Blood Bank Test Flashcards
BB samples are routinely kept for ____ days total
10
Samples are OK to use for XM for ____ days from date of _______
3 days
collection
Samples must be kept in the BB for ____ days from date of transfusion
7
5 reasons to check patient’s history
- Look for past blood type - must match current
- Look at transfusion history (no trans? likely no Abs)
- Look for antibody history (clin sig? must honor it)
- Look at transfusion reaction history
- Look to see if any special requirements (CMV, IRR, Ag neg, freshness)
What are the Ag frequencies of: D C E c e K
D = 85 C = 70 E = 30 c = 80 e = 98 K = 9
Computer/Electronic XM:
- requirements
- Current Ab screen must be negative
- Must be no history of serum antibodies
- Two patient ABO/Rh types must be on file
Coombs XM (full) - requirements
must perform in addition to the IS XM if there is
1. A history of or current unexpected clinically significant antibody
For FDA requirements for component prep, cGMP stands for what?
current good manufacturing practice
What is the primary goal of RBC preservation?
- that _____ of transfused cells should remain viable for _____
75%
24 hours
What biochemical changes happen when RBCs are stored:
- K
- NA
- Hgb
- ATP
- 2,3 - DPG
- pH
- K: i
- NA: d
- Hgb: i
- ATP: d
- 2,3 - DPG: d
- pH: d
How long do these preservative solutions allow blood to be stored:
- ACD
- CPD
- CPDA-1
ACD: 21 days
CPD: 21 days
CPDA-1: 35 days
Adsol: 42 days
What is the process of making packed cells and platelet-poor plasma?
Do a hard spin on whole blood
What is the process of making platelet concentrate and platelet-poor plasma
Take whole blood and light spin then hard spin the platelet-rich plasma
What can be stored at 1-6C
- Whole blood
- packed red blood cells
- leukocyte-reduced RBCs
- washed RBCs
- deglyc’s RBCs
- thawed plasma
- irradiated RBCs
What can be stored at room temp (22-24C)
- Plateletpheresis platelets
- random platelet concentrate
- thawed pooled cryo
What can be stored at -18C
- Frozen plasma products
- Frozen cryo
What can be stored at -65C
- Frozen RBCs
Expiration 24 hours
- Open systems
- pooling products
- washing
- deglyc’d rbcs
- thawed FFP
No change in expiration
- closed system
- sterile docking
Expire in 10 years
frozen RBCs
Expire in 5 days
- plateletpheresis platelets
- random platelet concentrate
- thawed plasma (PF24)
Original date or 28 days from date of irradiation whichever is sooner
- Irradiation
Expire in one year
- frozen plasma
- frozen cryo
Expires in 6 hours
- Single unit thawed cryo
Expires in 4 hours
- thawed and pooled cryo
- washed platelets
QC:
- Leukocyte-reduced RBC must have residual leukocyte content of ________
< 5x10^6
QC:
- Single Apheresis Donor platelet must contain ________ platelets
> or equal to 3.0x10^11
QC
- pH of plateletpheresis
> or equal to 6.2
QC
- CRYO must contain ______ of Factor VIII
- CRYO must contain ______ Fibrinogen
VIII: > or equal to 80 IU
Fibrinogen: > or equal to 150mg
QC
- Platelet count of random platelet concentrate
> 5.5X10^10
QC
- max hematocrit of packed cells
< or equal to 80%
How do you ship Red cell products (liquid)
Wet ice or crushed ice, not touching donor units (separate by cardboard)
How do you ship Platelet products
Ship at room temp
How do you ship frozen products
ship with dry ice
Who gets Fresh Frozen Plasma?
- liver disease
- coagulation deficiencies
- DIC
- TTP
Who needs CRYO?
- vWBD
- Hemophilia A
- XIII deficiencies
- fibrinogen deficiencies
- fibrin glue
Who gets platelets?
Thrombocytopenia
Who gets irradiated cellular components?
- prevent GVHD
- Oncology Patients
- Transplant Patients
- Infant Patients
- Directed Donor fm 1st degree family
- IUT’s
- ITP
- HLA matched platelets
Who gets packed red blood cells?
- Symptomatic anemia
- Most surgery patients
(massive trauma, BM, ECMO patients, PUBS, neonates)
Indications for RBC Transfusion (Normal Patient)
Hct less than 21% or Hgb Less than 7 g/dL
Indications for RBC Transfustion (coronary artery disease and unstable angina/myocardial infarction/cardiogenic shock)
Hct less than 24% or Hgb less than 8 g/dL
Indication or RBC Transfusion (Rapid blood loss)
> 30-40% of estimated blood volume not responding to appropriate volume resuscitation, or with ongoing blood loss
_____ Hgb almost always indicates transfusion
_____ Hgb rarely indicates transfusion
6g/dl
10g/dl
One unit of packed RBCs raises the Hct how much?
3-5%
One unit of packed RBCs raises the Hgb how much?
1-1.5 g/dL
Who gets leukoreduced packed cells?
- Febrile transfustion reactions
- Prevention of HLA antibodies
- Oncology, Transplant, neonate patients
Who gets washed?
- IgA deficient patients
- EKMO patients/babies
- Removal of anticoagulant or increased K+
Who gets Frozen/Deglycerolized RBCs
- IgA deficient patients
2. Rare phenotypes
Who gets CMV negative?
Bone Marrow Transplant patients
Infant/neonatal patients
Pregnant women
Random Platelets should increase the plt count ______ for each unit in pool
5-10,000/uL
Platelet Pheresis or “single -donor platelets” should increase the platelet count by _______
20-60,000/uL
Who gets HLA matched Aphaeresis Platelets?
Severely thrombocytopenic patient known to be refractory to random donors
Trigger for therapeutic platelet transfusion?
Less than 50,000/uL
Platelet transfusion trigger for patients with chemotherapy-induced thrombocytopenia
10-20,000/uL
What are 3 disease states when are platelets not needed?
ITP
TTP
HUS
Indications for Cyro
Fibrinogen less than or equal to 100 mg/dL
Fibrinogen Less than 150 mg/dL with active hemorrhage
- Treatment of Factor XIII deficiency
- Fibrin Glue
- Von Willebrand’s disease
