2:30 - Episode overview
4:22 - Transfusion in pregnancy
5:52 - Kell in pregnancy
6:47 - Transfusion in neonates
9:58 - Intrauterine transfusion
11:00 - HDFN: Haemolytic Disease of the Fetus and Newborn
13:17 - Anti-D antibodies in HDFN
17:35 - Estimating FMH
20:23 - Anti-D prophylaxis
24:52 - Managing maternal alloantibodies
26:38 - Other important antibodies
31:20 - NIPT
33:00 - Episode Summary

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

IVIG & Rituximab – both involve Antibodies – and both can lead to infusion reactions that you may be called to as a junior doctor. But where do these antibodies even come from? Why are we even giving these treatments? What are you meant to do when called to review the patient? Head back to the wards, get your cheese ready and welcome back consultant haematologist Dr Alison Chandler to the pod to teach us about infusion reactions

Timestamps:

0:53 - Yes, Nick is having a stroke
3:58 - Intro to IVIg and Rituximab
5:22 - What is IVIg?
6:46 - Where does IVIg come from
9:54 - Types of IVIg
13:58 - Indications for IVIg
19:17 - Administering IVIg
21:28 - Acute IVIg reactions
29:47 - Delayed IVIg reactions
32:31 - IVIg summary
33:36 - Intro to Rituximab
35:39 - Indications for Rituximab
40:45 - Rituximab Reactions
50:29 - Rituximab Summary

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Keen to augment your blood transfusion game but confused as to when, where and why? Join the Bloody Minded boffins as we cover all the major modifications to blood products you can order. More importantly, why you should and sometimes shouldn't bother ordering them. Have a sensible conversation with your blood bank after you listen to this episode.

Timestamps:

00:58 - How the blood bank actually works
04:03 - Aged Products
07:30 - Frozen Cells
10:32 - Transfusing the Bombay phenotype
12:10 - Leukodepletion
13:57 - CMV negative
19:17 - Irradiated units
19:52 - TA-GVHD
27:58 - HLA Matching
32:46 - Take home messages

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au