purpose - Answers use in vitro test procedures to predict in vivo survival in potential recipient
AABB requests for blood - Answers -come down with samples
-transfusion service shall only complete, accurate, and legible requests
AABB patient sample - Answers -identified with fixed labels and have unique identification
-TSL will have a policy to reduce risk of misidentification
Labeling regulations - Answers -full name
-unique identifier
-date of sample collection
-phlebotomist ID
-If patient transfused within last 3 months with red cells
-If patient history is unknown
-If patient has been pregnant in the last 3 months - Answers sample collected within 3 days of possible
transfusion
(day 0 is the day of specimen collection)
pretransfusion testing of patient blood - Answers -abo and rh type
-unexpected abs
-pretransfusion testing for autologous and allogenic transfusion
-comparison with previous records
serologic crossmatch - Answers -taking sample of recipient serum/plasma and testing it against donor
cells
-take something that is physically attached to unit (the segment)
compatible crossmatch - Answers neg and pos check cells
Crossmatch compatible - Answers -if no clinically significant abs were detected
-if no record of previous detection
then:
,at minimum, detection of ABO incompatibility shall be performed
minor crossmatch - Answers -taking abs and testing against patient red cells
-don't do this anymore
major crossmatch- routine - Answers patient serum against donor cells
full coombs crossmatch - Answers -IS, 37C (with LISS), AHG
-ensures complete compatibility
-routinely used for patients with current or historical ab production
immediate spin crossmatch - Answers -IS phase only
-only detects ABO incompatibility
-patient has no previous records of Ab and patients ab screen is presently neg
electronic crossmatching - Answers -computer does work
-patient has no current abs present
-no history of abs
-must have at least 2 identical abo/rh types
-eliminates physical crossmatch
-method requires FDA approval prior to implementation
emergency released or uncrossmatched - Answers -utilized in trauma centers-urgent need for blood-
physicians takes responsibility
-based upon theoretical compatibility of group O blood as the universal donor
-assumes recipient serum does not contain any red cells abs
-pull and retain segments for subsequent crossmatching retrospectively
neonatal crossmatch - Answers -abo/rh compatible with baby and mother (O cells)
-phenotyped for any antigens corresponding to maternal sig abs
-for exchange only, crossmatch with mother's serum if sig ab identified maternal serum
-may need to perform minor crossmatch of components if exchange transfusion ordered
Interpretations - Answers crossmatch compatible
, IS crossmatch compatible
crossmatch incompatible
least incompatible
Limitations for compatibility testing - Answers -cannot guarantee 100% success
-indicator of probable success
-transfusion reactions still occur in 1% of blood transfusions
selection for blood transfusion - Answers best choice is the same blood
massive transfusion - Answers -BB medical director can determine point at which maximum crossmatch
limit exists
-point at which patients blood volume has been replaces via transfusion usually within 24 hours
-if known ab-prefer to at least provide ag neg blood if time permits
-resume crossmatching when emergency ends
establish target inventory levels - Answers -min/max levels of each blood type
-calculated based upon historical usage, hospital size, trauma, OR, ER, oncology, transplant, ETC.
Maximum Surgical Blood Ordering Schedule (MSBOS) - Answers -establish realistic blood usage based
upon surgery type
-helps eliminate over-ordering-products not used
effective blood utilization - Answers BB activities are monitored by internal transfusion committee
-want anybody who is transfusing blood on this committee
antigen phenotyping - Answers -patient has ab need: ANTIGEN NEG BLOOD
-if patient has pos screen: only phenotype once because it does not change
neg control - Answers neg for corresponding antigen (K-k+)