Quiz 2 Flashcards
How often do centrifuges need serological calibration?
Once a year (annually)
How often do centrifuges need tachometer and timer calibrations?
Twice a year (semiannually)
What does a tachometer measure?
RPMs
How are the optimal speeds and times determined for hemagglutination rxns?
Hemagglutination rxns are performed using the centrifuge set for specific time and speed
How often are incubator, fridge, and freezer temps recorded?
Daily
How often are the alarms for fridges and freezers tested?
Quarterly (4 times a year)
When is an alarm for a fridge or freezer supposed to go off?
Before the upper or lower limit of the product temperature is reached (not when or after it is reached)
What is the temp range for QC reagents?
2-6C
What is the temp range for RBCs?
1-6C
What is the temp range for frozen plasma or cryo?
Less than or equal to -18C
How often are the clocks and stop watches tested?
Twice a year (against the atomic clock in Boulder)
How often are automated blood typing/screening systems tested?
It depends on the manufacturer guidelines - reagents are QC’d on the day of use
When is reagent QC done?
On the day of use (some are used daily)
For antisera reagent QC, what types of cells should be selected?
Heterozygous cells with weakened antigen expression
For reagent cell QC, what kind of antisera should be used?
Diluted antisera
What is the purpose of doing reagent QC with diluted Abs and weakly expressed Ags?
To ensure the reagents are sensitive enough to detect weakly expressed antigens and low quantity antibodies.
How long are records of QC and equipment validation stored for?
Approximately 10 years
How long are records for Ab IDs and donor deferrals stored for?
Indefinitely
How and why are records of errors or adverse reactions kept?
- They are documented as SI reports
- To minimize errors that affect patients - aka process improvement
What are the requirements for labeling a pretransfusion sample?
- Blood bank ID (a DH req.)
- 2 patient identifiers
- Time and date of draw
- Initials of the person who did the draw
Why do type and hold specimens need to meet the same labeling requirements as type and screens?
Because the order could be converted to a type and screen and used for pretransfusion testing
If a type and screen is ordered and the patient has a negative Ab screen, what kind of crossmatch must be done before transfusion?
Only IS crossmatch is required
If a Ab screen is positive, what kind of crossmatch must be done before transfusion?
IS and IAT is required
In the case of an emergency transfusion can you give uncrossmatched blood? What type of blood do you give?
- Yes, and then you would do a post-issue crossmatch.
- Female of child-bearing age get O neg blood
- Men and women older than 50yo get O pos blood
In an emergency situation, when is it acceptable to give O pos blood to a woman of child-bearing age?
After ten units of O neg blood have been given
When is it okay to give blood that is not crossmatched (pre or post)?
In the case of a massive transfusion, after 10 units have already been crossmatched (the pts blood volume is pretty much replaced at this point)
What is the average adult blood volume?
5000 mL
How and when should platelets and cryo be crossmatched?
- Plts and cryo should be the same Rh as the patient, but does not need to match the patient ABO type
- If the product has more than 2 mLs of RBCs it has to be crossmatched
How is blood selected for a neonate (4-6 months old or younger)?
Type O blood is usually given (to make sure the blood is compatible with mom and baby)
- If mom doesn’t have Abs there is no need for a crossmatch
What are the requirements to qualify for an electronic transaction?
Two different draws with matching types, a negative screen, and no history of clinically significant Ab(s)
If a patient has been recently transfused with nonspecific blood, can you still give them type specific blood after? Why or why not?
Yes, because there wasn’t any Abs in the nonspecific RBCs that were given (aka no plasma)
What kind of blood should be given to an Rh neg patient?
Rh neg (Rh pos can be given in the case of an emergency)
What kind of blood should be given to an O pos patient? List the choices in order.
O pos, O neg
What kind of blood should be given to an A pos patient? List the choices in order.
A pos, A neg, O pos, O neg
What kind of blood should be given to an B pos patient? List the choices in order.
