Chapter 1: Vein to vein: Flashcards
A summary of the blood system in Canada
Who are the technical Committee for the Canadian Standards Association (CSA)?
The Technical Committee includes health professionals as well as **representatives from the federal, provincial and territorial governments, user groups, and blood operators. **
In developing the CSA Blood Standard, the technical Committee consults equivalent standards in Canada and other jurisdictions, including the AABB Standards for Blood Banks and Transfusion Services and the Canadian Society for Transfusion Medicine’s Standards for Hospital Transfusion Services
Name 2 Canadian surveillance systems in TM and transplantation?
**1- Transfusion Error Surveillance System (TESS)
2- the Transfusion Transmitted Injuries Surveillance System (TTISS)
3- the Cells, Tissues and Organs Surveillance System (CTOSS). **
The information collected through these voluntary surveillance systems is used to identify trends in transfusion-associated errors, adverse reactions and injuries in Canadian hospitals at the national level. They are also used as benchmarks for national and international stakeholders.
Overall, these surveillance systems aim to improve transfusion processes and maximize patient safety.
What is the role of Provincial Blood Coordinating Program (PBCP):
Provide** leadership and support to regional health authorities within their province** and to Canadian Blood Services. They work together to ensure that blood components and products are managed safely and effectively. The PBCPs also serve as liaisons between the regional health authorities and the provincial governments regarding blood product management.
Which test are performed by CBS only on subset of the donations based on risk information obtained via the donor questionnaire and what are the criteria of testing?
1- Testing for antibodies to Trypanosoma cruzi (Chagas disease)
Donors are designated as at-risk if they, their mother or their maternal grandmother were born in Mexico, Central America or South America or if the donor has resided in these countries for a significant period of time.
2-
1-Which test is performed seasonal and also s based on donation history.
2-What is the test method?
- Testing is performed for West Nile Virus (WNV) in **six-month cycles. **
Universal donor WNV testing starts on the Monday before June 1st and continues until the last Sunday before December 1; during the rest of the year.
selective testing is done on donations from donors identified as being at risk based on the questionnaire due to travel outside of Canada in the eight weeks prior to the donation.
2- West Nile Virus (WNV) RNA testing is also done in pools of six samples. However, to enhance sensitivity, single unit WNV NAT may be used in selected geographic areas during outbreaks of WNV.
What is the next step of positive WNV pos NAT?
The reactive pool is resolved to the individual reactive specimen. Donors reactive on the multiplex screen test are indefinitely deferred, whereas donors reactive on the WNV screen test are deferred for 56 days.
Name one false positive cause of this WNV assay :
Apart from detecting both lineages of WNV, the WNV assay will also react with other viruses in the Japanese encephalitis virus serocomplex including Japanese encephalitis virus (natural infection and vaccination), St. Louis encephalitis virus, Murray Valley encephalitis virus, and Kunjin virus.
What are the test methos for screening and confirmation of WNV?
Screening: WNV NAT
Confirmatory:
**Sequencing or alternate NAT **may be done at reference laboratory on WNV NAT-positive specimens when history suggests a potential exposure to another member of Japanese encephalitis virus serocomplex
Name 4 tests and methods (screening and confirmatory) are performed on each blood donation:
- Testing on all (HIV 1/2, Hep B/C) or some (Trypansoma cruzi – Chagas)
- Group and Screen (ABO Rh group)
- Assist hospitals with testing of patients with complex transfusion needs
- Antibody testing for pregnant women with antibodies
- Reassess donor and testing processes as new pathogens and testing processes evolve
Blood collection: Ensure donor safety by monitoring for potential adverse reactions during collection process
Which organ does need to confirm the new technique prior to the implementation of major changes in CBS methods?
**Health Canada **must approve changes made to donor screening and testing processes prior to the implementation of major changes.
decision making
Which framework is used to support the decision making in CBS?
The Alliance of Blood Operators (ABO) has developed a risk-based decision-making framework for blood safety to support blood operators in their decision-making process and facilitate proportional responses to risk.
Used by CBS in the screening and testing Babesia microti and Zika virus
Retrieval
1- Product inventory retrieval definition:
2- Two examples
1-The procedure involves identifying fresh blood components that could compromise the integrity and safety of the blood supply and removing them from the blood operator’s inventory.
2-
a) inventory retrievals: The retrieval and destruction of a platelet unit from the blood operator’s storage when the unit tested positive for bacterial contamination.
b) the retrieval of blood components stored in the hospital blood bank: when a blood donor reports a fever within a few days following the donation.
If the blood components have already been transfused, the blood operator medical director, the hospital blood bank director (or hospital unit) and recipient’s attending physician will determine if recipient notification is required.
Traceback
Traceback investigation definition:
It is the process of investigating a report of a potential transfusion-transmitted infection (e.g. HIV, HBV, HCV, WNV, Chagas) in a blood recipient.
A traceback investigation may lead into a lookback investigation, if the donor tests positive for the infectious agent and has previously donated blood.
Lookback
Lookback investigation definition:
The process of identifying and contacting recipients of blood components from a donor who, on a subsequent donation or testing, is confirmed to have tested positive for the presence of a transmissible infectious agent (e.g. HIV, HBV, HCV, WNV, Chagas).
A recall initiated for blood products manufactured from these donations.
When Canadian Blood Services learns that a blood donor has tested positive for a transmissible disease, a lookback procedure is initiated on that donor’s previous relevant donations
Lookback
What is the role of hospital in a lookback process?
A communication with hospitals that received blood products manufactured from these donations is initiated to identify and notify recipients. Recipients are tested for the infectious agent found in the donor and Canadian Blood Services may be informed of the results.
