In March of 2019, the Transfusion Medicine and Hematology Labs went to extraordinary lengths to provide excellent care to a pediatric patient who presented to the ED with a history of sickle cell disease and a critically low hematocrit.
On the Blood Bank side, Blood Bank technologists Krishna Patel, Logan Wharton and Diana Holloway did a fantastic job expediting the patient’s antibody workup, minor red cell antigen phenotyping, and crossmatching. With their fast hands and terrific knowledge of immunohematology, they were able to phenotype the patient and offer an extended match of compatible blood in what is likely record time. They surprised the Pediatric Hematology Team with how fast the workup was done. Dr. Eric Gehrie, Blood Bank Director, believes that they saved her life with their outstanding effort . . . the little girl recovered and was discharged home. The combination of critical anemia, small body size, sickle cell disease, and a newly positive antibody screen is a very serious and complicated constellation of issues for the Blood Bank. There are serious risks to not transfusing, but there are also serious risks to transfusing an incompatible unit. At 19 kilograms total body size there is not a lot of room for incompatible blood. Transfusion Medicine is deeply grateful to Krishna, Logan and Diana for their outstanding dedication to patient care. Dr. Gehrie was personally involved in every aspect of the case with maximum concentration on it. Having this team of dedicated technologists who were able to go the extra mile to help resolve it was truly extraordinary. It is not something that can be taken for granted — they saved a life.
On the Hematology side, clinical lab scientist Fola Oluwafemi was extremely helpful because a CBC needed to be performed on a sample of blood that was initially sent to the Blood Bank. When centrifuged, it was noted that the hematocrit was very low but could not be quantified. Our patient was too small and too sick for another tube to be drawn for a CBC test. The stakes were high, and with Fola’s help, the sample was run STAT in the Core Lab for a CBC using the tube that was sent to the Blood Bank, which revealed a hematocrit of 10.5% — critically life-threatening low for anyone – but especially a 5-year-old. Sometimes in the Hospital we find ways to not get things done that are outside of the usual workflow. But in this case, what was recognized in Fola was the leadership she showed in making sure the right thing got done for the patient, and right away. Fola could be heard on the phone directing the other technologists in the Lab on what to do – she did an extraordinary job, and with the information that the hematocrit was this low, it was recommended to increase the transfusion rate for the patient who was in extremis at the time.
Most Pathology employees work behind the scenes, and this story illustrates their vital importance and commitment to patient care. Each and every day, lives are saved because of the hard work of our medical laboratory professionals.