B pos, B neg, O pos, O neg
What kind of blood should be given to an AB pos patient? List the choices in order.
AB pos, AB neg, A pos, A neg, B pos, B neg, O pos, O neg
What kind of blood should be given to an B neg patient? List the choices in order.
B neg, O neg, B pos, O pos
What kind of blood should be given to an A neg patient? List the choices in order.
A neg, O neg, A pos, O pos
What kind of blood should be given to an AB neg patient? List the choices in order.
AB neg, A neg, B neg, O neg, AB pos, A pos, B pos, O pos
What kind of blood should be given to an A2 patient with anti-A1? List the choices in order.
O, A2
What kind of blood should be given to an A2B patient with anti-A1? List the choices in order.
O, A2B, B, A2
Define major crossmatch.
Crossmatch done with pt plasma and donor cells (current method)
Define minor crossmatch.
Crossmatch done with pt cells and donor plasma (historical method).
* when whole blood was given
If a pt has a positive Ab screen, what sort of crossmatch needs to be done?
IS and IAT crossmatch
If a pt has a negative Ab screen and a history of a clinically significant Ab, what kind of crossmatch needs to be done?
IS and IAT crossmatch
Which Abs may not be considered clinically significant and why?
Cold autos, anti-I (unless allo anti-I), MN, P1, Lewis
If a patient has a negative Ab screen and a history of a warm auto, what kind crossmatch needs to be done?
IS crossmatch only, because warm autos are often transient Abs
When is antigen typing a pt with an Ab not required?
- When the pt has an Ab that is not clinically significant
- When the pt has an Ab to a low frequency Ag
What kind of crossmatch is required for a pt with a clinically significant Ab to a low frequency Ag? Is antigen typing required?
IS and IAT crossmatch, with no Ag typing
What kind of Ab ID and crossmatch might you do for a pt with a warm auto?
A saline ID and crossmatch
What kind of Ab ID and crossmatch might you do for a patient with a cold auto?
A prewarmed ID and crossmatch
If you suspect rouleaux in an antigen type or Ab ID, what sort of enhancement might you use to resolve this?
LISS enhancement (PEG is too strong)
If a pt sample is positive in every IS donor crossmatch, what might be the reason?
- The ABO may have been mistyped (strong reactions)
- Could be due to rouleaux (weaker reactions)
- Could also be a cold auto (do autocontrol)
What might be the cause of incompatibility in an IAT crossmatch?
- The pt could have an Ab to a lower frequency antigen that did not show up in the Ab screen or ID
- The donor could be DAT pos
- Pt could have a warm auto
If a donor is DAT pos, what will the pt crossmatch look like? When can this donor donate again?
The pt crossmatch will be incompatible because the donor cells are coated with IgG and will react with the AHG
- Donor can donate when they are not DAT pos anymore, healthy blood can be DAT pos
How should a unit of blood be properly labeled?
With ABO ID, at least 2 pt IDs, compatibility testing results, and donor ID number
What needs to be recorded when releasing products?
- Visual inspection, 2 pt IDs, and compatibility results
How long are pre-transfusion samples kept for (pt sample and donor segment)?
7 days from the date of transfusion (day of transfusion is day 0)
What might a change in color of an RBC product indicate?
Contamination
What does a green tinge in plasma indicate? Is it okay to transfuse?
The donor was on birth control, yes it is safe to transfuse
What does platelet swirl indicate?
It indicates that the platelets have not been activated (still have discoid shape) and are good for transfusion
What might hemolysis in an RBC product indicate?
Contamination or old age
Is it okay to transfuse a lipemic plasma product?
Yes
What might icterus in a product indicate?
The donor could have had hepatitis
What should be done with a clotted RBC product?
It should be taken out of stock and the collection center should be notified so they can improve their collection process
What is a yellow clot in plasma made of?
It is a fibrin clot
