Overview of Modern Blood Bank Laboratory Flashcards
What facility is involved in the collection, storage, processing, and distribution of human blood and blood products for transfusion?
Blood Bank Laboratory
Blood Bank laboratory regulating agency?
FDA (Food and Drug Administration)
Blood bank laboratory accrediting organization?
AABB (American Association of Blood Banks)
Whole blood allowed to cooled to room temperature can be used to prepare what component other than PRBCs?
random platelets
Whole blood allowed to cool to 1-6 degreed C can be used to prepare what component other than PRBCs?
frozen plasma
What is the most common method for collecting platelets?
apheresis
Fresh frozen plasma must be prepared within how many hours of collection of a whole blood unit?
8 hours
What blood component can be further manipulated to prepare cryoprecipitate?
fresh frozen plasma
TRUE OR FALSE: Tests only need to be performed on a donor unit the first time a donor donates.
FALSE. Testing is done after every donation, even if the individual has donated before.
When are blood component products officially labeled?
After all testing is complete and carefully reviewed
What testing is done on a donor unit?
ABO/Rh
Ab Screen (on plasma products)
Viral Marker tests
Syphilis Test
TRUE OR FALSE: When donor units are received from an outside source, testing is performed at the new facility to ensure that the results match the results on the donor unit label.
TRUE
What testing needs to be reconfirmed when a donor unit is shipped to a new facility?
ABO/Rh
Confirmatory testing is performed in which laboratory?
Main laboratory
A minimum of how many identifiers is required for patient samples to be used for blood bank testing?
two identifiers
Which two identifiers are required for blood bank sample testing?
Patient’s full name and date of birth (and/or medical record number)
What is the purpose of cord blood studies?
If a Rh negative mother gives birth to a Rh positive baby, fetal-maternal hemorrhage testing is performed to determine how much of the baby’s blood the mother was exposed to.
Name 5 types of routine testing a physician may order on a patient’s blood bank sample?
- Type and Screen
- Type and Crossmatch
- Prenatal Evaluation
- Postpartum evaluation
- Cord blood studies
What tests are performed when a physician orders a type and screen?
ABO/Rh typing and Antibody Screen
What tests are performed when a physician orders a type and crossmatch?
ABO/Rh typing, Ab screen, and major crossmatch
If a clinically significant antibody is found in a patient, what type of units must be administered to the patient?
corresponding antigen-negative units
What tests are performed when a physician orders a prenatal evaluation?
ABO/Rh type the mother and Ab screen the mother for potential antibodies that may be implicated in HDFN
Why are postpartum evaluations done?
Determine the Rh type of the mother.
If the mother is Rh negative and delivers and Rh positive baby, fetal-maternal hemorrhage testing is done.
A fetal-maternal hemorrhage of what volume is considered significant?
> 30 mL whole blood
What study is performed to determine a mother’s candidacy for RhIg?
Cord Blood Studies
Women who have clinically significant antibodies and deliver a baby need to have what tests performed on the infant’s cord blood?
ABO/Rh typing and DAT
Which laboratory is considered the problem solving section of the transfusion service?
Reference laboratory
What information is beneficial when resolving discrepancies detected in routine testing?
Patient’s diagnosis, age, pregnancy, drug, and transfusion history
The following testing methods can be used to resolve which type of discrepancies?
- Testing with A2 cells or anti-A2 lectin
- Room temperature antibody ID
- Adsorption, elution, and autoadsorption studies
- removal of RBC-bound cold autoantibodies
- Secretor studies
Inconsistencies between forward and reverse ABO group typing
Which discrepancies can be resolved using the following:
- Rh phenotyping
- Adsorption and elution using Rh antisera
- isolation of cell populations
- Use of rare antisera and RBCs
Rh discrepancies
A positive antibody screen with a negative DAT or autocontrol indicates possible…
alloantibody immunization
What may be the result of an immune reaction to a drug, a disease state, or a delayed HTR?
Positive DAT
Warm antibodies may mask the presence of what?
clinically significant antibodies
What may cause ABO discrepancies, a positive DAT, and may mask clinically significant alloantibodies?
Cold autoantibodies
Transfusion reactions must be investigated to determine if the reaction is…
antibody-mediated
Initial studies for transfusion reactions include…
ABO/Rh, DAT, and visual inspection for hemolysis
What regulation established personnel qualifications for laboratories performing certain types of testing?
CLIA ‘88, Subpart M
What is the name of the manuals that outline the operations of the laboratory?
Standard Operating Procedures (SOPs)
Details on how, when, and why particular procedures are done can be found where?
Standard operating Procedure (SOPs)
