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Immunohematology > Compatibility Testing and Blood Administration > Flashcards

Compatibility Testing and Blood Administration Flashcards

1
Q

Fresh Whole Blood

A

Very rare
Must be exact same blood type as person receiving

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2
Q

Stored Whole Blood (WB) Info

A

Volume: 450 mL
Increase: O2, Carrying capacity, Hct by 3-5%, Hgb by 1.0-1.5g

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3
Q

pRBCs Volume

A

250 mL

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4
Q

Leukocyte Reduced Blood Components Use

A

Prevent Immunosuppression
Prevent Sensitization to Leukocyte Antigens
Decrease Transmission of Viruses (especially CMV)

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5
Q

Leukocyte Reduced Blood Components Values

A

<5 x 10^6 WBCs (1/3 power reduction)
With Bedside Filter: <1 x 10^6 to 1 x 10^4

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6
Q

Irradiated Blood Components

A

Eliminates T Cells
Prevents Graft vs Host Disease
Directed Units from Blood Relatives

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7
Q

Frozen RBCs

A

Volume <180 mL
Decreased WBcs
No Plasma/platelets

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8
Q

Frozen RBCs Use

A

Rare/special blood types
Autologous units

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9
Q

Frozen RBCs Storage Info

A

MUST coat in glycerol (prior to freezing)
Expires 24 hrs after thaw and deglycerol (wash)

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10
Q

Washed RBCs Purpose

A

Decreases chance for allergic reaction
Patient with IgA deficiency or IgA antibodies

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11
Q

Washed RBCs Info

A

Washed with Saline
Removes plasma
Removes some WBCs
Expires 24 hours after wash

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12
Q

Plasma Products

A

Fresh Frozen Plasma (FFP)
Cyroprecipitate (Cryo)
Factor Concentrates
Platelet Concentrates

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13
Q

Fresh Frozen Plasma (FFP) General Info

A

Contains plasma and clotting factors
Expires 1 year
Volume: approx 220 mL

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14
Q

Fresh Frozen Plasma (FFP) Uses

A

Coagulation deficiencies
Volume Loss

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15
Q

Fresh Frozen Plasma (FFP) Transfusion Consideration

A

Must be ABO compatible
No allo-antibodies present
No leukodepleted, irradiated, or required to be CMV Negative

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16
Q

Cryoprecipitate Contains

A

Factor 8, 1, VWF, and 13

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17
Q

Cryoprecipitate Information

A

Volume approx. 15 mL
Frozen at 18 C or lower
Expires 6 days after thaw
Store at RT after thaw

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18
Q

Cryoprecipitate Compatibility

A

ABO only

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19
Q

Factor Concentrates

A

Handled by Pharmacy
8 and 9

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20
Q

Factor Concentrates Transfusion

A

ABO not an issue

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21
Q

Platelet Concentrates Preparation

A

Previously pooled
Single donor apheresis used frequently

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22
Q

Platelet Concentrates Volume

A

Volume 300 mL
Contains 3 x 10^11 platelets

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23
Q

Platelet Concentrations Transfusion

A

ABO Compatible if possible
Increased survival
RBC contamination possible
Consider Rh positive units to Rh negative patients a concern

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24
Q

Compatibility Testing Purpose

A

To select products for patients that will survive well
Will not cause significant RBC destruction

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25
Q

Compatbility Testing Sample Requirements

A

Test Request Form
Proper Labeling
Patient Armband (specific for Blood Bank)
No hemolysis
Crossmatch sample expiration (72 hrs)
- Kept for 7 days (at minimum) after transfusion

26
Q

Compatibility Testing Neonates

A

Lower volume transfusions
Cold stress concerns
MUST be CMV negative

27
Q

Laboratory Procedures for Recipient

A

Verify Identification
Record Check
Perform ABO/Rh (Weak D not required)
Perform Antibody Screen (ID Ab if present - Auto Control)

28
Q

Laboratory Procedure for Donor

A

Verify Identification
Record Check
Infectious Dx Testing
Perform ABO/Rh (Weak D IS required)
Perform Antibody Screen
ID Ab if present (Not Used for Transfusion)

29
Q

Crossmatch Types

A

Major Crossmatch
Minor Crossmatch
Abbreviated Crossmatch
Extended Crossmatch
Computer Crossmatch

30
Q

Major Crossmatch

A

Patient Serum + Donor Cells

31
Q

Minor Crossmatch

A

Patient Cells + Donor Serum

32
Q

Abbreviated (IS) Crossmatch

A

Can only Perform if:
No antibody in history
Negative Screen

33
Q

Extended Crossmatch

A

Perform if:
Antibody in history
Positive screen

34
Q

Computer Crossmatch

A

Can only perform if:
A type and retype has been performed (on patient and pRBC)
No history of antibodies
Negative screen

