Events during September 2023

The Air Ambulance covering Derbyshire, Leicestershire and Rutland first approached Blood Transfusion in February 2021 to discuss the idea of them being able to carry blood on the aircraft so they can carry out lifesaving transfusions at the roadside. In the previous months the medics on board had been documenting those patients they had attended that they thought would have benefited from being transfused at the scene of an injury.

The majority of these were road traffic accidents and stabbings where blood loss had led to severe morbidity or even mortality. After months of meetings discussing what equipment was needed (e.g. blood boxes, temperature monitoring devices, storage etc.), finances, validation procedures and trialling the process we finally started providing blood on board in February 2022.

The Arenaviridae have the dubious distinction of containing among their members one of greatest proportions of hazard group 4 viruses of any recognised taxonomic family. These viruses cause persistent asymptomatic infections in their rodent reservoirs, however zoonotic spill over often results in viral haemorrhagic fever (VHF) and high mortality. Transmission to humans occurs via contact with infected rodent excreta, through contaminated food and inhalation of aerosols. Human to human transmission also occurs. In sub-Sharan West Africa, Lassa virus (LASV) has been identified as a VHF since 1969 and is endemic over much of rural Nigeria, the countries of Mano River Union, Ghana, Togo and Benin.

From a global health security perspective, it is of significant international interest since it the most commonly imported VHF into non-endemic countries. In nearly every imported circumstance, the cryptic nature of Lassa fever and related difficulties in diagnosis, places enormous demand on clinical, laboratory and public health resources of the recipient country. Given our current understanding of LASV and other evolving members of the genus, attention should be focused on other new and emerging mammarenaviruses which have similar incubation times and could result in similar human disease with a propensity to overburden public health systems.

From earlier work that I had done in a sexual health setting, I identified that there were barriers for women with a learning disability attending for cervical screening. I was invited to talk to a group of women about cervical screening as part of an initiative called 'The Josephine Project'. Josephine is an anatomically correct cloth doll which is used for health promotion purposes - she has body parts which can be detached and has a 'space' in her head where women can put ideas on paper. Within a mock up clinic, Josephine, along with her friends (the women in the group), attended the sexual health clinic to have a cervical sample taken. This work was very successful and led to several women taking up the offer of screening.

Myself and Jilly realised that as Nurse Colposcopists this work could be translated into a secondary care setting and so Josephine was invited to the colposcopy clinic following an abnormal cervical screening result. This presentation discusses some of the barriers for the women with a learning disability and how 'Josephine' came to life to help and support some of those women.

Update on endocervical adencarcinomas

ISO15189:2022 has undergone a major revision and was release in December 2022. David was one of the core drafting team responsible for the latest version and will discuss how the document was developed and agreed by the international community, why the changes were made and the purpose of the new standard.

Areas covered in this lecture will include the change in the format of the standard, why Point of Care testing is now part of the main assessment, if applicable and the increased empathies on risk and patient welfare.ISO15189 was revised and released in December.

ISO15189:2012 had reached its periodic review date and there was international consensus that it needed revision. The new version was published on 6th December 2022 and there are some key changes which include an emphasis on a patient-focused approach and to promote the welfare of patients - i.e. putting the patient at the heart of the service. There is also more emphasis on a risk based approach to the Quality Management system. In addition ISO 22870 (POCT) has been incorporated into ISO 15189:2022.

This presentation will review POCT definitions, highlight key considerations for currently accredited POCT services and also for organisations considering applying for accreditation to include (or extend) POCT in their scope.

POCT is referenced implicitly throughout ISO 15189:2022 and with additional distinct requirements as an Annex A.

The presentation will discuss generic POCT services, and highlight considerations on both current POCT services and also emphasise considerations for planning new POCT services, and that overall, when compared with ISO 22870:2016, things have not changed as much as one would think. Principles are similar, and POCT could even be considered as another specialty within pathology, regardless of where it is or managed from.

Delegates will learn:

What Gestational trophoblastic disease is, including the different types and how they arise
How to handle a sample at the dissection bench including comparison with normal products of conception
How to distinguish between the different types of disease and mimics
What a diagnosis of gestational trophoblastic disease means for the patient
What the malignant entities of Gestational Trophoblastic Disease include

There are many job roles and opportunities available to biomedical scientists outside of the laboratory, but what does a biomedical scientist do working within the Blood Stocks Management Team?

Learn about a different role, the transferable skills that are required and how this role is different from working in a laboratory environment. Why is this role important to Blood Transfusion laboratories and is it beneficial having a biomedical scientist as part of the team?

The lecture will include a basic introduction to a busy mixed urban and rural Helicopter Emergency Medical Service in the East of England and the logistics of carrying and administering blood products to multiply injured, major trauma patients. The types of patients that typically require a transfusion will be presented and we will hear from patients that have since recovered and how they feel about having received a prehospital transfusion.

Chronic lung infection is the leading cause of morbidity and early mortality for people with cystic fibrosis (pwCF). Microbiological surveillance to detect lung pathogens is recommended as best practise in CF patient care. Here we studied pathogen detection in forty pwCF over several years. We found that microbiological culture, the diagnostic gold standard, was significantly disparate to targeted culture-independent approaches for detection and determination of chronic infection status of two important pathogens in CF. Pathogen detection was significantly lower by culture and consequently infection status was also misclassified in the majority of cases.

In particular, the extent of chronic infection by both Pseudomonas aeruginosa and Staphylococcus aureus not realised with culture was striking. Our findings have implications for the development of infection and clinical care of pwCF. Future longitudinal studies with greater patient numbers will be needed to establish the full extent of the clinical implications indicated from this study.