Immunohematology/Blood Bank

Question 1

What color top is used in a blood bank specimen?

Answer 1

Pink with EDTA. Like lavender but bigger and specific for blood bank.

Question 2

What is “Type and Screen”?

Answer 2

Looks at PT’s cells (Type) and serum (Screen). ABO and Rh on cell for Type. Antibody screen for antibodies in serum for Screen.

Question 3

What is Crossmatch?

Answer 3

Done outside body before transfuse. Mixing donor blood with PT’s serum and seeing if they clot. If clot don’t transfuse!

Question 4

Type and Cross Match includes what?

Answer 4

Includes Screening from “Type and Screen”.

Question 5

Which are the RBC antigens?

Answer 5

A, B, AB, O, Rh, and some others

Question 6

What does “Type” look at?

Answer 6

Antigens on the RBC’s cell surface

Question 7

What does “Screen” look at?

Answer 7

Antibodies in PT’s serum.

Question 8

What does a Crossmatch look at?

Answer 8

Mixture of donor’s and PT’s blood before being transfused. Looking for clumping. If clump then not a match.

Question 9

What is Coombs Test?

Answer 9

Looks for RBCs that are coated with antibodies which are called “sensitized” RBCs

Question 10

What is the blood called when someone donates a liter of their own blood?

Answer 10

Whole Blood. Contains everything.

Question 11

What is “apheresis”?

Answer 11

Blood taken out, blood separated out, and what don’t want put back into PT. Often done to get platelets.

Question 12

What is “white blood cell febrile reaction”?

Answer 12

Common blood transfusion reaction. When some WBCs are in the packed RBCs and causes a low grade fever.

Question 13

What is the volume of whole blood that is transfused?

Answer 13

500mL

Question 14

What is the volume and contents of “Packed Red Blood Cells”?

Answer 14

300mL of just RBCs

Question 15

Fresh Frozen Plasma is given when what values are elevated or when you can’t wait for which Vitamin?

Answer 15

Give for elevated PT/PTT to correct. Also given for elevated INR when need to immediately correct and can’t wait for Vit K.

Question 16

For every 1 unit of PRBC Hgb and Hct goes up by what percent?

Answer 16

Hgb goes up by 1, Hct up by 3%.

Question 17

If you give 1 unit of PRBCs and the Hgb and Hct don’t raise by the expected levels what might be going on?

Answer 17

If not going up then some ongoing loss, usually bleeding. Could also be hemolysis.

Question 18

Component of blood is used in “universal donor”?

Answer 18

RBCs only.

Question 19

Who are the Universal Donors and Universal Receivers of RBC blood?

Answer 19

Donor is O-. Receiver is AB+.

Question 20

Why is O- the “Universal Donor” for RBCs?

Answer 20

O- has no antigens on RBC cell surface. Can donate RBCs to anyone and their antibodies won’t react.

Question 21

Who is the RBC “universal receiver”

Answer 21

AB+. it’s great to be AB+ as can get from everyone.

Question 22

What are the donor and receiver rules for RBCs and FFP?

Answer 22

FFP has opposite rules of RBC. AB+ is universal donor for FFP. O- universal receiver for FFP. Due to antibodies in serum.

Question 23

What does Anemia cause symptoms?

Answer 23

Due to decreased oxygen carrying capacity to tissues

Question 24

What are some major symptoms of anemia that might require transfusion?

Answer 24

Syncope, Dyspnea (SOB), Chest Pain/MI

Question 25

What do you base your reason to transfuse blood during anemia?

Answer 25

Clinical symptoms and not as much on Hgb number. Hgb less than 6 is usually symptomatic and good reason to start transfusing.

Question 26

A Hemoglobin less than what number is a good reason to transfuse PRBCs?

Answer 26

Less than 6, which is usually when PT is symptomatic

Question 27

If a patient with a Hgb of 6 receives one unit of PRBC what would you expect their new Hgb to be?

Answer 27

7

Question 28

At what Hgb number would someone with anemia be very symptomatic and require transfusion?

Answer 28

6

Question 29

What is the normal platelet range?

Answer 29

150,000 to 400,000

Question 30

What number platelet should be maintained in actively bleeding patient?

Answer 30

Above 50,000

Question 31

What are the two types of platelet transfusion and how many platelets does each contain?

Answer 31

Platelet Apheresis Pack (10k to 60k) and Platelet Concentrate (5k to 10k)

Question 32

Which blood product is given when the patient is actively bleeding and needs all Factors replaced?

Answer 32

Fresh Frozen Plasma (FFP)

Question 33

When would you initiate a Massive Transfusion Protocol?

Answer 33

Trauma, major GI bleed, etc

Question 34

What is increased in Massive Transfusion Protocol and what is decreased?

Answer 34

Increase Plasma (where Factors are), decrease FFP:PRBC ratio

Question 35

What is the most common site for ABG artery puncture?

Answer 35

Radial Artery

Question 36

What does Allen’s Test check for?

Answer 36

Good collateral flow to hand from radial and ulnar arteries

Question 37

If doing an ABG from an existing Arterial Line what do you need to discard and why?

Answer 37

Need to discard whatever is already in the line as it’s tainted with heparin.

Question 38

When labeling an ABG collection tube what do you make sure to include what might be currently treating the patient?

Answer 38

Supplemental oxygen and amount