35
Q

Causes of Incompatible Crossmatches - RBC products

A

ABO Incompatibility
Patient alloantibody reacting with Donor Cells
Patient autoantibody reacting with Donor Cells
Positive DAT on Donor Cells
Rouleaux

36
Q

Selection of Blood Products for Transfusion

A

ABO Compatibility
Rh Specificity
Antigen Negative Blood
Labeling of Crossmatched Units

37
Q

ABO Compatibility

A

ABO/Rh specific if possible
ABO Compatible
- If whole blood, must match FFP and pRBC ABO requirements
- If pRBC must match ABO requirements only

38
Q

Rh Specificity

A

IF patient is Rh neg, must give Rh negative pRBC

39
Q

Antigen Negative Blood

A

Donor pRBC MUST be Antigen negative for corresponding patient antibodies
ex/ patient is anti-C, must receive C negative blood

40
Q

Labeling of Crossmatched Units

A

Receive a patient specific tag (pulled from “general” supply)

41
Q

Length of Time Blood Can be Checked Out

A

30 minutes if not used (length of time out of fridge to avoid bacterial proliferation)
If using cooler, can be maintained for 7-8 hours
** PLATELETS NEVER GO IN COOLER **

42
Q

Types of Transfusion

A

Routine Transfusion
Autologous Transfusion
Massive Transfusion
Emergency Transfusion
Neonatal Transfusion

43
Q

Routine Transfusion

A

Random Donor
Directed Donations

44
Q

Autologous Transfusion

A

Patient’s own blood

45
Q

Massive Transfusion

A

Replacement of 1 or more blood volumes in 24 hrs
Exchange Transfusion in Neonate
** Requirement to follow transfusion protocol after 5 units **

46
Q

Emergency Transfusion

A

Negative pRBCs (O negative and AB plasma)
Uncrossmatched

47
Q

Neonatal Transfusion

A

Small Amount (50-80 mL)
Fresh Blood (<7 days)
CMV Negative - must be confirmed CMV negative
Irradiation Recommended (required)

48
Q

Blood Administration

A

Verify Patient Identification
Bedside Filters
Leukocyte Depleted
Blood Warmers

49
Q

Routine Crossmatch, Negative Antibody Screen

A

ABO/Rh - no weak D required
IAT - negative
XM - US only (verify ABO compatibility)
ABO/Rh verify - performed by another tech (retype)

50
Q

Routine Crossmatch, Positive Antibody Screen

A

ABO/Rh - no weak D required
IAT - positive
Antibody Identification panel - must identify antibodies
Antigen type patient - patient should be negative for antigen corresponding with antibody
Antigen type units - Antigen negative units required in some cases
XM - extended, including AHG
ABO/Rh verify - retype

51
Q

Routine Crossmatch, Autologous Units

A

ABO/Rh - No weak D required
IAT - if positive, perform antibody identification
Units are not XM, but assigned to the patient
ABO/Rh - retype

52
Q

Routine Crossmatch, add on to current specimen

A

Crossmatch sample is valid for 72 hrs
- ABO/Rh - always perform when sample is removed from storage
- IAT - not repeated
- XM - IS or extended, depending on original IAT results

53
Q

Type and Screen - no units requested

A

ABO/Rh - no weak D required
IAT - if positive, perform antibody identification
- IAT is positive, call physician and inform (may request units)
ABO/Rh - retype

54
Q

Retype of ABO/Rh

A

No previous record of patient
Sample is removed from storage for additional testing
Take over another tech’s work

55
Q

Neonate Crossmatch

A

ABO/Rh - no reverse group or weak D required
IAT - usually also include A1 and B cells (looking for maternal anti A and/or B, if positive, identify antibody)
XM - unit is usually not crossmatched, but assigned to neonate or aliquots of a unit are used, if antibodies are present must be considered in crossmatch

56
Q

Neonate Definition

A

Less than 4 months of age

57
Q

Neonate Sample

A

Cannot be cord blood
Must be drawn from baby

58
Q

Compatibility Testing for FFP, Cryo, or Platelets

A

ABO/Rh - no weak D
ABO/Rh - retype

59
Q

RBCs antigen negative not required

A

Lea, Leb
P1
M, N
Bga, Bgb
Sda
Lua
I, H, IH

60
Q

RBCs E antigen negative

A

Should also type for c antigen
If c negative, selected E negative units for transfusion

61
Q

RBCs C antigen negative

A

Also typed for E antigen
If E negative, select c negative and E negative units for transfusion

62
Q

RBCs antigen negative cells

A

Cw
D, C, e
K, k
Kpa, Kpb
Jsa, Jsb
Jka, Jkb
S, s, U
Lub
Fya, Fyb

Immunohematology (17 decks)

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