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CSMLS > TM Pretransfusion Testing > Flashcards

TM Pretransfusion Testing Flashcards

1
Q

Define (Major) Crossmatch

A
  • ensures ABO compatibility between donor cells and patient plasma
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2
Q

What happens after a crossmatch ?

A
  1. allocation/ tagging:
    - to one patient only for 96 hrs
    - unit is tagged (first, last, ULI, BBIN)
  2. Issuing; units leaves blood blank
  3. Transfusion
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3
Q

Pre-transfusion testing criteria

A
  • informed consent
  • patient ID, sample collection, labeling
  • patient history
  • ABO Rh
  • antibody screen
  • crossmatch
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4
Q

T or F: ABO Rh is done with every single pretransfusion testing

A

TRUE; ABO Rh is done with every single pretransfusion testing

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5
Q

Requirements for identifying patients for pretransfusion testing …

A
  • two means of identifying = nurse/ barcode reader AND phlebotomist
  • unique identifier; ULI/ PHN/ military ID/ RCMP ID
  • legal first and last name
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6
Q

What information MUST be on the requisition?

A
  • first and last name
  • ULI
  • BBIN/TSIN
  • time and date
  • 2 signatures (nurse/ barcode reader AND collector)

NOTE: patient ID + labelling MUST occur at bedside

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7
Q

Specimen type for pretransfusion

A

2 EDTA

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8
Q

What info must be on the specimen tube?

A
  • first and last name
  • ULI
  • BBIN
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9
Q

BBIN

A

blood bank identification number

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10
Q

TSIN

A

transfusion service identification number

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11
Q

What must you do if there are any missing info, illegible, or mismatches (letter/number)?

A

reject specimen and request recollection
- fill out occurrence management form (RLS)

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12
Q

when are full clerical checks performed?

A
  • specimen received in lab (acceptance/ rejection)
  • ABO, Rh, Ab screen
  • result entry

NOTE: perform constant checks (accession) performed continuously throughout testing

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13
Q

T or F; We check transfusion Hx on each patient with every collection

A

TRUE
- ABO Rh type
- Ab screen results
-Ab ID/Ag typing
- adverse events (transfusion rxns)
- previous transfusion/ pregnancy
- special instructions/products (irradiated, washed, IgA deficient)

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14
Q

how many ABO Rh tests must be performed to comply with electronic XM?

A

2
- historical type is OK if performed by testing lab
- ABO Rh is always done on current sample
- any discrepancy must be resolved
- mismatch from historical record must be investigated (repeat patient ID, collection)

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15
Q

what is an antibody screen?

A

detects significant antibodies
> Rh, Kell, Duffy, Kidd, Ss

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16
Q

Minor crossmatch

A
  • designed to test the DONOR’S SERUM/ PLASMA with the recipient’s red cells
17
Q

Advantages of a type & screen

A
  • prevents allocation of blood that won’t be needed
  • permits more stock to be available
  • makes good use of time and resources
  • decreases cost
  • if blood IS required, electronic XM is quick!
18
Q

Type & Screen

A
  • patient ID, valid sample
  • Hx check
  • ABO Rh
  • Antibody screen; if no history and Ab screen is neg = STOP

When transfusion needed = electronic XM

19
Q

How does the procedure for Ab screen differ if there is Hx of clinically significant Abs OR Ab screen is positive ?

A
  • Ab ID, DAT !
  • Ag type patient (should be Ag neg)
  • Antigen type donors (based on Ag frequency)
  • SEROLOGICALLY crossmatch 2 units
20
Q

How is blood issued in an emergency ?

A
  • if ABO unknown or unresolved discrepancy = issue group O
  • if Rh unknown/ discrepant:
    issue Rh pos to males > 4 mos and females >45 y/o

issue Rh neg to males ≤ 4 mos and females ≤ 45 y/o

NOTE: all unmatched blood is k neg in EDM zone

21
Q

limitations of Ab screen

A

may miss Abs to low frequency antigens not represented on screen cells

22
Q

limitations of IS crossmatch

A

Immediate Spin:

  • false neg due to weak ABO Ab; important to check ABO typing
  • false pos due to cold IgM antibody reacting at RT (allo or auto)
23
Q

Limitations of serological XM

A
  • weak Ab and dosage (donor cell heterozygous expression of Ag)
  • donor Ag neg for corresponding Ab
  • screening cells are more sensitive than donor cells
24
Q

3 general characteristics of Ab screen cells

A
  1. O cells
  2. Representative of general pop’n (R¹R¹, R²R², rr)
  3. at least 1 cell with homozygous expression of Ag show dosage
25
Q

CABORh

A

Confirmatory ABO Rh:
- tested from a different draw time
- if 2 separate ABO Rh already exist, DO NOT DO CABORh

CSMLS (46 decks)

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